Wednesday, September 12, 2012

name a hero, explain and thank them for it

Steve Martin is one of my heroes, not for his fiddle playing or even his stand-up, but because  the first time I ever saw The Jerk, which he co-wrote and starred in--it resonated.  I had finally found somebody who understood my inability to belong in any place that I actually fit. He nailed the ambivalence of foster care and my alienation from a crazy family before that. It wasn’t just that I was black on the inside and white on the outside, at least sometimes, but that I was a variation of white, black, brown, yellow and red on the inside- from all my families- even if the outside never seemed to match up.   

“Ashy-white thing.  Four-eyed, buck teeth and your momma wasn’t a glassmaker.”  Turns out my momma was a glassmaker, an hour-glass maker, anyway.  

Thanks for being alive, Steve and putting your misfit characters into the world.  It made me darkly-optimistic at eleven that I could find my place to be.

Tuesday, September 11, 2012

February 12, 1982: recommendations and my delayed response

This psychiatrist made five recommendations, single spaced- a page long. I'm happy to post all of it, but these sentences stand out:

1) The child should be removed from the home.  I do not think this child will develop normally in this environment.

2) Many of her conflicts are internal (depression, phobias) and I think intensive therapy two or three times a week with this child for a period of six months to two years could mean the difference between a totally dysfunctional borderline adult and a productive member of society.

Thirty-one years later, all I can say is thank you dear psychiatrist. Thank you for using your words and getting me out.

At forty I understand a few things that didn't make sense at nine.  The deep down dirty secret is this: I told.  My bio-father was transitioning from guru to cult leader, right before my eyes.   He wasn't alone, he was pushed even, by a wife with a Ph.D in communications and a business in stress reduction workshops.  My step-mother's  arsenal included the Meyer's-Briggs and a teenage daughter who was as backfische as can be.   My father's arsenal is best described by the psychiatrist who interviewed him thirty years ago, "a bearded white male who was quite tall and muscular."  In other words: hot young Jesus material.  A carpenter to boot.

A year after your death, all I can say is thank you dear dad.  Thank you for finally moving on.

February 12, 1982: diagnosis and dynamic considerations

Psychiatric diagnosis:

Access 1 - Conduct disorder a typical  with depression
Access 2 - Borderline personality traits
Access 3 - None
Access 4 - Severe
Access 5 - Fair

Dynamic considerations:

This young girl shows many classic signs of the abused child and the neglected child.  Her superego is quite severe and her world is split into good and bad.  She also has suffered multiple traumas which include abandonment, physical abuse, and sexual overstimulation (by history).  She describes her feeling at home as being one of constant tension and not knowing whether she is being good or bad.  She does not have enough internal reality testing in her superego to internally know whether she is good or bad.  She seems to be in constant fear that her anger will overwhelm her and cause her to be abused.  I would suspect that she feels the reason she was abandoned early by her mother is she was bad.  It seems that her early dependency needs were not met at least by her father and probably also not by her mother.  She probably is in great conflict when she gets in close proximity to something she wants.  Since as an infant when she had basic needs she was simply locked in a room and cried herself to sleep.  I would suggest that she has a tremendous amount of unconscious and preconscious rage which is directed mostly at herself during this interview and probably episodically at the environment.

February 12, 1982: interview with the child

Lee Stephanie Barr is a 9 1/2 year old, white female, who looks smaller than her age, has short, brown hair cut in a pageboy and has a hint of hyperteleorism (sic).  She came willingly to the interview room and shared a coke with me.  She was a very anxious child and many times she would be pulling on her fingers and biting on her fingernails.  She sat quietly in a chair throughout the interview and seemed to be extremely over-controlled.  She was able to discuss with me her reading habits, that she liked mysteries.

She stated that sometimes, she felt very sad and lonely inside.  She stated that she hated her natural mother's guts and this was a constant source of irritation to her.  She also stated that sometimes she felt she might die.  She said the way she might die would be to be in a car wreck or something like that.  When I asked her if she ever thought about hurting herself she said that she guessed that someday she might commit suicide but had made no plans.  When I asked how she would commit suicide she said she would take a knife and stab herself but she didn't know how she could do that.  During this time she was very tearful and her affect was appropriate to the suicide thought content.  She, however stated that she had no intentions of hurting herself at this time.

At this point in the interview I asked her how she would feel about living outside the home at this time.  Her affect brightened considerably and she stated she thought that would be a good idea, although she was going to miss her parents.  We talked about several issues about ambivalence about leaving so many people.  She stated she was extremely frightened of her father.  She did this in a forthright and open manner and did not seem to be manipulative at all.  She stated she was frightened  that if she said the wrong thing at home he would take out the belt again and hurt her.  She described the beating incident as a fifteen minute yelling and screaming session in which he put her up against the wall and beat the back of her legs with the belt.  She was terrified that it might happen again.

She stated that she had a lot of trouble with anger that was in her.  She also had a lot of trouble figuring out whether she was bad or good.

She described her peer relationships adequately.  She had one best friend who never sits with her on the bus.  She said school was a constant source of irritation since the children pick on her there.

She stated if she had a child that didn't act right she would give the child a spanking.  She said she could do this because she owned the child.

However, when I gave her an example of doing the same thing to an animal she said it wouldn't be right because it would hurt the animal.

