Wednesday, November 3, 2010

Kherosine Suit - Inviting Flames

Adoption is a traumatic experience for many people. Adoptees and first families tend to bear the brunt of the painful experiences that result directly from the adoption process (adoptive families often have their pain front loaded in dealing with infertility, child loss, et cetera). Amongst some there appears to be a trend toward self diagnosis in the aftermath of adoptions that didn't meet the needs of one or more parties involved. The specific diagnosis I've encountered is P.T.S.D. or Post Traumatic Stress Disorder for those unfamiliar with the acronym. This self diagnosis is often used to explain the severity of one's reactions when they seem inappropriate or to steer those considering adoption away from that possibility. It is tempting to say that it is used as a "Get out of Jail Free" card but that isn't entirely fair.

There are many people for whom the adoption experience has been terribly traumatic. It's important to recognize this truth. I still agree with Jim Gritter's notion that pain is at the heart of every adoption decision. It is possible that there are some who have been so traumatized by the pain of adoption that P.T.S.D. is a viable diagnosis.

Unfortunately I think the trend for self diagnosis has diminished the likelihood that these genuine cases are taken seriously. But this isn't the case for P.T.S.D. alone. Self diagnosed depression, A.D.H.D., bipolar, even sociopathy diminishes the gravity of the reality these diagnosise carry. This is especially the case when the claimed mental health condition is used inappropriately to justify otherwise unacceptable behavior. The didactic tale of the boy who cried wolf applies, very tidily, here.

Here I step onto my soapbox.

Mental health difficulties are serious conditions. They deserve to be taken seriously. Just as a person who claims to be diabetic eating a cake, I can't take seriously a person who claims P.T.S.D. that isn't in ongoing therapy. If one takes mental health seriously it isn't a justification for poor behavior. On the contrary it holds that person to a higher degree of accountability. To claim to have P.T.S.D., whether diagnosed by a professional or not, means taking ownership of that experience and the responsibility for recognizing it. If one accepts a diagnosis there is an implicit acceptance of responsibility for taking every reasonable step to ensure the condition in question doesn't unduly effect others.

If I am depressed I am responsible for taking steps to mitigate how that effects my other relationships. That doesn't mean keeping it a secret so no one feels poorly for me. Instead it means finding the help I need to establish coping strategies so my depression cannot get out of control and begin damaging others. Similarly if I suffer from P.T.S.D. I must also accept the responsibility of taking every step possible to normalize my relationships and interactions with others.

So what's the point of all this? Well, the short nasty version is if you have P.T.S.D. and know it you don't get to take it out on other people. No matter who the person is, what s/he thinks, says, or does. Acknowledging trauma prohibits one lashing out from that trauma. To say otherwise is to spit in the eye of every person who has ever struggled with any mental health disorder.

In Response

13 comments:

  1. with several people in our life I have wished that they could recognize the need for some help, but they have each been so reluctant. it can be painful to see, especially over time. I feel helpless, but I know they need to want to help themselves.

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  2. Great post. I'm a birthmom and definitely have grief issues and depression right now. It's been 3 months, but I know I will have to work through them. for awhile. The biggest thing I do, which is hard for me, is to respectfully decline invitations or events that I know I may not be able to handle. I try to anticipate, well it sounds great now but do you think you can really handle the party/the people/etc. I know it seems simple but I'm the sort of person who doesn't say no to anybody and hates to miss anything. But one or two instances after placement turned into emotional fireballs so I have just learned to say no up front, and then if I feel like going go, but don't commit and then flake. The way this relates to your post is that at first I figured oh no big deal my friends know what I'm going through, they will excuse my cancellation or flaking at the last minute, they know I'm a mess because of the adoption. Then I realized I don't want to be the person who is flaky and undependable because "she went through that adoption stuff". The adoption isn't an excuse for me not to be accountable for things and a decent human being and later have meltdowns on people. I don't have to be happy all the time but if I do try to force the "normal" I turn into a crazy person. So now I just take a step back and think about things a little bit more before I act on them.

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  3. Coming from a family where mental health issues and mental health professionals coexist, I have born the brunt of both the unfair attacks and the resulting help offered. Each have been equally difficult in their own way.

