I will say unto God my rock, Why hast thou forgotten me? Why go I mourning because of the oppression of the enemy?
It is no exaggeration to say that when the next morning came, with the sun, you are a little surprised at first. The world continues on. You don't eat. You are raw, as if your emotions are paper cuts. You are dizzy, you are faint, you are nauseated. You feel like a ghost.
And the brain, or my brain, went into hyper-rationalization. I sat in my room, in a chair in the corner for hours. I tried to figure out every possible explanation for why we were where we were. Like a secret code you think you can work out. My thoughts would consume me and when I would look back at the clock, I had lost 10, maybe 15 minutes in this maze. On its own not much time, but when repeated throughout the day dozens of times and you finally look at the clock, it’s as if an hours-long flash forward had occurred. I kept replaying the same questions and same possible answers:
Why would she do this? She is unhappy. Why is she so sad? Is it her non-existent relationship with her dad? Is it that she dislikes me? Am I too strict? Does she dislike her stepdad that much? Lots of kids don't like their stepparents. Maybe she wasn't trying to kill herself. Maybe this was her typical pattern of when she doesn't get what she wants she escalates anything in an effort to throw a metaphorical grenade at the situation. Why would a person who was going to commit suicide decide not to take pills because they heard it makes them sick? Would a person who really was suicidal even care about that? So maybe she is just manipulative? But why would she risk so much just because she was unhappy with punishment? Does she have a personality disorder? Those people who pathologically lie? But yet there are times she seems so real and genuine. And on, and on, and on.
But mostly, I was enveloped in sadness. A sadness that so oppressive that I couldn't seem to get out of it.
Our counselor called me and said her contact at the psychiatric hospital, the administrator, was going to be unreachable for a while. She had no other contacts there she could call to get her released. Grace would be there for the time being. Doing what? I didn’t really know.
The scheduled, permissible time to call Grace per the paperwork I received was at 5. At 4:59, I was dialing and asking for to speak to child 9832, which was also on the paperwork as the way to identify Grace. My child was literally now a number.
Grace's voice seemed fine. She talked about how it was going. Said it was ok. Said she roomed with someone and that it was hard to sleep. Grace's softness in her voice led me to believe that perhaps she really was that depressed to the point of suicide, that there was something chemically wrong with Grace; this was out of her hands. She was not making conscious oppositional decisions. She was really sick.
It is in some ways an affirmation of a parent’s love, and perhaps hope, that any tiny semblance of change, her voice in this case, can spark immediate tender feelings: Poor Grace. I needed to direct my thoughts and energies to figuring out why she was so sad and be uplifting and helpful to her.
Pages from Grace's journal while in the hospital
I only told the people I had to, and even then, it was not a description of what happened the night prior. I had to tell my work why I was not in that day and only gave them the basics: Grace was checked into a hospital last night. I did not get much sleep. I need to take a vacation day today.
I told her two older siblings who were both away at college. I told my stepmother and let her tell my father. We had all already lost a family member to a suicide of course, his first born and only son. I did not tell my mother. She had advanced stages of dementia and there was no need to confuse her.
I had to call the school and explain her absence. I told them she was being hospitalized and I was not sure when she would be out. I didn’t give a reason and they didn’t ask. Some of her friends knew she had cut previously. It would not be hard to put things together and figure out she was not ok.
I really don't know who all stepdad told, or what he said about it to others. Recall, we were not living in the same home; we saw him on weekends when he did not have his children or if he was in our area for work during the week. Grace had no relationship with her father as mentioned earlier but I did tell him what had happened.
After a couple of days, you feel a bit like what it must have been like to have leprosy. Word spread. Parents and moms who had previously talked to me or texted disappeared. This is a group of students and parents who have been together since Kindergarten. I had one solitary mom and classmate from this tightly knit, Christian school reach out to me a couple of days after Grace had been admitted. I had no doubt Grace was now branded. I had no doubt I was being talked about. And in retrospect, I selfishly and shallowly admit I was embarrassed because of it. I was still taking Caroline to school in the mornings and because they had siblings in the same grades, the families at Caroline’s school now knew as well. People disappeared, even when they were right in front of you. They would look away when I would show up for morning drop off, or when I was in the hallway at the school.
We (me, Caroline, stepdad) visited Grace at the facility on the first day that an in-person visit was allowed. We signed in and sat in the waiting room with the other parents and family members who had loved ones there. The families keep to themselves, talking only with each other. Had we all been in the waiting room of a pediatrician’s office or even a school office, there would at least be some kind of intermingling – particularly with the younger children present. We are all very different as evidenced by dress, mannerism, and even accents but are all bound in a way that is so ugly and sad: to “visit” our minor children who are in a juvenile psychiatric hospital. You find yourself trying to make stupid conversation in hushed tones to each other, like this is in fact just a visit to a doctor’s office, or school office.
When the time came, the orderlies/men in scrubs came and opened the secure glass double doors to let us in. We sat in the open cafeteria area that was right inside the double doors. There were round tables and four plastic chairs to a table. All the families had now taken their tables and were sitting. The patients were released all at once and when Grace walked out through another set of double solid doors and over to us, she was almost giddy, like happy.
