|
|
Bipolar Disorder in Children, Adolescents and Adults |
Chapter 5: Family Dynamics
Any illness, particularly mental illness, has a profound effect upon the family. Divorce rates skyrocket when there is a disability in a child or parent.
Working with families of children with disabilities is both challenging and deeply rewarding . Rarely will you witness the strength of human spirit more indomitable than in these families as they cope with the impossible schedule and needs of their children, the grief at not having a typical life and the hope that their child will overcome the odds before them and not only survive but flourish in their world. This client situation presents for the therapist a uniquely sensitive arena of concerns where the impact of our actions and interactions may be magnified due to the extreme ongoing stress of the situation. The situation of disability, especially when first recognized, is a situation of loss. The family and the child depending on age are likely to go through the stages of a grief process: shock, denial, anger, bargaining,and acceptance. (Kubler-Ross). It is important for the therapist to recognize and understand this process. This understanding will go further toward healing than any other single intervention.
Phoenix Helm Simpson, Uncharted Waters: Working With Families With Children With Special Needs at www.psychceu.com
Siblings
Marina's Story
Bipolar Illness in a child takes a tremendous toll on the marriage and the family. Often the siblings feel neglected and abused. The parents can feel inadequate and overwhelmed. No one feels safe.
Gary's sister, Marina, started withdrawing from her brother at a very young age. When she was just a baby, he would throw things at her, once almost blinding her by throwing a rock at her head. Gary, three years older, had the size advantage over his little sister. She soon learned to be very good and quiet; both to hide out from Gary and to differentiate herself from him. She became forgotten and invisible. She got so adept at hiding that her kindergarten teacher noted in her first parent conference "It is a joy to have Marina in the classroom, but at times we hardly know if she is here or not. Please work on expressive language at home, as she seems to have a difficult time speaking up." Marina had learned well from Gary's rages. She just disappeared.
By the time Marina was in latency, she had distanced herself from her brother. She had a strong network of friends, but she never invited anyone over. Her mom was very upset when the recess aide reported that she had overheard Marina saying that Gary was not her brother. When confronted about this, Marina burst into tears. "I hate him! He is the worst brother. All he does is yell and break things. He was never a brother because he never did one thing a brother is supposed to do! Brothers are supposed to help their sisters, and teach them cool things, but all he does is be mean! I hate him!"
When she reached adolescence, Marina began to develop the cognition to understand about her brother's illness. She was very upset one day about a situation with some of her friends. They had a spat, as is common in early adolescence. She was sobbing so much that her mother suspected it was more than the incident with her girlfriends. Finally, Marina admitted that she was terrified that she was bipolar because at times she felt very happy and other times sad. Her mother was able to reassure her that this did not mean that she was bipolar, and that everyone feels happy and sad at times. She explained bipolar as an illness of extremes, pointing out when Gary was sad, he was very very sad; that when he was happy it was different because it was manic and that Gary's rages were part of the illness.
Marina had another crisis when she started her menstruation. This coincided with studying genetics in biology and Marina knew that in addition to Gary, her paternal aunt and grandfather had all shown signs of bipolar disorder. She became very frightened that she would someday have a child like Gary. Finally, a visit to the family doctor helped Marina to accept that while it was possible that she carried the gene for bipolar disorder, there were (hopefully!) many years to go before she would have a child. There was a lot of new research, and there might even be a test to screen for bipolar disorder by the time she was pregnant.
When Gary was 18, he left home to go to a college which offered a lot of support for students with special needs. Marina, then 15, started acting out. She became defiant and angry, talking back to her parents. She refused to take any phone messages from her brother when he called and made plans to be away during the entire time he was home for breaks from school. It was as though she felt it was "her turn" and all the anger that she had felt for so many years of feeling neglected and not protected came to the surface. Her parents were horrified, at first suspecting that she too was bipolar. It was only through education and counseling that they were able to realize that it was good for Marina to finally be expressing her feelings. They also needed help finding an appropriate boundary around verbal abuse. They were so shell-shocked from raising Gary that they did not know how to respond appropriately to Marina's verbal attacks.
For more information on siblings, please go to:
Understanding
Sibling Issues of Special Education Students NICHCYNews Digest- Number 11,
1988 Parentpals.com Special Education and Gifted Guide
http://www.parentpals.com/gossamer/pages/Detailed/684.html
Parenting Children and Adolescents with Bipolar Disorder:
Stress on the Marriage
Giving birth to and raising any child with special needs puts a tremendous stress on a marriage. In the Gary and Sophie's families there were terrible times in which both children came near death; Sophie from her suicidal gestures and Gary from his mania and alcohol fueled acting out.
It was very difficult for the Gary's parents to stay together. There often were differences in parenting style. Gary's mom, Nancy, would get very upset with her husband's inflexible manner, feeling that he sometimes seemed to bait Gary. It was primarily through their strong religious commitment that their marriage survived.
Karen and Ron had a course of couples therapy before they were married, when Sophie was a toddler. The therapy dealt with step-parenting, contrasting beliefs about finances and lifestyle, and their age difference, as Ron was almost 15 years older than Karen. They returned to therapy when Sophie was diagnosed with bipolar disorder. They worked on co-parenting and supporting each other through the hard times. Ron was finally able to see that his comments to Sophie that "one day she would wake up and be very popular" had not, in fact, caused her suicide attempt. Karen went into individual therapy to process her feelings of grief and guilt that Sophie was a child with bipolar disorder. She also found an Internet chat group, which was easier for her to get to than a support group.
They did well until Sophie's absent father, Daniel, entered the picture. One day he appeared on the doorstep and demanded to see his daughter. He said he wanted to take Sophie on a road trip, on the back of his motorcycle. "I want her to see America", he said. "Not just this America, but all the Americas: the U.S., Canada, Central and South America. I haven't slept since I got the idea. Where is she? Let's go get her right now!"
Fortunately, Sophie was in school that day. Karen and Ron called me in a panic, wondering what to do. Ron was ready to call the police and have Daniel arrested for trespassing and owing back child support. They rented a room in a nearby motel for Daniel, telling him it looked like he could use some sleep.
I was able to meet with Ron, Karen and Sophie that afternoon in a crisis session. Karen told Sophie that her biological father was in town and wanted to see her. Sophie said she was very curious about him and had wondered if he was a movie star or something. It was decided that she would meet with Daniel in a cafe with Karen at a nearby table. Ron was feeling so angry at Daniel and so protective of Sophie and Karen, that he agreed not to go to the meeting, fearing he would lose control.
A few days after the meeting, Sophie went into a deep depression. It was different than her earlier depression, as it felt more like grief. When she was able to talk about it, she said she was very sad that her father was a "bum and a dope". I was able to briefly meet with Daniel and realized that both he and several of his relatives had symptoms of bipolar disorder, although none had been diagnosed, according to Daniel.
This incident stressed Karen and Ron, as their differing parenting styles came to the fore. Karen did not want Ron to contact the district attorney about past child support. She only wanted to put the past behind her. Ron wanted to "lock the bum in jail and throw away the key". It was finally Sophie who helped, telling Ron that she thought of him as "the father of my heart" and that if Daniel were in jail, it would mean that she would think about him all the time. Ron agreed to let Daniel go.
Daniel met with Sophie once more, then he left town, talking incessantly about the road trip. A few weeks later, Sophie received one postcard from Daniel. It showed Mount Rushmore. The message was, "Someday, MY face will be carved in this mountain! Stay happy, kiddo!"
888-777-3773
|
©
2000 - 2010 www.psychceu.com
all rights reserved. |
