Control What You Can Control

Some weeks are tougher than others. This has been one of those weeks. A friend of 30+ years, 57 years old, collapsed at his desk, dead from a massive heart attack at the treatment center he worked at. A director at a program I am consulting with informing me that his wife, mother of a 3-month old and 3-year old, committed suicide this week. The same program continuing to struggle to get back on its feet following months of neglect and indifference towards the students and staff. And finally, the potential collapse of financing for my new RTC platform just as we were about to cross the finish line.

So what do I do? I go back to my ancient friends, the Stoics. Back to Marcus Aurelius. Back to Epictetus. Back to Seneca. Back to controlling what I can control. It is the only proper course of action. And in doing so, going back to why I/we all do what we do in adolescent behavioral health. It is this last reminder that I share with you today. The world of residential treatment is at an inflection point, its future uncertain. Funding pressures, staffing concerns, regulatory constriction, and patient acuity, are driving many people out of the space. But not me and not today. I am doubling down. I am stepping it up. I am increasing my intensity and focus. The team I have assembled WILL build the next generation RTC platform. It may take us longer than we want, but it will be built.

And it will be built for mom's like this one. A mom who came to us a few years ago completely devoid of hope for her family and her son. A mom who had been abused and used by the system. A mom who simply wanted her precious boy to have a normal life. Here are her words, which compel my team and I to continue to march towards our goal of "Healing At The Speed Of Excellence." Enjoy. Contemplate. Respond. These are powerful words.

"My son has Reactive Attachment Disorder (RAD). I am often asked, “What is Reactive Attachment Disorder?” The quick, textbook answer is that RAD is a disorder caused by a lack of attachment to any specific caregiver at an early age, and results in an inability for the child to form normal, loving relationships with others. But that answer doesn’t really tell you anything about RAD, or what it is like to live with RAD or to live with someone who has RAD.

Recently someone asked me, “What does it [RAD] look like?” I think this question gets more to the heart of what this disorder really is and how it plays out in the lives of the people who struggle with it every day. And, honestly, I didn’t answer this question very well when I was asked. For the last several weeks, I have thought about this question, and how I would answer it if I was asked again. Here is how I would answer this question now:

What does Reactive Attachment Disorder look like?

It looks like the sweet, smiling, beautiful face of this precious child of mine.

It looks like trauma. Trauma from the years before he was mine. Incredibly painful trauma. Unfathomable drama. Trauma that has left such deep wounds. Deeper than I can ever imagine. Trauma I cannot understand, and in all honesty, I probably could not handle knowing.

It looks like sleepless nights. Every night. Since the day he came home eight years ago. Nights of endless waking, secretive binge eating, terrifying dreams, sheer panic. Endless sleepless nights.

It looks like fear. Always fear. Intense fear. Fear that I will walk away and not return as others in his life have done. And, at the same time, just as great a fear of letting me get close to him, because there is fear I might leave if he lets me in. Fear that he is alone and will always be alone. Fear that no one understands him and what he is going through.

It looks like anxiety. Heart-racing, fight or flight level anxiety. Constant, never ceasing anxiety. Chew your fingernails until they bleed anxiety. Pull your hair out in big clumps anxiety. Anxiety that plays out in countless ways. Ways that often cause harm to himself or harm to others.

It looks like shame. Toxic shame. A feeling that he is utterly unworthy. Intense self-loathing. Overwhelming, paralyzing shame.

It looks like rage. Rage he can’t control. Rage he doesn’t understand and cannot explain. Rage which explodes with such intensity that it is frightening to those around him. Rage that has caused extreme destruction. Rage, that once ended, sends him into a spiral of shame for what he has done in his rage. Which produces more rage.?

It looks like a vicious cycle.

It looks like countless therapists and therapies.

It looks like almost daily phone calls from schools and suspensions from those schools.

It looks like countless visits to psychiatrists and countless medications tried.

It looks like a trip to the psychiatric hospital, and currently a stay in a residential treatment center in Missouri.?

It looks like a child who wants so badly to just fit in and not be different.

It looks like staying home rather than going out, because it is easier. Easier because people may not understand what is going on inside my precious child when he is screaming, kicking, cussing, hitting, or biting. Easier to not face my own shame when these behaviors show up in public.

It looks like silence. Silence that comes when people ask about your children. What grades they are in and where they go to school. Silence when you say your youngest child lives in another state at a residential treatment center. Silence because the other person understandably does not know what to say to that answer.?

It looks like total exhaustion. On every level. Physical and emotional. His and mine.

It looks like anger. Anger that I can’t fix it. Anger that this mamma has done all she can and it is not enough. Anger that he has to live with and deal with this every day, and he did nothing to deserve it. Anger that this is taking over his life and mine.?

It looks like sorrow. Deep sorrow that my sweet boy lives with this all day every day and he has no escape.

It looks like calling out to God and begging him to heal my son.

It looks like unconditional love. Unconditional love for a child who has pushed me beyond what I thought I could handle, and forced me to look at who I am and truly evaluate what I hold most dear. Unconditional love for a child I will continue to fight for, protect, and call my own.

This is what RAD looks like."