Friday, June 15, 2012

Naming names

I have often worried that by using my children's names I may be sharing too much about them for their own good. I do not so much worry about what folks think of me. I believe that the problems facing our family are nearly universal, and yet many folks would prefer not to share such information in order to protect their children from any invasion to their privacy.

I no longer care whether my children might be candidates for Ivy League degrees. I do dare to hope that readers will view these notes with understanding toward the young people whose vulnerability may be exposed here.

That said, I feel less protective of the adult representatives of civic and social service agencies whose interference in our affairs has yielded no improvement in the welfare of my children, much less justice for the wrongs done to them. I feel no protective instincts toward the Guilford police, for example, who failed to develop an adequate case against the man who sexually assaulted two of my daughters. Nor the Guilford School District, which harbored not one but two running coaches known to have had illicit relationships with young girls. Nor yet the lawyer who defended our rapist in court--the same vicious, lying clown who represented Joshua Komisarjevsky. Nor yet toward the social workers at the Connecticut Department of Children and Families, who investigated a claim against me personally that was filed by the wife of my daughter's rapist, alleging that I am an alcoholic who beat my children. Nor yet toward Anthem Blue Cross and Blue Shield, which has paid but a pitiful share of the costs of mental health care for three children suffering acute (suicidal) symptoms of post-traumatic stress, and which further insists in writing that my son, Tim, is at fault for his own continuing suicidality and addiction.

This latter claim comes in response to an appeal filed against Anthem's decision that Tim's residential treatment is unnecessary to his care. They insist--despite ample documentation from Tim's doctors and other clinicians--that Tim's only problem is marijuana use, and that if he would only obey parental injunctions to abstain, he would be fine living at home. Never mind the evidence of PTSD; never mind that when he gets high on marijuana he suddenly feels compelled to take life-threatening doses of morphine or ecstacy. He just needs to behave better, and all will be okay.

While Anthem forestalls any reimbursement, I am paying for Tim's ongoing care by emptying my retirement account. I have reported our conundrum to the Hospital of Saint Raphael, my wife's employer and the source of our health insurance. The very polite women in the Human Resources office there explain that, overall, they consider Anthem to provide very good coverage. When pressed about Anthem's record on mental health--which includes repeatedly denying receipt of claims and the provider paperwork required to process them--they admit that "the only real problem is how Anthem handles mental health." I point out that "the only real problem" is ruining us financially. They promise to demand answers, which yields long conversations with Anthem's appeals team, who promise to expedite all the paperwork if only I can get all the providers to resubmit it. The real problem, they explain, is that we are using out-of-network providers--no wonder we are getting snagged in their paperwork! They still deny that Tim requires residential care.

Fortunately for us, Connecticut sponsors an Office of the Healthcare Advocate, whose legal team is pursuing a complaint against Anthem for their evident attempts to evade reimbursing essential care. And yet even they have to warn me that Anthem is grandfathered out of the Connecticut law that mandates fair treatment in such cases. So, we could lose.

My wife's employer, the Hospital of Saint Raphael, is famous for rescuing the destitute from the streets of New Haven--no insurance required. Ironic that they can't do better by their own "insured" employees. Saint Raphael's is currently being swallowed by Yale-New Haven Hospital--a financial necessity in these times, I am told. The other day, my wife attended a presentation about her new healthcare benefits and came away optimistic about the new, more comprehensive Anthem plan that will take effect in a little over a month.

I'll believe it when I see it.

Friday, June 8, 2012

Relapsing

Why do the crises always come when we are away?

There is an unspoken rhythm and balance to this cycle. It's a little like the way the kids have taken polite turns before expressing their traumas. Tim waited for Molly to stop self-injuring before taking his near-fatal overdose. A couple of the kids--Emma, Buffy--deny their troubles altogether in order to allow their perceptively needier siblings space to suffer and heal. All of the grown children carefully control their contact, so as to contain the doses of adolescent and parental toxicity they must absorb when at home.

