Wednesday, March 30, 2011

Guest Blogger: Family Member Asked for a 5150 for Mentally Ill Loved One

Our guest contributor has a family member who is mentally ill. In this post, "Linda" describes what it is like to take care of "Joe" and the time she had to request a 5150 for him. The 5150 is an involuntary psychiatric hold that I wrote about previously.

Marcia, you always have a very helpful nonjudgmental commentary that can be very useful for people struggling with tough decisions, ethical dilemmas, and multi-layered situations, and thanks for that.

I wanted to say a few words which I think may be helpful for some to hear, although opinionated as is my nature. I have a family member, “Joe”, who is diagnosed with schizophrenia and taking anti psychotic meds.

I admit it is hard to be "your brother's keeper" even for loved ones. Their outbursts and behavior can wear you down and make you feel unappreciated, angry, and sometimes even unsafe around them.

And just like addictions, brain disorders are something that one seems to want to have a lot of empathy for those who fall prey to, but it's not always easy. I sometimes feel guilty if I do something that makes Joe upset or can feel like I'm violating him with my firm "it’s good for you" nature.

I have had to 5150 my family member not by my authority but by insisting the boarding house where Joe lives call it in. In fact, the attending physician who monitors my relative's case in this county said it's not illegal for patients to decide to stop taking their meds so the psychiatrist could not compel him to do anything including taking his prescriptions to avoid severe symptoms such as hearing voices and deep paranoia.

I was frustrated because I felt the system was doing nothing preventative; it was going to be all punitive. I felt that the professional caregivers were doing nothing to avert an impending disaster. I knew in my heart that Joe needed to stabilize on medicine and get a restart in a controlled environment, and my fear was that Joe was going to hurt someone or get arrested, both of which has happened in the past.

I tried to convince Joe to self-commit, but he refused. So I discussed the behavior with the home, and we concluded there was danger to others and Joe needed to go into a hospital for a short stay. It was not to teach him a lesson or mess with him - which is sometimes hard for the afflicted to perceive - and then they go ballistic.

But after months of visiting Joe’s social worker and medical team and trying to intervene and lean on the team to suggest group therapy and talking to the licensed board and care residence to monitor the medication better, it didn't seem that I was getting anywhere and all the advocating can take a toll. (I might add that I do not have a conservatorship and Joe needed to sign a waiver at the clinic, so they would discuss the case with me. He had signed it during his "better days" so it was in effect later when he was not agreeable.)

Just like Charlie Sheen who seems to have an ongoing struggle, my family member has repeated incidents, and it burns me out. Many people call Charlie Sheen a jerk and let me tell you, people with these problems can be, but they do deserve our compassion, not help avoiding the consequences of their actions, and if you have the strength to give, they will be better off with your efforts on their behalf.

Even though we don't want to let our love ones down, I want to tell people out there that it is ok to take a breather; turn your back if you can't deal with their problems at that moment. Long after Joe got out of the hospital from that particular 5150 in better condition as a result of the stay, he continued to manifest behavior that violated me, so I made the decision to cut ties. I needed to for a few months not to talk to him, to concentrate on my life, and rejuvenate so that I could come back more refreshed and in a healthy state of mind for myself.

I didn't know if or when I was going to come back because I felt a lot of anger over the way I was treated after I had "helped" him repeatedly, and I felt abused when he was so hostile in return. It was emotionally painful to do this during the holidays and his birthday, causing me guilt because I do feel a responsibility to contribute to better his quality of life and safety.

After "the breather" though, I'm not angry anymore, and I just called up to see how my family member was doing. There was no apology from him, but I didn't need it. I accept that's who he is and now with my new self protecting boundaries in place, I can be kinder and able to offer advice that may be well received or not, but continue to be a support to him by just showing my love and concern.

Monday, March 21, 2011

Guest Blogger: Fern Weis's Top 5 Parenting Tips

Our guest blogger today is Fern Weis, and she provides tips and some insight into her own family. She is a certified coach, middle school teacher, wife, and parent of two wonderful young adults. She specializes in supporting and educating parents of teens and young adults through individual and group coaching, as well as educational workshops. Fern continues to volunteer as a facilitator of family weekends at Hyde School. She is committed to strengthening American families, one family at a time. Learn more about her work at www.familymatterscoach.com. You can also contact her at fgweis@gmail.com. And now...here's Fern.


