Friday, May 22, 2015

Was writing this book therapeutic? Q&A on suicide, bullying, trends in treatment, and the next book

Q&A from Readings 

I was in St. Louis last week promoting my book. I give a talk with a few readings in it where I talk about a lot of the issues in the book and give some anecdotes from my professional experience. I like to have people write their questions down so that they can ask things anonymously. I've written up a Q&A from the 2 talks I gave most recently which includes answers to some questions which were asked aloud as well as some that were written.

Narrative as Therapy

This question was more of a comment that I found interesting from a psychiatrist who'd read BetweenFamilies. He seemed to see narrative as a means of separating the self out of it, in order to see the value of a person/character. Then by externalizing and finding solutions to the problem through narrative, integrate those same solutions back into the self. I love it. I hope so.

Was writing this book therapeutic?

Yes and no. There were parts that were just work and other parts I found helpful.

The No- When I was 17, I attempted suicide and there are scenes from the book that came directly from that experience. I still feel guilty about having done this and writing about it opened that wound up for me. I'm not sorry I wrote about it, but I wouldn't say it felt therapeutic.

The Yes- I stole from my own life when I wrote Seffra's bullying and sexual exploration scenes. I found writing about them made me more able to see myself as a normal protagonist and watching the way I wanted it to go for her and the way I'd dealt with those issues was validating and cathartic.

How have treatment centers changed since the 1990s when Between Families takes place?

I can't speak for all treatment centers but will try to give a general idea of some changes that have taken place.

1. There are fewer children in institutions today than in the 1990s. Legislation and best practices have caught up to the concerns about institutionalizing children and so the number of children spending time in treatment has been greatly reduced.

2. Children stay in treatment centers for shorter periods of time than they used to. The standards for how long children stay has also changed. Seffra, in that way, is more indicative of current practice. When she was in treatment, in all actuality, she would have stayed much longer, more like a year and a half or two years. For the purposes of story arc, I made her stay more along current lines of 6-12 months.

3. Restraint policy has made huge strides in reducing the frequency of restraints. I mention this in the front matter of my book, but children are physically restrained far less frequently and the standard for when it is acceptable to restrain has changed. Even since I started working with kids in the early 2000's, these things have changed. It used to be that children were restrained for non-compliance, meaning, they didn't do something an adult told them to do. That is unacceptable and reportable as institutional child abuse in today's treatment world. Children are only permitted to be physically managed, or restrained if they are a serious threat to themselves or others. Obese children are not restrained as the danger to their health is too risky, and children are not allowed to nap after a restraint due to the health risks.

4. Treatment centers are fewer and farther between and I believe they provide broader and better programming now. The reduction in the number of children going into institutions and their shortened stays as meant that the centers who have continued to provide treatment have changed to accommodate the clients that they get. This means they take a wider variety of client and so many different needs are met in one location. Additionally, the approach has been (in most places) to come from a place of compassion and try to take into consideration the needs of the child and the meanings of the behavior, so as not to simply manage an environment but to provide a short term place for a child to be in a truly therapeutic environment and to stabilize before moving onto as to close a home environment as possible. For example, when I worked in residential, we had a sensory room so that kids who had trouble with sensory integration could go to a room for breaks where there was a therapeutic swing, weighted blanket, and other items to provide for their specific needs.

Some philosophies and spiritualities propose that everything that happens to us has opportunities to help us grow from the pain we go through. For adults who have experienced traumatic abuse and have difficulty moving out of being in victim mode, do you believe that all people have the capability to heal and rebuild their lives, or is that the fortunate exception?

The cases that I saw where I was genuinely afraid there was no coming back, I can number on one hand. I am an optimistic person by nature, but I believe most all people have the capability to do much, much more than any of us could conceive. Ralph Waldo Emerson said it best, "what lies behind us and what lies before us are tiny matters compared to what lies within us."

I don't know that it feels like that when we're in the thick of it but I absolutely believe it to be true.

Has a neurochemical relationship been established to explain the resultant health issue of high ACE scoring in people?

I don't believe so. I think the score has been studied extensively in relationship to all manner of problems in later life and links to high ACE scores and heroin are distressingly strong. This is not based on research but I suspect intuitively that the significant stressers of trauma in early life happening at the same time as a body is developing the building blocks of cells and all its systems, interferes with those important processes and there are resulting long term health consequences.

In the case of an abusive situation that's been dismissed by Social Services, are there other options?

My experience in my own community is that there are many options and community partners who seek to help in these scenarios. The child welfare systems is overwhelmed and aware of the controversial nature of having cases with families and are attempting to offer voluntary services and send families to outside agencies for casework. It really is community by community though.

What do you hope people will take from this?

I hope the public will be aware of the lives that people lead, including people like Seffra and the kids I've known who she is based on. I hope people who have led these lives will take strength from Seffra; that they will see a gritty real character and sympathize and wish for her to succeed and in so doing will see and accept themselves in new light. I hope if someone has lived this way and this story did not resonate with them, they will write their own, better version.

I hope people will see strengths in Seffra and in kids like her. They are remarkable people.

When does the next book come out?

The good news is the rough draft is written! And while that's definitely something, there are many factors that will determine how long it will take for the second book to come out. Quality over expedience though.