Throughout the second half of the interview the patient was tearful and required kleenex.

Monday, September 10, 2012

February 12, 1982: interview with the parents

Mr. Barr is a 34 year old white male.  He stated in his social history that he has been married three times and divorced twice.  The patient is his only child.  Allegedly, first wife was five years older than he.  His second wife was nine years younger than he.  His present wife, Norma, is 10 years older than he.  Mr. Barr is the second child of three boys, his father was a general practitioner in Florence, Texas.  It is stated that he had a poor relationship with his father.  The social history also states that Mr. Barr demanded lots of love and affection from his father and never seemed to get enough.  As an adult it is alleged that he was trying to hurt his father by telling him things like:

1.) I am heavy into drugs;
2.) My wife and I were taking LSD to see if we can produce a normal child; and
3.) When Lee Stephanie (sic) was in the grandparent's care,  Mr. Barr would take her away when he would notice that they were enjoying her company.

Mr. Barr's mother died when he was 14 years old.  His father died four years ago of a heart condition (quoting Mr. Barr).  Allegedly, Mr. Barr emotionally abused his first wife, Juliet Habsburg-Bourbon (sic) in the same manner that he allegedly abuses the child (interrogation, accusations, yanking, pinching, poking, and hitting).  Mr. Barr was in the Air Force for four years and was stationed  at Lackland in San Antonio.  He has three years of college and took courses in pre-med psychology.  Presently he works as a carpenter and helps his wife teach communication skills seminars.  Allegedly he and Norma attend the Unity Church of Positive Prayer.

The patient's step-mother, Norma Barr, is a white female approximately 44 years old.  She has been divorced once.  She has  two children.  Her oldest son Chad is 20 years old and her daughter Shea is 18 years old.  Her ex-husband is the dean of ________ in Clarendon, Texas.  She has been married to Mr. Barr since 1979.  She has a Ph.D. in communications skills and teaches seminars in stress reduction.  Little is known at this time about her early psycho-social development or anything other than the facts already stated.

The parents were slightly anxious people as they came to my office.  Mr. Barr is a bearded white male who was quite tall and muscular.  Mr. Barr was directed by his wife throughout the interview into what general areas she should talk about.  As an example, his wife told him to start the interview by relating to me the early childhood of Lee (sic).  He did this in a very detailed manner.

He stated that he and his wife had married when he was living in the northwest and attending the University of Oregon.  They had the child after two and a half years of marriage.  He stated that the child was " always strong willed" and if wasn't until she was 18 months old that he realized that she cried and tantrummed when she didn't get what she wanted.  He stated that the only way to stop her tantrumming behavior was to put  her crib and shut her door and let her cry herself to sleep, or to give her what she needed.  He preferred the former method.  He stated that he and his wife had great difficulty in their relationship and had several separations before they were divorced.  They came back to Austin and finally divorced here.  The child was given to the mother and remained with her until age 4.  The father states that the mother had multiple boyfriends and that the child slept in the same bed while the mother had sexual intercourse with these several boyfriends.  He then described the child's natural mother as being "crazy"and described her fascination with witchcraft.  He stated that she tried to drill a hole in the front of her head at one time and that she also put a very large bell on her right ear and ripped her earlobe.  He stated that he thought she was doing "drugs and that these were causing her to become crazy."  I asked him about the family history of the mother and he statd that her mother was living in San Antonio with 8 dogs and in his opinion she was also crazy.  He stated that his first wife's father was an internist in New York who many times would abuse his first wife.  He stated that even when she was an adult he would spank her across his knee when she was nude.  He did not elaborate on this.  He stated that at the age of 4 years the patient was taken to his parents' house in Vernon, Texas by her mother and left.  He said that the mother told his parents that if the did not take the child, she would start ringing doorbells until someone would.  He then stated that he did not even know this had happened for 2 1/2 months.  He was not able to give an explanation about why he had not kept up with the whereabouts of his daughter during that time.  He stated that after his father died he had remarried, his present wife, and he sued of custody of the child.  The case was settled out of court with the stepgrandmother giving custody over.  He stated that ever since the child had been in their home she had been a problem.  She is described by him as being extremely manipulative, always wearing a happy face but being very angry.  He did not describe his own feelings about the child but did give an objective description of the child's behavior.  He tended to lump the child's behavior into bad and good character and did not give my any insight into why she is the way she is.  Rather, he stated that there was something wrong with the child and that it was he who was the abused person and not the child.  He denied abusing the child except for one spanking incident which the child had reported to the school.

Norma Barr was a meticulously dressed, silver haired lady.  She gave a very detailed account of her feelings on family life and also her feelings that rules are made to be followed.  She stated they did not allow the child to watch soap operas or the t.v. show "Dallas".  However much to her dismay the child would not follow the 17 rules that had been written down to the house and this had been a constant source of disagreement.  At no time did she express any dismay over the fact that the child had been beaten by her father.  Mrs. Barr became quite anxious at every point in the interview at which I mentioned family therapy or trying to "fix this situation".  It was again an objective descriptive type of interview with this lady.  She described all of the behaviors of the child in a matter of fact way.  She stated that they had "done everything in their power that they know how to do."  

When I mentioned the possibility of placement the parents were very supportive and stated they wold do whatever it took.  They were also receptive to permanent placement of this child.

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