Parents are often unsure about how to relate to their children after they come home. This is particularly true if the hospitalization resulted from some significant life-changing event, like a suicide attempt. During a family session where we were discussing discharge plan for a 16-year-old teenager who was struggling with low self-esteem and suicidal thoughts, a father asked bluntly “Am i suppose to kiss her ass now?”
For some parents, child’s hospitalization is a rude introduction to mental illness which can leave them feeling shell-shocked. For others, it’s yet another setback in a long struggle with their child’s chronic illness. For all parents child’s illness creates a sense of sinking apprehension: “what am I doing wrong??”
The father who captured the dilemma so nicely, felt blindsided when it emerged that his occasional comments about his daughter’s weight were very hurtful and exacerbated her underlying depression. Resentment persisted when he would enforce house rules and curfew.
The short answer I gave the father was a categorical “No.” His daughter will continue to go to school, and should be expected to do her homework, clean her room, and turn in her cell phone at 10pm. Her life is not all rosy, but she is neither an invalid, nor royalty.
Supporting your son or daughter with mental illness does not mean relaxing common sense rules, compromising on safety, or giving in to more demands. Rather it means 1) improving communication and staying 2) rational, 3) supportive and 4) consistent. The specifics of implementing these principles vary from child to child, but at their core, these principles are the foundation of good parenting. It’s worthwhile to deliberately think about and discuss each one within the family as well as with treating professionals.
For the young teenager coming home after a week in the hospital, we discussed treatment recommendations, safety plan, her needs and responsibilities, as well as the needs and responsibilities of the parents. We asked the parents to put themselves in her shoes, and to try to imagine what it’s like to be an adolescent who on one hand is wrestling for independence, and on the other, needs warmth, love and support. This is true for all teenagers. In her particular case, the struggle with weight, body image, and depression provided additional challenges.
Supporting your child after hospitalization refers to being “tuned-in” to the particularities of their age, development, strengths, and struggles. Being tuned-in does not mean avoiding the topic of illness or dysfunction, or pretending that everything is normal. It means being increasingly sensitive and available. In most cases, saying something like:
could open a dialogue. Underlying this statement are the first three principles of parenting outlined above. Checking in with your child regularly and consistently with this attitude takes care of the 4th.
Our patient told us that she is not willing to get into discussion about her weight or body image with her parents at this time. One area she thought that her parents COULD help her, was by not having soda in the fridge which would help her cut out liquid calories. We all agreed on treatment recommendations (therapy and medication), and a safety plan.
Parents have an important role in their children’s lives, long after they learn to brush their teeth and feed themselves. After a psychiatric hospitalization, the balance of their needs, abilities, strengths and struggles is particularly tenuous. Attending to the basic principles of good parenting will help in the most complex or difficult situations facing your child and your family.