Sunday, September 28, 2014

Water First

from The Heart of the Matter blog 
My garden was out of control this year. I blame the compost bin, which split down the sides this year and forced us to chuck a full year's worth of loamy chunks into our raised beds before we planted, but my son Chris takes credit for emptying his pond filter into the fallow beds, disgorging all manner of scum he's convinced is the source of all bounty.

Or maybe we have tiny gardening gnomes who weeded at night. None of us did the weeding.

Regardless, the few plants we inserted did well. Better than well. Not all of them, actually. A couple of pepper plants were routed by the insane growth rate of one pumpkin and two watermelon plants, plus a couple of eggplant and cucumber plants. And a billion tomatoes we did not plant. Have a look.

watermelon and cukes

rogue tomatoes (and an oak sapling)
 We watered, the sun shone, and the plants grew because whatever was in the dirt was apparently a veritable feast of nutrients. The vines stretched under the picnic tables, the tomatoes leaned over the fence. You couldn't gently step between the cucumbers to pick the three kinds of tomatoes (cherry,
 grape and roma) without squishing a stem. We all got into the habit of snacking on overflowing bowls of tomatoes in the evening while dinner was in motion but not quite taking form. And if we could find them, we picked the cucumbers when they were smaller and sweeter and snacked on them that way too. Making room for more cucumbers to come.

The pumpkins and watermelons were a whole other matter. We've tried to grow them before, in the ground above a rock wall in our backyard, but the soil wasn't as rich or deep and they never took off. Not until this year did we learn that for all those buds and flowers and leaves, only a few pumpkins and watermelons grow, and they need to be nurtured and guarded and protected. Lifted off the ground with cardboard so they wouldn't start to rot. Marveled at every day, with all of us peeking in on them and saying "wow, that's amazing." When they were picked, the pumpkins were different shapes and sizes, and one took about a month longer than the others to mature.

Kind of like kids.

This week I thought of little else beyond my friend Lesley Siegel, who died on Wednesday of cancer. She was a marvel of a woman, an inspiration, a kick-ass boss and a crusader. She gave me many of my sharpest, most accurate criticisms, and the one compliment about my work as a psychologist that I hold nearest to my heart.  She was the Medical Director where we worked at Riverview Hospital, and then for the whole of DCF in our state. She was a crusader for kids in state care, who were the majority of who we treated as a state-funded psychiatric hospital, and  moved the state mental health system as a whole toward effective, trauma-informed psychiatric care in less restrictive settings and with minimal use of meds.

When she was blocked or frustrated in her first two missions, she focused on the third, because that was within her control. She made every doctor who wanted to prescribe psychotropic meds to a child in foster care convince her and her small battalion of nurses that the plan was sound and the meds were needed. Often they couldn't, and this is why:

This is a tomato plant that was badly supported. I have a piece of PVC and some yarn rigged to hold up the plant (because I wasn't prepared for tomatoes, and couldn't keep up with their growth), but in the process I tied the yarn too tight and cut off the supply of water. The leaves withered, and the plant looked sick. Chemicals added to the soil would not have helped, It needed better, looser, kinder supports.

If a plant is dry, water first.

There's an opinion piece by Michael Price about being moved from home to home and treated more casually than the furniture that Lesley commented on, and she's right. I have one son who was in foster care and very much needs his neuroleptics. I have another who weaned himself off when he turned twenty and looked and felt better immediately. I felt like a fool for keeping him on so long, and his psychiatrist shook her head and said she should have considered he had a personality disorder earlier, and tried him off meds and with a different kind of therapy.

That treatment will at some point probably be DBT,  which is intensive and complex but often effective for kids who have experienced trauma, and another treatment Lesley championed. Under her guidance, we were trained by the treatment developers, and rather than asking why a child in distress would need the treatment, we reversed course and asked "why not?" If trauma was the cause of a child's distress, then DBT and related treatments should come before meds, or instead.