In a recent blog post, Marcia Stein posed some serious questions about the downward spiral of Charlie Sheen. She also asked readers to share their own experiences. I am pleased to be able to share part of my life with you and what I learned along the way.

In our family, it was our son spiraling into a pit as a teen (and taking us down there with him). What was so painful was that somewhere in this out-of-control teen was a kind and loving person who didn’t know how to come back to us. When he was having a good day, we would hope against hope that this was a sign he was turning around. We were not facing reality. When we could no longer deny it, and accepted what was happening and that we had no control, we pulled him out of high school. First step, a one-month wilderness program to separate him from his community and from us. Second step, two years at an amazing boarding school called Hyde School, a program of family-based character development.

The deciding factor in choosing Hyde was the intensive parent program. While we considered ourselves good people, and understood that he made dangerous choices, we knew that we needed to change, too. We couldn't ask the school to 'fix' him, and then have him come home to the same parents. We had to do things differently, see ourselves differently.

I learned that I taught my children so much about how to see themselves and life, not only by my words, but by my actions, reactions and responses to people and events in my life. It's frightening how much our children learn from us that we are not aware of.

I learned that you cannot stand by. It hurts to take difficult steps, but it hurts more to watch your child self-destruct. Change is hard, but not changing takes you in the opposite direction of where you want to go. So…

1) Do the hard thing. Don't worry about your 'relationship' with your child. He has lots of friends, but only one set of parents to teach him how to get through life. Children need us to set limits. They don’t have the self-control to do it for themselves. If you don’t do it, who will? Whether it’s saying ‘no’, or having a serious intervention, do it!

2) Understand that parenting is more about YOU than your children. Step up! You know all those qualities you want to see in your children? You want them to be truthful, persistent, courageous, compassionate, generous, thoughtful, curious and optimistic. Make sure you are the best role model you can be (for your own benefit, as well as theirs). Have you given up on a dream? Have you ever been less than honest? Do you tell them to be more assertive, and then avoid saying what you need to say to others? Do you expect more from them than you do from yourself?

As they get older, you have decreasing control over the choices your children make, the actions they take. They are counting on you (even though they will deny it) to show them how it's done, and to be their guide.

3) Ask others for their insights about you (this includes your kids). I can sense some of you mentally walking away from this one. But we are often the last ones to see our own inconsistencies. It’s the inconsistencies that prevent us from moving from struggle to confidence. The mixed messages make parenting, decision-making and personal growth more difficult.

Ask the people who love you most (spouse/partner, kids, trusted friends and family) for their input. You don’t want them to sugarcoat it, and you don’t want them to be cruel, either. You are looking for helpful feedback so you can be a great example for your children and enjoy life more.

3) Listen, listen, listen! Your kids want to be heard. It doesn't matter whether you agree with them or not. Listen and become the trusted adult they turn to when there's something really important to talk about. This is not the time for judgment, criticism, or fixing it for them. After they have vented is the time to help them with coping and problem-solving strategies.

4) Be a teacher, guide and mentor… but don’t be ‘the fixer’. Too many young people are not prepared to launch themselves into independence. When we give them the answers and solve problems for them, they are not learning the skills.

Step back. Guide and teach without doing it for them. And if you are not always the right person to teach the skill or lesson, you have options. Ask for help in being a better teacher. Consider who might be more effective in helping your child work through challenges. There is no shame. It really does take a community to raise children.

5) Share your struggles with your children. What was challenging for you growing up? What did you fail at? How did you deal with it? Our kids see us as adults who mostly seem to be in control and know what we’re doing. As confused, hormone-ridden teens, they can’t imagine being competent and self-assured. They need to know that it does get better, that we were once like them and we, mostly, successfully muddled our way through, too.

