Spirally down...

[ECE]

Our son is 17 and 1/2 and we are watching him spiral down. He dropped out of school last August with only 4-5 credits needed for graduation, he doesn't work and he has dipped into some criminal behavior - stealing. He talks about suicide and tells us that it is just to scare us. He refuses to see a therapist and blames us for everything - including his criminal behaviors. We adopted our son as an infant and it seems that some adoption issues are entering the picture also - his anger at his birth family comes out in his rages. He gets very verbally abusive towards both my husband and me and breaks things around the house and punches holes in the walls. When he does not get his way or we try to impose a limit, he loses it. After the most recent incident, he tried and failed to break into a bike shop, was paper arrested and brought home in hand-cuffs; he was totally disrespectful to us when we gave him consequences. We took his cell phone and discontinued his car insurance for driving. Both privileges, we explained would be returned if he went back to school or got a job/apprenticeship, and that he start to show more responsible behavior. His rage escalated and he took my cell phone and physically restrained me from getting it back. He continued to be verbally abusive and pound holes in his bedroom walls. He was also threatening to hang himself. At this point, we talked to Suicide Prevention who recommended we call 911 and have him taken to the mental health hospital near by. We did this and that is where he has been for the last 4 days. We have attended all of their meetings but our son refuses to attend and insists we get him out of there. The first couple of days he told us if we didn't get him out of there, he would punch us in the face. He is so angry that he does not speak to us at this point. We feel that it is time to find him an alternative living situation rather than home. This is agonizing and we now are faced with deciding what is best. He has much support from family and has had many successes in his life but he doesn't seem to be able to draw from this which makes it all the harder. He is a good kid that is spirally down quickly.

[Mike Bradley]

Dear Parent,
What an agonizing situation for you. However, know that you are closest to solving his problem right now. His raging and threatening tells you that you are close to getting at something he's determined to keep hidden.
Under no circumstances should you "get him out" of the hospital. Those folks need to figure out what is going on with your son, and what treatment he needs. This sounds potentially like a bio-chemical disorder that is best diagnosed in that hospital. If you haven't already done so, get any bio-family mental health medical history data you can as quickly as you can to help the docs.
Finally, be sure to report his violent threats to his docs so that they take the proper actions to keep everyone safe here.
Good luck and please keep us posted.

[ECE]

Last night we had a break through with our son. He called and wants to talk about returning home and is willing to listen to our conditions. The doctors have identified him as ADHD and are treating him with a mild dose of Concentra and have also labeled him as having Intermittent Explosive Disorder and want him to take mood enhancers. To date, my son is taking the Concentra but refuses to take the mood enhancers. They expect he will be released from the hospital this Friday. We have some worries. Despite our son's statement that he will follow our rules, we are not convinced that he will follow through especially when the going gets rough. When he does come home we expect that he will not only follow house rules but also get counseling and find a job if he doesn't return to school. Our concern is what happens when he doesn't follow through. We are not sure what real consequences we can enforce and we know we do not want to rely on the police. We are busy looking into the birth family's medical history - we know the birth mom was labeled with a conduct disorder when she was a teenager. We conveyed this information to our son's health providers. We want to hang in there and help him through these difficult times but it is difficult for us to figure out the best thing to do. Thanks for your response, it is more than helpful.

[Mike Bradley]

Dear Eileen,
I hope that this is a breakthrough but it might also be his way of getting out of a place where he can't get what he wants by being crazy. Before he leaves the hospital, create a written contract with your son about the conditions of his returning home. Be sure to include a clause about his agreeing to take the mood meds if he becomes explosive again. Also insist on family therapy so that you guys have a forum in which to work out future issues and to begin to reconnect.
Finally, don't be too slow to call the cops. As you've seen, your son can control himself when he chooses to (as he's done in the hospital) so part of his therapy must be to give him clear limits concerning unacceptable behavior. Tell him that it's fine (and important) to TELL someone that you're angry, but it is not OK to BECOME that anger and take it out on others as abuse or rage.
If he honors his contract, then great! If he doesn't, then you'll have another point of data proving to him that he has serious issues. Try to not get your hopes up too high until you see if he's "for real" or not.
Keep us posted.

[ECE]

Well, the family meeting we had with our son and his social worker and counselor about his coming home was less than fruitful. Our son is still so angry and blaming us for his misfortunes and bad decisions that the meeting went down hill quickly. He also realized that he did not want to come home after the meeting. We were all trying to be very positive and listen to what he had to say about what conditions he wanted when he was home but he failed to make the connection that we, as his parents, would still contact parents of his friends if they were involved in illegal activities that we were aware of and that we would continue to go into his room if his behavior was suspicious (remember he was caught stealing). He did all the talking and basically refused to listen to us, we were not able to talk about any of our own conditions. In my opinion, I think that his social worker is right that we should stay positive and give him a chance to talk but I also think that he needs to face the reality that we will not allow these inappropriate activities to continue and as his parents it is very appropriate for us to contact other parents and check his room when warranted. He is now on a mood enhancing drug called trazadome (100mg). I am also concerned about the fact that this mental health hospital is not doing more to connect us with the necessary community services that he will need. The facility he is in is a critical care facility where the length is on average 5-7 days, he has been there 8 days, but instead of referrals, they suggested we go home and start looking on the Internet for available services. They did say that he will need to see a psychiatrist on a regular basis as long as he is taking this drug. Feeling quite overwhelmed and hoping for some more suggestions. We really liked the idea of the written contract.