My poor plant here was splashed with pond goo, which Chris thought would be good for them like it was for the soil, or maybe he was just careless, but the plants were hurt and never recovered their photosynthesis balance. Again, adding chemicals to the soil wouldn't help, they needed to be washed off  as soon as we noticed signs of distress, and then given added supports so new, healthy leaves could grow. And they needed to be protected from humans randomly chucking pond goo their way.

Lesley wrote up her approach to giving medication approval, without the plant metaphors, for this national presentation. In her approach, she's helped a lot of kids. She also helped me, with her example. She seemed fearless, though I know this must not have always been true. She was funny and original, in the way she told me to match my shoes to my pocketbook once in a while, or to read this book tonight, or to think again when I came up with a too-pat answer. She was brilliant.

Because she always remembered that kids need love first. Then support and a healthy environment. After that, if they're struggling, then fine, get them some good mental health care. Even meds.

But never instead.

Love, Lisa

Sunday, September 14, 2014


The word implies improvement. Cars become safer, medical treatment more effective, the universe better known. While change is can be positive, negative or indifferent, progress is good—ending a stalemate, closing in on a goal.

Or so I thought.

1.    1.
forward or onward movement toward a destination.
"the darkness did not stop my progress"
forward movement, advancegoingprogressionheadwaypassage
"boulders made progress difficult"
1.    1.
move forward or onward in space or time.
"as the century progressed, the quality of telescopes improved"
go, make one's way, move, move forward, go forward, proceed,advance, go on, continue, make headway, work one's way

Last week Mark and I moved our daughter Ciara to college and the feelings swirling around our backyard get-together the night before she left--and the truck during our trip to Providence, and the dorm room as we helped her settle in--were decidedly mixed. She’s a bright, intense, fascinating creature and raising her has been a daunting labor of love. That she settled easily into a college that felt just right for her was a relief so satisfying that I was in tears and a dazed kind of awe. 

Ciara's new groove
She is progressing toward the life she wants, but it’s not an improvement over the life she had before. She loved her high school and thrived there. She has remarkable friends and a family that made it to every game or meet or assembly in a rotating cast of twos and threes and fours. She had the attic bedroom at home with her own bathroom. In her words, she had it Gucci.

But this isn’t simply a heap of change either. There’s nothing random about where she’s going to school, or even her life in high school before. More than any of our seven other children, she has an internal motor that drives her forward, whether what comes next is a challenge or reward, or even a painful confrontation. Ciara is fearless in that way, which doesn’t mean she doesn’t get scared. Only that she doesn’t let fear change her course. 

Leaving home is progress, but like change, it’s a mixed blessing. She’s excited and nervous. We’re delighted and sad. Progress comes in muted colors as well as shiny, bright ones.

This week Mark and I moved our son Chris from a homeless shelter to a rented room and our feelings are just as swirly. Chris is just as determined as Ciara to find his own way in life, and when he moved out earlier this year to attend Job Corps we all knew he wasn’t coming back home. He’s a clever, passionate, sensitive soul who is equally tough to deter from the course he’s chosen and is convinced is right for him. Except his choices, in hindsight, are often setbacks, and the progress he wants to see—toward independence, and his own version of happy comfort—is minimal. The difference is how thoroughly his “now” goals wrestle his “later” goals into submission. His focus is intense, but mostly on what he wants today. Where Ciara is the fabled ant, he’s the grasshopper.

Chris's new pad
Not an easy way for an adult to live. Of all our kids, he’s made us the most gray. Also the most aware that parenting means that you always care, but not that you always do for your kids, or even that you always like each other. Hard feelings have passed back and forth. Advice has been given and rejected. Help asked for and refused. Substance abuse, learning disabilities and psychiatric problems are only partly to blame. The rest is the same steely will Ciara possesses, aimed in a different direction.

He was razor-close to being back on the streets but an apartment came through three days before his discharge, and a job one day after that. The look on Chris’s face as he took in the tiny room that was his alone and free of our usual parental tyranny was just as quietly eager as Ciara’s, and as parents we felt just as nervously proud.

From an early age, kids play the game of life by their own rules, with all the inherent ups and downs, disappointments and successes.

Leaving parents like us on the sidelines, cheering them on with our fingers crossed.  

Love, Lisa