She sat down and talked about the girls she was meeting. One was a meth head, one had gender identity issues and the meth head was really nice to her. And her roommate snuck in a homemade Ouija board and they played it. And Grace snuck some extra food to her room from the cafeteria. Grace was enjoying her stay and enjoying group therapy where all the girls would talk about their problems. Grace also announced she was nothing like these kids but did like all the cool people she was meeting. And hey, she added, there was a girl with some cool piercings like Grace would like when she got out. There wasn’t much back and forth conversation, the usual give and take when people talk. It was largely she who talked followed by periods of silence as we watched her tell us about her new reality. Time was up and the orderlies made an announcement to the families it was time to leave. People hugged their children, and I hugged Grace and then we left.
The visit was dis-heartening. I think I expected a Grace who was more subdued, who was not seeing this as an adventure, who was realizing there was nothing about this entire ordeal that was “normal” or healthy. Who was realizing she needed help. Who was realizing that her family has been so worried and so tired of the lying and cutting and oppositional behavior. I had hoped that she was ready to get better and come back and be a part of the family. This was a Grace who had simply met new friends and was learning new things. This was not the same soft-spoken Grace that was on the phone call.
I returned to my office on Friday - four days after Grace had been admitted. I was later told by my boss that it was hard to look at me. Not because I looked pale and drawn, because I did, but because the emotion was so raw. And I was a shell of a person.
The sun kept rising and setting. The days kept coming and going. My day to day experience consisted of moving through routine motions but missing a key part of my body, a ghost limb. You can’t focus. Something is missing.
Grace’s therapist had warned me that there would be calls from the hospital suggesting Grace go on different meds, more meds. It was their go-to treatment for these adolescents. Just know the calls would come, she said. And they did.
Actually, at the intake, the tech gave me a paper that asked for blanket approval for thorazine, an anti-psychotic, which I denied because she already on meds, and I knew she would never be at that point. We got calls about sleeping pills for her because she could not sleep. I said yes on the first night for no really good reason now that I think on it. But, when I called the next morning to check on how she had done with the sleeping pill, they had not administered it. Why? By the time they got back to her, she was asleep. The first line of defense. Give them pills.
I declined it the other times. And I asked for the doctor to call me; it took over a week to get a call.
As the therapist had told us, the situation was now out of our control. Our access would be limited, and our ability to get information on her would be limited.
We called once a day at the set time and talked for 10 minutes, no longer and sometimes it was even shorter. We could visit twice a week for an hour, no longer. The more distance I had from the initial intake and Grace’s first phone call with me, the more I returned to my original position that some of Grace’s behaviors were not driven as much by depression or even a desire for suicide but rather driven by something else. I didn’t know what the “it” was, though. Wanting to control her surroundings, or hating me, lack of a spiritual ground, or simply doing whatever it took to remove herself from a situation she didn’t like - like mice who will chew their legs off to escape a trap – seemed to be good possibilities for the driving force.
After my first phone call with her new psychiatric hospital therapist, I learned that the goal of the hospital was only stabilization, not to help her transition back to home and living with the family. And so I really don't know what their group therapy sessions revolved around other than I was told about the things that made Grace unhappy, in Grace’s point of view: I had her password to her facebook and phone, "all the kids" were doing the things Grace was doing: sneaking out, using foul language, cutting, sexual texts. I was "really strict," she didn't like that there was a stepdad now, she didn't like that things had changed when we married. She was, in her therapist’s words, "normalizing" her behavior. Asserting that the things she was doing were "normal."
And beyond that not much else was learned, and in fact, I already knew all of the above. And how many other countless kids object to the same parental limits and go through these same difficulties, yet don't try to kill themselves? And we were also missing a key point I thought: Grace got angry because I took her electronics when she snuck out; she could not get them back. That is precisely what precipitated her stay at this hospital. I punished her; she didn’t like it. I am not suggesting that she wasn’t also dealing with depression, but I am suggesting her reaction to a punishment was a catalyst for the next couple of years for the family.
My schedule adjusted, again. My afternoon becomes structured around the time that I am allowed to call my child. You don’t want to have another phone call right before 5 and don’t want to be somewhere away from a land line or cell signal. You don’t want to be in the middle of cooking. You don’t want to be watching television. If you call a little past the time, you will get a busy signal because other parents are calling. Then, you will be repeatedly re-calling until a line opens up. There was one day I just didn’t want to be held hostage by 5 o’clock, so I didn’t even call. But, that day, stepdad did. Her older brother and sister also called her a couple of days. We drove to the facility on the days that we were allowed to see her. On those days, I would need to leave work a little early to swing by the house and get Caroline first to make it to visitation in time. We are either calling her or visiting her.
Her grandparents came to the psychiatric hospital to visit her as well. They thought about what the exact right thing was they could say to help her. Her grandfather, in particular, believed that if he could just phrase something the right way, it would all make sense to her. I believed the same.
