Getting the kids involved . . . could someone teach me a thing or two???

I’ve had a number of responses to the blarticle from January 13th (” . . . the good doctor was WRONG”).  Seems what my ex-patient had to say hit a nerve.  I’ve always been pretty aware of my own limitations as a mental health practitioner. Limitations on the effectiveness of the medications, limitations on the “power” of my voice to make real change in a kids life.  I certainly do my best and, believe it or not, seem to get good results from both the meds and the advice I dispense.  But I AM acutely aware of the limitations . . . and my powerlessness . . . in these situations.  Having had experience on both sides of the mental health system has given me many insights.  People who come to me (especially parents of kids who are not well) want me to fix things . . . and fast.  Parents who have to watch their kids suffer with depression, behavior issues or addiction issues are in indescribable pain.  The worry that is involved is excruciating . . . and the powerlessness of the situation is perhaps the worst end of it.  I can personally put up with almost anything if the solution is at hand and I can see exactly what needs to be done.  I can be very strong in mind, body and spirit . . . but if I don’t know what to do to help my kid . . . if the chance for mis-step is high . . . or if there is nothing I can do . . . the physical heart ache can be intense.  And the physical heart ache can seem unending.

It is with this pain that people come to my office.  Fix my depression.  Stop the mania.  Make the voices go away.  Make my kid stop using drugs.  Hurry . . . quick . . . before they die . . . or hurt someone else . . .

What is a shrink to do???

Getting kids and their parents to change is a monumental challenge much of the time.  And much of it is that the kids are not invested in or interested in changing.  (This is the part where I want some edumacation . . .)  All of you ex-kids out there . . . be honest now . . . how would you have reacted if your psychiatrist had said . . . ”I’m not going to give you medicine . . . instead . . . I want you to . . .

Stop using drugs . . .

Stop hanging out with all of your negative friends . . .

Start getting your homework done . . . every night . . .

Start spending time with your parents and talking to them about your stuff . . .

Start going to bed on time and not staying up till all hours of the night watching tv . . .

And, by the way, you need to take the tv out of your room . . . and

Start going to the gym and exercising for 30 minutes 4 times a week . . . and

Start eating right . . . like three balanced meals every day . . . and

Start reading inspirational books . . . and

Start meditating/praying/getting in touch with your higher power . . . and

Start going to therapy weekly to work on stress management and relationship communication issues . . . and

Then . . . I’ll have a separate conversation with the parents about how they need to . . .

Start enforcing the rules of the house . . . and

Not let the kids get away with stuff . . . and

Spend time with their kid playing games/music etc. . . . and

Make sure that meal-time is spent together . . . without the tv on . . . and

Get your own life together by whatever means necessary . . .

Is this going to happen if I say it should happen???  How would you respond???  How would your parents have responded???  Do you think you would “buy in” to that sort of a model of treatment and completely change your life to a healthy lifestyle that would probably help (tho it is impossible to predict if it would completely eliminate symptoms).  I mean, look at your “healthy” adult lifestyle and how different it is from when you were a kid.  How hard is it for you NOW to change lifestyle issues that you know you should change???  If I could kids to settle down and follow some  . . .

r . . . u . . . l . . . e . . . s . . .

their life would be better.

Ok, so the chances of this are not great.  Do we kick back and let things go??? You know . . . use the “kids will be kids” model of child rearing???  Let the hormones be the hormones and let the child learn by their mistakes???  What if you intervene and the kid wants nothing to do with your intervention?  What if they think they know better and don’t want your input.  What if they are failing at school”  What if they have been suicidal or self injurious?  What if they are openly disrespectful?

What is a parent to do . . .

What is a shrink to do . . .

I’d love to hear from ex-kids who had experience in the mental health system who now have kids and are trying to keep their kids out of the mental health system.

Someone . . . please . . . teach me a thing or two.

–Dan Hartman, MD