Recently, we visited California for Mary Kim's graduation. Whether or not she can admit it on any given day, Mary Kim has blossomed both personally and artistically during her masters study at Cal Arts. Like her sisters Kathryn and Emma, she already far surpasses her late-career dad in her ability to keep her eye on the horizon while navigating the triviality and frustration of the day to day. She deserved a celebration, and so Mary Ann, Emma, Buffy, Molly and I bought tickets we couldn't actually afford and flew out for a four-day festival of commencement, meeting her friends, and basking in the real and reflected sunshine of the moment in Southern California.

What happened while we were gone? Tim--for reasons a person can understand but which it could be fatal to tolerate--signed himself out of rehab. When we told him he could not subsequently go home--our first venture at tough love--he found a friend to let him crash. He promised to go to AA meetings, and we began the process of trying to talk him into returning to rehab and the rehabbers into taking him back (a prospect they could consider, but not until after the Memorial Day weekend). I called the airline to see about emergency tickets home. They kindly offered available return seats at double the rate we had paid to fly to Los Angeles to begin with. Because all of my money and available credit is invested in rehab futures, I couldn't go back. And, as it turned out, I couldn't have done anything more to help Tim if I had.

The friend who took Tim in did drive him to AA meetings. She also dropped him to see a friend, not knowing this particular friend was a user. Tim arrived back at her home bearing gifts of Ecstasy and Klonopin, which he knocked back with cooking wine and Nyquil to calm the shakes. He then entered a psychotic state, in which he believed the television was speaking to him, the mother of the house was coming on to him, and the father was trying to rape him. It was the father whom he hit.

Tim ended the day on a gurney at Yale New Haven Hospital with a police babysitter, under arrest for assault, resisting arrest, and--because why not throw the book at him?--domestic violence. (After all, he had been living in this house for the weekend.) From California, we placed calls to police and the medical staff at the hospital, all of whom informed us we had no right to know what was happening--Tim being a legal "adult" and entitled to privacy from anyone who might actually advocate on his behalf. Despite this awful truth, I persuaded the consulting psychiatrist to admit Tim, based on his counselors' conviction that he has been medicating against post-traumatic stress--and that, despite his insistence that marijuana is his "drug of choice," his patterns of consumption suggest that marijuana is only what Tim uses to disinhibit himself when he wants to put a chemical (morphine, Ecstasy, Klonopin) gun to his head.

My medical feint worked, but only in keeping Tim away from an immediate arraignment. In fact, nobody at Yale bothered to explore his para-suicidal behavior. They waited for him to detox, then turned him over to the cops, who got him arraigned ASAP, lest he receive treatment before they could prove him evil. It seemed that, this being a holiday week, the regular professionals were on vacation. It was nobody's fault.

Fortunately, the delay bought us time to call a lawyer and to mend fences with the rehabbers. Tim is now back where he needs to be, released from criminal court on a promise to appear after he completes residential rehab.

I attended a presentation the other day on the neurological effects of drug addiction. I learned how addictive drugs fool the dopamine receptors in the mid-brain to believe that what feels like Big Pleasure is actually Essential to Sustain Life. Adolescents' developing forebrains--the source of their limited reasoning skills--are short-circuited--rendered even more useless than they otherwise would be in an 18-year-old male. These medical truths are the basis of Tough Love theory: A kid must experience the real, woeful consequences of his own addiction if he is to realize that--whatever his brain is "telling" him--a state that seems like Nirvana is actually the lowest rung of Hell. He can't learn it any other way. So, tough love it shall be.

It doesn't help at all that the middle-aged "adults" who are cops, nurses, and doctors show no more reason or accountability than Tim does. To a person, each I spoke with over the course of a week patiently, then impatiently, explained to me that the problem I sought help for was not theirs to solve.