You already know how important this job is. And while you weren’t given a user manual for your children, it doesn’t always have to be difficult. Learn when to step in and when to step aside. Listen as least as much as you speak, if not more. Ask for help when you need it. Inspire your children by sharing your own difficult experiences. Your children need this from you, now.

P.S. My son graduated high school and college, and is employed in his chosen profession. The child we thought we had lost is a motivated and generous young man who gives me bear hugs, tells me about his work day, and dances me around the kitchen. His sister, who prefers not to be highlighted in my writing, is an amazing young woman and daughter, and friend to all who know her. Life is good.

Monday, March 14, 2011

Information About the Involuntary Psychiatric Hold

I have blogs and websites with tools to analyze traffic, see what terms people are using that lead them to my sites and my book. I use analytics to learn more about what information you’re seeking, and I occasionally use that along with discussions, emails and calls to determine topics to present.

Due to the ongoing discussions about Charlie Sheen and similar or more extreme experiences of others, this article is devoted to a difficult subject: the involuntary psychiatric hold or commitment. Involuntary commitment is when a person is placed in a psychiatric hospital or ward against his or her will. This must be in compliance with the mental health laws, is usually limited in duration and requires regular reevaluation.

I will direct you to some informational websites to help you or your friends as I am not in a profession that deals with these matters: I simply know how to research.

A Wikipedia entry at http://en.wikipedia.org/wiki/Involuntary_commitment#Alternatives has a good overview of the history of involuntary commitment and some information about the process in different countries.

In California, Section 5150 allows a qualified officer or clinician to evaluate a person and have that person involuntarily confined. There are specifics as to who is qualified to evaluate a person and what circumstances would lead to this decision. Generally speaking, the person must be a danger to self and/or others and/or be gravely disabled. There is a Wikipedia entry regarding Section 5150 at http://en.wikipedia.org/wiki/5150_(Involuntary_psychiatric_hold).

There is a brochure describing the California involuntary 72-hour and 14-day hold that explains the process and a person’s rights under the law. This informational piece was created by the California Network of Mental Health Clients in Sacramento. The brochure is at http://www.disabilityrightsca.org/pubs/502401.pdf and their number is 916-443-3232. They have provided additional resources if you need them.

The last topic I will mention is “conservatorship” or “guardianship.” You can read an explanation at http://en.wikipedia.org/wiki/Conservatorship. In order to be another person’s conservator, you must have clear and convincing evidence that it is necessary to provide for the other person’s “physical health, food, clothing, and shelter” or that the person cannot “substantially manage his…own financial resources or…resist fraud or undue influence.”

I started this article by mentioning Charlie Sheen. It’s terrible to watch and I can’t imagine what this is like for the family and friends who love him. What would I do if I were in their shoes? I don’t know, and it’s hard for any of us to know from a distance exactly what’s going on and why. I can say this on the basis of my research - you don’t have to stand by and watch, and you don’t have to walk away because you don’t want to be enabling the behavior. A good psychiatrist and/or an attorney can help you sort through the options.

For those of you living in these extreme situations, I hope this has given you some information to consider and the courage to act. You will absolutely need courage and resolve.

Sunday, March 6, 2011

Parenting Troubled Adults and Notes about Charlie Sheen

Even if you don’t read tabloids or view gossipy entertainment shows, it’s hard to avoid the train wreck that is Charlie Sheen’s current situation. The headlines generated by his behavior are dominated by stories of drugs and alleged violence.

I have seen several of his movies and watched Two and a Half Men occasionally. There’s no doubt this is a talented actor who can easily master drama and comedy and do it with style and charisma.

He reminds me of another actor with range, style, charisma and a terrible history, Robert Downey, Jr.

Information provided here is drawn from Wikipedia entries that have citations.

Both were born in 1965 and were born into show business families, and both started acting careers as children.

Downey has said that his father was a drug addict and introduced him to marijuana at age 6 and the two did drugs together, eventually Downey also drank alcohol to excess. He dropped out of high school to pursue acting. He was arrested several times, was put on probation and was sentenced to serve time in the California Substance Abuse Treatment Facility and State Prison. He went through rehab and rehab programs repeatedly until it “took” in 2001.