    And it is certainly true that if you don't take your own mental health seriously, it is difficult for those around you to excuse or even tolerate your behavior. It's also true that a person in the grips of a true mental illness often does not have the capacity to seek or accept the help they so desperately need.

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  4. "It's also true that a person in the grips of a true mental illness often does not have the capacity to seek or accept the help they so desperately need."

    I agree with Sara about this. And sometimes people need a chance to grieve and mourn even to arrive at self-awareness about something like PTSD. It does suck when loved ones suffer from those lashing out, no doubt. But I also am leery of blaming the victim and telling them to
    "play nice." Getting help is important, but not everyone has the same time-frame or trajectory in that process.

    I am wondering exactly at whom you are levying your criticism, as it is quite broad. It is true that acknowledging trauma is the first step in getting help, but it is not always a fast path to happiness, nor should ill people be judged for not conforming to a plan that loved ones hatched up for their own convenience.

    I suffer periodically from pretty severe mental illness myself, am in ongoing therapy and on meds. I try to be accountable for myself and my behavior, but when ill, I am usually become ill because my coping mechanisms are fried. That makes me short of temper and patience, where usually I would have more cushion. I do the best I can, but I also don't see it as my job to worry about taking care of others when I can barely take care of myself and feel suicidal. In fact, taking care of others at the exclusion of taking care of myself is what tends to trigger exacerbations of my mental illness.

    "Acknowledging trauma prohibits one lashing out from that trauma."

    In my case, moreover, I suffer from chronic physical illness because my natural mother LIED to me about family medical history. You're saying that I shouldn't be angry with her for this? That the trauma is my fault and I should be medicated and nice? I should thank her for her insensitivity, because otherwise would be "lashing out"?

    I am suggesting that you have presented something very complicated as something very much simpler than it might be.

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  5. As per usual, when attempting to address accountability and culpability for one's state, my meaning has been lost. Specifically in the statement "Acknowledging trauma precludes lashing out from that trauma." The people I was attempting to address are a minority I've encountered for whom, as I understand it, self proclaimed P.T.S.D. is akin to a badge of honor. This post has nothing to do with the timeline in which one "should" seek treatment or even exactly what form of treatment is best for a given individual. The point is that mental illness is not an acceptable justification for treating others poorly. Ever. Mental health problems can fuel and even have a direct causal link to treating other people in less than lovely ways. But it never justifies it. In acknowledging mental illness a person also accepts responsibility. This is very similar to substance abusers who are in recovery. Acknowledging that one is an alcoholic conveys accountability for how s/he uses alcohol and how that may effect his/her relationships. The people to whom I refer in this post appear unwilling to accept similar responsibility for making amends in the aftermath of brutish behavior. I am unwilling to accept this shirking of responsibility as I feel it degrades our collective appreciation for the dignity of individuals. The real point in this is the need for amends. To carry on the simili of the alcoholic, consider the drunk who sinks deeper and deeper into the bottle over years. The alcoholic is suffering from an illness. The alcoholic has also been presented with innumerable opportunities to turn around and begin recovery. The illness does not eliminate responsibility for damage dealt by the ill. It may be mitigated, but not eliminated. To accept a diagnosis is to take ownership of an illness, the first step in recovery. I believe, firmly, that the reason acceptance is the first step is because acceptance brings accountability with it. It is the recognition of accountability for my actions that causes me to re-evaluate them and try to do better next time. And to remind everyone; I have experience from both sides of the equation. I spent most of my childhood, the entirety of my adolescence, and a significant period of my twenties on medications and in therapy. I have spent a disproportionately large portion of my income on my mental health. I take healing very seriously. That is why I get furious when I encounter a person who claims a diagnosis and expects their actions to carry no consequence as a result. Accountability opens the door for healing to be a genuine option. Compassion fosters the actual healing process. But compassion without accountability does nothing to draw the ill toward healthy interaction. Instead it continues to encourage poor boundaries and entitlement.

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  6. I can see what you're saying, but I still think you're not hearing what I am saying.

    Yes, those who self-diagnose with PTSD and treat others abominably don't have a leg to stand on. They need to get a clue and be accountable. I abhor their self-pitying whining as much as you do. Their selfishness is in direct conflict with my Midwestern values of politeness.

