Each week I go to therapy. I have made it my consistent practice since 1999 to meet with my therapist regardless of the state of my circumstances. I never know what will come out in the session. Sometimes I complain about everyone in my life. Sometimes I unload the stress I am carrying. Sometimes I express gratitude for the healing grace my therapist has shown me. Rather than a problem-solving session, it is a place where I can be myself and that is okay. It is a place where I am welcome and where I can’t get it wrong.
It is common for people to ask therapists, “Are they mentally ill? Is it a mental illness?” This question comes up often from parents asking for their child, who is struggling. If the answer is “Yes,” and if a diagnosis is provided with some root causes added, the parent often feels some relief and is more apt to respond with empathy rather than frustration or anger. I hear this same question raised when people are talking about a public figure like a celebrity, politician or mass shooter. In these cases, the therapist does not have the ability or license to formally diagnose the person but may talk about behaviors consistent with a specific diagnosis. With the diagnostic manual and our training, our license allows us to weigh-in on a diagnosis after personal observation or testing. There are clear lines drawn that delineate if symptoms reach the clinical level qualifying the individual as “mentally ill.” Yet, rather than thinking of mentally healthy and mentally ill in a binary way—mental health goes in one pile and mental illness goes in the other pile—I have found it helpful to think of the mental health-mental illness distinction as a continuum and one that we are all on. In this way of thinking, we all have some mental health and some mental illness. This takes some courage and we must walk past the shame and stigma which would have us externalize any of the bad we see in us, dismissing or at least minimizing it. I heard one person describe it this way—mental illness is anything less than ideal in the way we process, respond to, or treat another person.
Why the Adage to be a Parent not Your Child’s Friend is Actually Flawed
I often hear parents or parent educators utter the adage, “You should be a parent, not a friend, to your child”. I think this goes largely unchallenged in our culture. And the current ubiquitous criticism of parents as helicopter-parents or snowplow parents describes a parent who spends every ounce of their energy to remove discomfort and struggle from the child’s life and wants the child to approve of them. I believe there is a problem with this blanket criticism and the problem may start with our understanding of what it means to be a friend and only partly to do with our understanding of the role of a parent.
Families who make the difficult and courageous decision to send their child to wilderness therapy often hear from concerned friends and local professionals. These caring individuals have questions about “Wilderness Therapy.” Maybe they have heard stories of such programs or maybe the idea of sending a child away for treatment seems contrary to the notion that healing must happen in the family where the young person is surrounded by those that love him or her most.
It has been over twenty-two years since I first began working as a wilderness therapist. While the spirit and dedication of practitioners remains the foundation for quality wilderness-based therapy, many things have changed in that time: family support services, clinical sophistication, whole health curriculum, and a dedication to outcome research. Twenty years ago, when we began on our own adventure to establish the new standard in wilderness therapy, we knew that many would follow suit. We often stated, what makes our program great is not what we did yesterday, but what we are willing to imagine for tomorrow. At Evoke, one of our founding principles is our commitment to continually innovate where we see a need.
I have spent this week reflecting on the messages from the 2017 Forum for Innovative Treatment Solutions’ [FITS] Keynote Speakers. Dr. Nim Tottenham shared her research on attachment and the impact on brain circuitry. Dr. Gabor Maté followed with an illuminating message about how fractured attachments are at the root of many mental health and addictive disorders. Dr. Maté challenged the audience, sharing observations from his practice and life, suggesting that the only important variable we ought to study is the stress (trauma) on our clients—genetics taking a back seat or maybe being kicked out of the car altogether in the pursuit of understanding that the root cause of addiction and mental health is the events in a person’s life and the pain and turmoil where they originate. Addiction, he explained, is not the problem. It is the addict’s attempted solution to the problem. Lastly, Dr. Jami Gill reviewed attachment theory and encouraged therapists by suggesting that we have the capacity to repair attachment trauma by providing a safe container (or context) for others. That safe context, she explained, was the mind of the therapist, consultant, friend, or parent, and their capacity to listen and really hear the one with the attachment trauma.
I was once asked “How long does it take to understand the kind of childhood one has endured?” While this understanding comes at a different pace and with more or less clarity at times, one can hear the messages of a childhood by learning to hear our inner voices. The dialogue of self doubt; the justifications; the apologies; the “I hope you don’t think I am whining…” –all these offer glimpses into the spoken and unspoken messages of one’s childhood. The sometimes critical inner-voice can be recognized not just by listening to the negative thoughts, but also by listening to the qualifying comments. “I know this may sound selfish, but…” or “I don’t want this to seem…”
Therapists often talk about healthy detachment, but what about connecting and being close to our children?
Someone told me not to write on this subject unless I was prepared to write another book. They suggested, “Nothing you write, no matter how much, will be enough to answer the questions a grieving parent can ask.” Many reports suggest the greatest tragedy that a person can experience—which becomes compounded if the death is the result of a suicide—is the death of a child. As a father of four, I cannot imagine losing one of my children, and I cannot imagine how I would manage to go on with that kind of grief. I assume this is a wound from which I would never fully recover. When I am asked the question about how far a parent should go to essentially ensure their child’s survival, I cannot answer it. No therapist or expert can ever answer that question. Even if we did, and the parents followed our advice exactly, yet their child still took his or her own life, then the parents would likely blame both us and themselves for not doing more.
This question often arises when a family is left to explain where their child is after they have been sent to therapy. Enrolling a child in treatment can temporarily leave a large hole in a family unit, and parents often struggle to explain this to the community, to extended family, or to the child’s school. And while many parents may not choose to or need to send their child to a residential treatment center, they may still experience feelings of loneliness and isolation because of dealing with a difficult child who is struggling with addiction, depression, anxiety, or any number of other common struggles.