When I called the guy Tim hit to apologize for his behavior, he seemed gratified and even concerned about Tim's welfare. He did not at first acknowledge my offer to pay his unreimbursed expenses for medical treatment to his broken nose or to repair the furniture in his basement. But somehow, a week later, he found the courage to contact me, seeking $15,000 in "emotional damages." It seems his daughter is having nightmares, and, rather than take her to a therapist, he believes the family needs a new home security system to guard against Tim's return. Tim broke a dining room chair, and so they need a dining room set.

Tim is an addict and a teen-ager. What is wrong with everybody else?

Trauma and our co-dependencies

Much has been made by our various therapists of the complex relationship between Tim and Molly. As our two youngest children, they share a special kinship. Their experience of our family is similar: Unlike their elder siblings, they had never experienced a family with one of two or even four siblings. They came along at the end of a long chain. Doted on by their elder brothers and sisters, they have shared the best and the worst of our very large family. The center of all attention, the witnesses to all our sins.

In some very naive way, Mary Ann and I imagined we were becoming better parents as we became more practiced. And we have been more than heartened by the wise, self-motivated, resourceful adults our elder children have become. Yet, somehow we failed to recognize the traumas inflicted on the youngest of our brood by their elders' adolescent excesses and by our own personal failings--the latter more a constant over time than we would have hoped. And then there were the acute traumas from outside: the sexual assaults of two of our daughters, the failure of civil justice, the community reprisals against the victims, the fear of further invasions that inspired young Tim to lock all the doors at night and to stash a crowbar under his bed.

So much we didn't see until seeing it was useless.

We have been grateful for the generosity of our elder offspring in coaching us in the ways of the younger. Mary Ann and I were both "good" children. Even in adolescence, I sought to please. While Mary Ann rebelled against her mother, in particular, she never ventured into dangerous behaviors. Perhaps we were both too timid. As parents, our imaginations have fallen far short of what our children might do. We have been too inclined--myself in particular--to give the benefit of the doubt. Knowing in our hearts how extraordinary are our children's talents and their characters, we have lived in denial of the likelihood they could succumb to the unimaginable pressures of the era in which they have been born, to experiment, to tempt fate, and to lie directly or indirectly, explicitly or implicitly, about what is going on.

So, having been hurt, Molly and Tim have protected each other. Having felt intolerable amounts of each other's pain, they got numb together. Seeking protection from the adults who had failed them, they lied as necessary. For what we didn't foresee, Mary Ann and I have been blamed by therapists claiming to be "radical advocates" for one child or another (modern therapy eschews family approaches except as an "add-on" to private trauma work), by the police who have invaded our home using SWAT tactics to apprehend underage consumers of beer, by the state social workers who initiate interventions to protect our children from our failed parenting, and sometimes even by our own adult children, who fail to see why we have been so "indulgent" of Tim and Molly, when our expectations for them were apparently so different. We have had therapists explain to us and to our children that we are "tapped out" as parents. I have heard angry feminist advocates for sexual assault victims compare me to the real assailant, and even to their own raging fathers.

Clearly, I should learn to keep my mouth shut and to let the experts talk.

And yet, Molly and Tim are both improving, in part we believe, by their very separation. Tim is focused on his recovery, as least while he resides in a community of sober peers. Molly is attending school, going to work, seeing her angry feminist therapist, and progressing. Lacking Tim, she takes social risks--making friends, finding a boy she likes, attending class and work. Mostly, it's a good thing.

I now no longer attend family therapy sessions in which I am portrayed as the standard failed dad. I go to Al Anon meetings--no blame intended--and write large checks to the various experts my children see. Mary Ann pursues her career and nurtures Molly. Some day, we may again all live under the same roof, but I am in no rush. I have learned the limits of my own ability to save my children from the world in which they live. I know I have no allies in the civic or healing communities. I write checks and give the rest up to a god I doubt on normal days.

My days ceased being "normal" several years ago. No brag, just fact.