    There are those who are truly mentally ill, however, and who lack insight into themselves and their illness. While I don't condone what they might do as a result of their illness, I don't see the use in upbraiding them when they can't even see that they need help. When they can have insight and choose to make amends, and I hope they do, that's appropriate and desirable.

    I must say that I am not enamored with your metaphor of AA for accountability and mental illness. People who drink usually are compelled to do so by genes and ineffective coping. There are others, and I am thinking of some adoptees in specific because I am one, who suffer from mental illness brought on by situations not of our making. I have been told over the course of my life far too many times when I expressed sadness about my life to "buck up" and "be grateful." I stuffed down my anger and sadness because it wasn't validated, and I have become depressed to the point of attempting suicide more than once. I agree that I need to be aware that my illness can have impact on others, and when I hurt people I definitely want to make amends. That said, when I am in the throes of major depression and suicidal ideation, putting myself last is not the best thing for me to do. I have put myself last for much of my life. My friends will attest to this, and this is something I am trying to remedy in therapy. Sacrificing the self for others is as unacceptable as relentlessly putting the self first. But I don't think I need to apologize left and right for putting myself last, except to myself.

    We are all different and suffer from mental illness for different reasons. We are not all raging narcissists who run roughshod over people and need a lecture about self-control and accountability, nor are we all intellectual people who can successfully analyze ourselves and take responsibility for how our actions affect others. Those who are most mentally ill often don't know it.

    You did say "Acknowledging trauma prohibits one from lashing out from that trauma." This is definitely debatable. "Prohibit" is a strong word. Often giving words to trauma and emotions is a necessary part of healing, and lashing out can be a part of that. It happens for me during therapy, and sometimes in real life, as I learn to assert that my needs are just as important as the next person's.

    I absolutely agree with what you say about compassion being necessary part of healing, both for the self and for others, and that those who use self-diagnosis as a mask to hide behind are contemptible.

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  7. Ms Marginalia - I am terribly sorry that you were not allowed to healthfully express the totality of your experience. The way your attempts to express yourself and access support were dealt with was wrong. Plainly wrong.

    I think we've been having parallel conversations. Knowing more of where you're coming from and what you wished me to consider I recognize where this may have come from. My diatribe was written with a very narrow focus. I'm afraid that it may have been applied to a larger context than I had intended. Clearly I've not been communicating very well. I apologize for that. I try to be diligent in my attempts to communicate with precision. Evidently I have failed. As an example when discussing lashing out I don't include expressing anger, sadness, or frustration in that definition. When I speak of "lashing out" I am thinking specifically of intentionally harming another person who is otherwise unconnected from the situation causing pain. Were I very angry with my brother, aware of that anger but unwilling to address it, and instead punched my coworker in the face until I felt better - that would better fit my definition than your experience. It's the awareness that's the linch pin in my ideas surrounding accountability.

    I don't know if this makes any more sense. If not I think it may make sense to assume that we're both trying to understand the other. It may not happen as soon as we'd like but we're trying. I'll continue to consider your ideas and experiences. Thank you for taking the time to share them.

    Once again I'm sorry if I've said anything that felt dismissive to you or your experience. I don't want to do that but I'm aware that it happens. I hope your struggles to express your needs and present your boundaries will continue to be respected and get easier for you.

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  8. Check out my latest post- you've been given the Cherry on Top Award :)

    http://a-cat-bythetail.blogspot.com/2010/11/thank-you-thank-you.html

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  9. I wonder if the very idea of having to be accountable is the reason some people, consciously or not, refuse to acknowledge they're suffering with a form of mental illness.

    That as in the example of an alcoholic, if they say they are, their society or own conscience will expect them to do something about it.

    Now that I think further, one could look at the condition of hearing impairment and wonder if it's the same part of the psyche that refuses to acknowledge and address partial deafness. It affects the mood and how others experience their time spent with the person who can't hear.

    I guess there are many situations where it gets difficult to have compassion for those who have opportunity to help themselves but for some reason refuse to do whatever it takes to help themselves, at the expense of others.

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  10. I think what you're talking about is being as asshole and using mental illness/PTSD to justify it. That really doesn't have anything to do with self diagnosing PTSD.

    There is very little research on first parents and very few professionals who know anything about adoption other than what they are told from pro-adoption (adoption is a win win win) assholes.