Sheen has been married three times and has five children. He was expelled from high school for poor grades and bad attendance. He has overdosed, been sent to rehab, allegedly threatened or hurt women in his life and created havoc in his life and in the lives of his ex-wives and children.

Last year, I heard an interview where Martin Sheen, Charlie’s father, said he found himself planning Charlie’s funeral at a certain point: the situation was serious and his son’s life hung in the balance. As a parent, that thought just struck me through the heart. It's got to be one of the biggest fears of family members.

Sheen’s latest escapades have been blasted all over the news and he has been calling in or appearing on various radio and TV shows. It’s mesmerizing and appalling, and it’s sad to think that this dangerous situation serves as entertainment to many.

I’ve wondered how a person like Charlie Sheen can get into so much serious trouble and not have their children removed from the home. This did happen last week, but look at his severe and acknowledged history of substance abuse. At what point does social welfare step in and protect the children? Perhaps one of the social workers, psychologists, psychiatrists or attorneys who read this article can provide this information.

I have also heard talking heads who have not met Charlie Sheen speculate that he may be bipolar. (A good explanation of this disorder is available on Wikipedia. It doesn’t seem professional to speculate on someone you don’t know and haven’t examined.

Might there be underlying reasons for the extreme drug abuse experience by both Downey and Sheen? Maybe some of the same reasons we see in other addicted individuals.

I would look to their early years for behavior and decision making, see if they were in some pain that they wanted to dull or treat by taking drugs or alcohol. Some people who have disorders self-medicate to help get through the day, while others simply love the feeling of escape and find themselves addicted.

Addiction is complex and difficult, and I know from meeting recovering addicts that treatment is not easy and it truly is “one day at a time.” It’s helpful for family members to seek their own treatment, to understand how they are only in charge of their own feelings and reactions. You can’t change another person, and enabling another isn’t helpful to anyone. (Please see my post on enabling.)

How do you stand by as a parent and watch your child spiral out of control? Have you experienced this? What did you do? What worked for you and what did not work? Do you comments or insights to share?

Tuesday, March 1, 2011

How to Listen to Disclosure of Family Estrangement or Difficulties

In my last post I wrote about the process of deciding to share difficult information about one’s family. This post is devoted to receiving this information.

Some of the richest and most heartfelt conversations I have had have been when someone decides to confide in me or when another person listens to my story.

When your family member or friend is having family problems and decides to share these issues with you, it takes a lot of courage, hope and trust that you will not judge, will listen carefully, offer help if asked, will not gossip. This is a confidential and difficult conversation.

Truly listening means that you turn off distractions: this is not a time for watching TV, texting and taking calls. Turn off your phone and give that person your attention. Listen with your head and your heart. Don’t ask a lot of questions, just a few to clarify the situation if needed.

Don’t change the topic unless you’re very uncomfortable hearing this news, and if you are, it’s better to just say you’re uncomfortable.

This conversation is about the other person, not you and your family, unless you’ve experienced a similar situation. Then it’s appropriate to share but limit your input: this person has a lot to say.

Be private and confidential. If the person wanted all of the family and friends to know, there are many ways to alert everyone. It can hurt the person’s feelings if you talk about this to others and damage your own credibility as a confidante.

Don’t judge the people involved. You’re hearing a part of the story and you’re hearing it for the first time. It may be shocking news, but all of it is in the realm of the human condition: the things that happen to people and the decisions we make.

Ask if there is anything you can do to help and provide resources if you have them. One woman called me regarding her son and after listening to her story, I asked if she wanted resources or how I could best help her. She was looking for resources and I gave her a few places to start, indicating there were additional resources in my book and on the blog if she needed them. It’s easy to become overwhelmed when you’re already dealing with a stressful situation. I also keep in touch, ask how things are going, and remember her on Mother’s Day and Christmas, two really hard holidays for her.

When you see or talk with the person in the future, ask about his or her child. I know from personal experience that the concern people show is helpful. It helps me to know that they haven’t forgotten I am a parent, and birthdays and some holidays in particular are really difficult.

Keep in touch and show concern and compassion. That’s the best way you can help anyone.