[Mike Bradley]

Dear Eileen,
In light of your son's age and on-going threats to himself and to you, stay adamant about his not returning home until you see a substantial shift in his violent tendencies. Be firm with the social worker at his hospital regarding this safety issue and check into your local laws about having him committed to residential treatment facilities until his potential for violence is reduced. He might be unsafe until he gets the right treatment to enable him to peacefully accept your house rules. He must have limits to keep him safe and open to doing the work required for recovering. As cold as this sounds, understand that now you must love him enough to not allow him into your home until he's safe for you and himself. Perhaps use those words in informing your son about your position.
Hang in there and please keep us posted.

[ECE]

Unfortunately, the mental health hospital felt that they were not where our son needed to be, our son was fine while at the hospital but remained hostile towards us. So now he is home and silent, refusing to speak to us except for an occasional obscenity or request for money to buy his own food etc. Life is difficult but it is not violent. We are hoping that with each passing day, he will work through this difficult time and come back around. However, it is hard to stay hopeful because he refuses to take any medications (they only kept him on the Concerta when he was released and a sleeping pill as needed), he does not tell us where he is going, he does not follow house rules and is staying out past curfew. A few times he has asked us to bring him back to the hospital but at the hospital, they made it clear that we should not bring him back there but call 911. We have not had reason to do that since he came home. He also did not follow through on his date with his probation officer because of the stealing incident. We are seeking family counseling for ourselves, our 15 year old daughter too, to try and address our concerns in trying to find the best way to raise him to be a healthy adult. We keep hoping the next 5 months go by quickly, he will then turn 18 and at least we will not be held legally responsible for his actions. On the other hand, we know that turning 18 is no magic bullet where miraculously he will be able to move out and be a healthy adult. We know that a confrontation is looming especially regarding the old VW bug we bought him a couple of months ago. It is currently not running and he is bound and determined to get it running. When we are not supportive meaning we pay for the repairs, the tow etc; he loses it. At this point, with all of his disrespect, irresponsible behavior and unaccountability I feel there is no way we will get that car running for him. On the other hand, if he made a commitment to work in the local VW restoration shop as an intern to not only get his car running but also learn the tools of the trade, I could support that. But another fear is that he would get the car running and not follow through on the internship. He has only applied for one job online and as far as I know has not followed through in person or over the phone. We feel stuck between a rock and a hard place. Some days, I feel he has all the skills and internal fortitude to get through this phase in his life and other days I feel more desperate like he will make so many bad decisions he will not be able to move past it all.

[Mike Bradley]

As hard as this is, count your blessings as well. You have shown him the line in the sand and he appears to be observing it for now. You've also learned that he can control himself when he chooses, so now define you job as getting him to choose wisely. Perhaps offer to match his future job earnings dollar-for-dollar for the "bug restoration fund" provided he observes the house rules as well. Be sure that he earns everything upfront (no credit).
And be sure to continue that family counseling particularly for your daughter's sake. Then dig in and wait him out. Time is on your side (5 months to 18) and he knows that very well.
Please keep us posted

[ECE]

I feel it is important to respond with the positive as well as the desperate news - and as far as our son goes he is maintaining and being respectful to us for the most part. He still has a ways to go - no job yet, not in school and still refusing to see a counselor but he is following house rules, has gone in to the VW shop three times and is helping out around the house to some degree. Our family counseling (for the rest of us) is going well. My daughter is a real trooper and so insightful for her age, she is able to maintain a connection with her brother and still deal with all his craziness. I don't want to make things sound like all is well, of course, we all are on pins and needles hoping that he does not spiral down again; but, for now we will take what we can get. Sometimes I wonder if he just has an unusually difficult time dealing with life transitions. He went through a similar spiraling down time when he entered puberty and now that he is leaving adolescence and entering adulthood a similar situation occurred, I wonder if these life changes are so scary that he temporarily loses it, learns and gets help and then is able to move on. This could be wishful thinking on my part too. Any thoughts on this would be helpful. Thanks for the forum and support.

[Mike Bradley]

Dear Eileen,
Yes, transitional phases can be terrible for many teens, a condition called anticipatory anxiety where they grieve the pending loss of the familiar and predictable (even if that life sucks) and they start to fear the unknown new life looming ahead. This is particularly true for kids such as yours who have little confidence in themselves, in their abilities to survive and even thrive in their new lives. Therapy is very effective with those kids if you can just get him there somehow.
So keep selling counseling. Don't hesitate to offer him incentives (bribes) to at least see what it's like. He might just "buy" one of these days.
Keep us posted.