    Therefore I think it's possible there are a lot of people with PTSD from losing kids who don't get checked for it or properly diagnosed. I don't believe in our current model for mental illness and treatment so I couldn't give a crap what a professional tells me. If I'm dissociated from reality and screaming and having panic attack after panic attack and having to be hospitalized and it started after losing my child for adoption, I would go with trauma.

    A large percentage of mentall illness is related to trauma. And interestingly, even the "genetic" cases are turning up to have a relation to trauma experienced by the parents or the grandparents.

    But you invited an entire debate about mental health diagnosis and treatment in our culture when what you meant to discuss is that whether you have PTSD or not, it's not an excuse to be a fucking asshole.

    Do people sometimes have mental illness that is so severe it inhibits their ability to treat people properly, control their behavior, or even seek any help at all even if they know they have a problem? Yes.

    Usually the people you debating with are not in that state. They're just in pain and they want to make others in pain also. This has to do with feeling powerless and percieving another as having the power to change their suffering and trying to FORCE someone else to care that doesn't care by berating them with insults. (Note, people who don't care or understand are not likely to care or understand more after being berated and treated like crap)

    I understand that feeling because a lot of it has to do with the reality that some people have money and could hypothetical save some percentage of women from losing their children. Yes it might mean giving away a lot of money and then not having a baby at the end. But I think the anger has to do with wanting to give resources to people that many not only don't want to give to, but actively want to fight the idea of help being given to.

    Do people who get pregnant and don't have the money to raise a child deserve to have resources sufficent to give their child a beautiful life? If your answer is no, because she sucks and deserves what's coming to her, what if she were raped? And if your answer to that is yes, if she were raped she deserves resources, then what if she was in an abusive relationship in which the other party was threatening her with suicide if she didn't put out without a condom, or throws away her birth control and then pushes her into sex and she doesn't fight back?

    And if you REALLY want to apply this "Women who were raped can be helped to give their child a beautiful life" then what if you can't prove it in court? So many times, there is not proof of these things. And then, how many guys would be falsely accused of rape if only the raped women get to have the support they need to really truly have the resources to address their emotional, psychological, financial, and developmental needs, as well as resources to address obstacles they have to parenting in the way they want their child to experience?

    It's understandable why the subject matter makes people go back to the worst pain of losing their children. What if we could be saving other humans from feeling this? What if we could save others from this pain?

    And what if we're not?

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  11. Sustainable Families - Thank you. You've succeeded in summing up what all of my blathering seemed to obscure. When people are loud ass holes it's harder to hear when a person really needs help.

    Again, thanks for the clarity and for your perspective.

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  12. I think the division between "happy first parents" and "unhappy firstparents" has less to do with how much trauma was involved (the happy first parents can often be just as sad as the "unhappies")--- and more to do with how willing a person is to accept the status quo.

    Did we as first parents deserve specialized programs to identify the specific obstacles preventing us from parenting, and targeted services offered to address those specific problems?

    I think yes. Until that happens, I can't say that any adoption was freely chosen, any more than when someone holds a gun to your head and says, "give me your money or I'll take your life"

    Sure you CAN choose to run away anyway. But what kind of choice is being dead? The same, sure you CAN choose to parent inadequately and ruin your child's life, but what kind of option is that?

    For people who love their children, it's really not an option. In order for parenting to fully be an option, we need to make sure that people ahve the resources to do a good job. THEN they can choose whether or not they want to (for themselves) rather than feeling like succesful parenting isn't an option at all.

    When people don't believe first parents deserve these resources, I must confess I get grumpy myself. : )

    I do USUALLY refrain from speaking with such jerky people, but occasionally I jump in and just hope I can use whatever restraint possible in dealing with people who I personally think are unbelievably cruel.

    It's not just adoptive parents who are opposed to better services for unplanned pregnancy. It's also adoptees and first parents. It makes me very grumpy when adoptees are so jerky about unplanned pregnancy. Then again, I just read an interesting article about how over-privaledged people tend to not be able to read or understand the emotions of others.

    Maybe that's what's happening. I don't think being overprivaledged is particularly ideal for kids, honestly. Perhaps we are hurtling our kids into a class of jerky people. Grump grump. Grumble. LOL

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  13. Gave you an award on my blog! xoxo Meghan

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What do you think? I'm curious.