At the visits, Grace maintained that she was different than all the other kids there. She was not as "bad" as them. She never saw herself as one of them. Even though, there she was. With all of them.
Grace stayed for almost two weeks. The first couple of days were a devastating reality: I have a child in a psych ward. A part of me is missing. I am a failure. I am embarrassed. Then, over the course of the following days, I came to see her being gone as almost a nice respite. I could come home and not be concerned with what kind of mood I would face, there would be no oppressive atmosphere in the home, Grace’s younger sister and I could have a regular evening without being in continual anxiety over what might transpire in the home. There was no shouting, no cuts I was having to monitor, no phone I was having to check, no discussion about what chore was undone or half-done, no urgency, no crises in the home. Then toward the very end of Grace’s stay at the hospital, I began to feel hopeful again; she would come back changed. The ignorance of this statement upon reflection years later is stunning to me.
We were required to have one family therapy visit at the hospital. Our therapist was so young, I would have been surprised had she had her own children. She was barely out of being a child herself. I am not suggesting that you have to have already raised one to understand, but I do believe it absolutely helps. I have no idea if our therapist was credentialed, if she was truly a therapist or how long she had even been at the facility. She called us back from the waiting room, to another set of rooms behind even more doors and only gave us her name. She said this session was intended for Grace to tell us what she had been doing while there and for us to talk about issues regarding her return to the house.
Prior to Grace coming in the room, the therapist told us this was the time we needed to let Grace know what things would be off limits. She said that restricting cell phones, laptops and television was recommended, and that since she had attempted a suicide, she would need to keep the door to her room open at all times.
I had already determined that the electronics were going to be set aside until I could verify she was at a stable place. I did not want her to get released and get thrown into whatever her friends might be saying to her, or about her. I also did not want her to watch anything on television I could not police and it was easier to ban television than to do channel locks at that time. I didn’t know if her watching some dark movie or scary movie would send her in a tailspin. Keeping her door open was an idea I had read about but because she was a teen girl with step brothers and a stepdad occasionally in the home, I didn’t consider it until the therapist suggested it.
Grace came in the room and it became confrontational almost immediately. Grace told us what she had learned which I do not even recall what she said because she was reluctant to speak. Stepdad was there, and he was not reluctant to speak. He was angry at the entire situation and told her immediately that we were not going to live in fear of whatever she was going to do next. She pretty well shut down after that portion and looked at stepdad with hatred, me – less so. I got us back on track with the point of the meeting, as I understood it, to tell her what things would be off limits for her when she returned.
As I am writing this now, there was nothing about this “family therapy” session that set any of us up for success. I have no idea if this is how all of these first family therapy sessions go, but ours was a failure. Not a failure from the standpoint of letting Grace know what her limits would be she got back home, but certainly a failure in terms of any real “therapy” getting accomplished.
Grace's notes on the family therapy session
My older children called and checked in with me just about every other day for updates; they sent me flowers one day when I was particularly struggling.
A few days before the staff will discharge the patient, they call you in for another meeting. Stepdad and I went back in for this discharge meeting. We were told that upon coming out, Grace needed to have a secure environment: We need to go through her room entirely, clear it out and start her with limited items. We were to remove all clothing with ties or any sort. Give her only basics - for safety. Some of this was discussed at the “family therapy” session, but this was in much more detail. We were to remove all sharp objects from her room - pencils, nail files, earrings, erasers (they can rub their skin off with it) paper clips, bobby pins, barrettes, anything that she can use to self-harm - which is a lot of things. Further, we were told to secure the house:
Locks on ALL doors and remove the locks on her room door and bathroom door. Lock up the wine. Lock up the meds. Lock up the scissors. Lock up the knives. Go through your kitchen drawers and remove things that can be used for self-harm. Secure all office supplies - staples, paperclips, pens. Lock up your closet. No cell phone. No internet. No TV.
Further, we must encourage Grace to get out of the house and exercise with someone. Walking, running - biking - anything physical will be a good coping skill for her. Grace will not be released until we have both signed an agreement that we will do all these things. Grace has learned some coping skills, we were told, but we need to assure a safe environment. And, her next obligation will be something called outpatient school. This was my first time to hear about this. Kate would not be coming back to the house and re-entering her life. It is a school, associated with the hospital. Grace will attend for a prescribed number of days. I immediately don’t like this because she has already missed so much of her own school. And, I thought that after we had completed our stay at the hospital, we could be finished with the entire psych hospital experience. The therapist tells me that they will have to notify CPS if I do not take her to outpatient school upon release. I knew I had a few days to fact check this because they could not give me a firm discharge date. We take our signed agreements about creating a secure environment and leave.
I received a call the next day that Grace was being discharged that very day. There was no preparing, it was simply: you need to come get her tonight before 6. Grace got discharged on Thursday, the day I returned from a work trip, and I was not home yet. Her step-father left work early to go get her. I now know that insurance companies ultimately determine length of stay. Her benefits had run out; she needed to leave.