The end of one year and the beginning of a new one seems to bring out a moment of reflection and evaluation in a lot of folks. I am grateful for that as several of my patients from years back have taken the time to send me a message. They usually just say that they remember me, and that I was helpful. Some say more than that, giving me credit for things I don’t remember saying, or for transformations that happened during the time that they were in therapy. I certainly enjoy reading those messages.
That’s the good part of the year’s end transition. The more upsetting part is that when one patient contacts me to say good things, it reminds me of some of the other people I was seeing at the same time. Memories get linked the way. I don’t like how much my memories of the people I didn’t help that much overshadow the good feelings I get from those who did well.
Yesterday, I went through that whole cycle while sitting here at my desk as the early sunset came pouring through the window, making reading on my computer screen difficult. A message from one person led to to search for the name of another. I quickly found what I expected. He was arrested last year for the possession of a Class A substance.
“Sammy” was a young man I saw about five years ago. He was sixteen the last time we met. He was brought to see me by his mother, who I had been seeing at the time. He was very ambivalent about coming. He wasn’t the ideal psychotherapy candidate. He was untrusting. He couldn’t make eye-contact. He was almost non-verbal. If he spoke at all it was in one word sentences. Two words made a paragraph.
All of this he came by honestly. His father had drifted away when the boy was about four. The father had a drug problems of his own, and probably many other problems in addition. His mother was very hard-working, very depressed and she herself had come from a family that was so messed-up it would take about sixteen pages to just give an overview. So, when she would get involved with some men who wanted to save her it was never good for her children. A couple of the men were especially harsh on Sammy, who was sullen, disrespectful, and not very cooperative.
I could go on and on, and I should actually, but no one reads two-hundred page blog posts. But the message is that “mental health issues” are very complex. They don’t lend themselves to clear, consistent solutions. Sammy was the kind of kid who, if I really wanted to help him I should have taken him home. I could have said to my wife, “Hey, this is Sammy. We are going to wash him, feed him, and keep him with us for five to ten years. We will sand end him to school here, where there is a good school system, and we will go to school once or twice a month to make sure we are on working together. We will try to limit his time playing video games and then try to help him make one or two friends. We will try and protect him from being bullied, and show him that he is talented and capable. We will try to make sure he smokes only a limited amount of pot.
It probably would have also helped if his mother came to live with us on weekends so he would know that she didn’t abandon him. If he went to be with her on weekends those two days would have probably undone whatever was gained during the five days he stayed with us.
But I din’t take him home. I have this rule about not taking any patients home. Even if I did I don’t know how successful an intervention it would have been. I’m not his uncle. His uncle is in jail.
I did go to several meetings at his school. I tried to get one of the school counselors to see him because his mother was having so much difficulty to get away from work in order to get him to my office. The school essentially told me that they didn’t like him because he was sullen, withdrawn and difficult. Essentially, they blamed him for having all of his problems. and even encouraged him to drop out and go away.
These memories bother me. When I read about people who are homeless, or people being shot by police for brandishing a stick or having a lump in their pocket, I think about Sammy. When I know that there are thousands of young men getting thrown into jail, or dying in messy apartments of drug over doses, I think about all of the Sammys I’ve seen.
The underlying causes are probably genetic, partially. Certainly abuse, poverty, and lack of supervision and encouragement don’t help. The lack of resources, support, and concern by the community adds to the problem. Then his difficulties get defined as a crime which makes everything worse.
So now I don’t know. I don’t know if he is in jail or just on probation. I don’t know if he will be scared enough, or get enough support to stay our of further trouble. Can he get a job and make enough money to support himself? Is he capable of having any kind of real relationship with anyone?
I know that he really never did anything wrong, or actually hurt anyone. He’s not a criminal unless being poor, depressed, confused, bullied and pushed aside is a crime. I know that his mother still cares. She is still out there trying to get him into a rehab, but the beds are full and the treatment is short.
The rest of the world doesn’t really care about him and all of the Sammys. They are difficult and embarrassing. Eventually they just get swept up and put in the trash. The real problem is that treatment is too complex, and more importantly, too expensive.
I know I tried. But it wasn’t enough.
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