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The Courage To Become - A Story of Growing Up

    There is a saying that the highest kind of courage is found in our willingness to sacrifice what we are for what we can become. Observing this process firsthand is one of the most gratifying things I experience as a counselor. Here, then, is one such story – with names and details changed to protect the privacy of those involved.

    If I were to have gone by my first impressions, I would have agreed. Yes, the young lady who sat demurely across from me on that initial visit definitely appeared to be suffering from some type of schizophrenia. It was her appearance that gave her away – that and stereotypic mannerisms as she began to speak about her situation. Glancing around with extended interest at everything in the office, this shrimpish, slightly pudgy woman ran her fingers through her matted hair and curled quietly into her chair.

    Her referring physician pegged it, I thought, until she turned her reflective brown eyes onto me. There was a presence in the intentness of her stare that fully contradicted everything I had experienced in working with schizophrenics.

    “I’m not schizophrenic,” Ellie said, “At least I don’t think I am, and I need you to help me find this out.” There was a childlike manner in her presentation. Running through my checklist of mental status signposts for symptoms of schizophrenia, the most prominent impression I gained was the sense of observing a 13 year-old girl in a 22 year-old’s body. It was apparent that she did bathe – on occasion – and her social mannerisms were atypical, to be sure. She was desperate to understand why she had to remain on her medications and why she had to suffer the control her parents had over her life.

    She spent the remainder of her session describing how she was still under the dominion of her parents. They were extremely disappointed in her, because she had been quite precocious as a child but she had, “become increasingly weird,” as she got older. Ellie’s father – a successful professional – was the family patriarch and her mother lived her life through her children. The youngest and smartest of four children, Ellie was slated to follow in the prominent footsteps of her father. She withdrew, by her descriptions, into her own world because she felt the life sucked out of her by her parents’ demands on her.

    “I didn’t want to study science. I hate science. I wanted . . . want . . . to study art . . . and to write,” Ellie said. The slightest flicker of a smile flashed across her face in the painful incongruence of her effort to fight back tears. Her initial demure presentation – taken by me as a sign of flat affect under the influence of the referral data – had thrown me off. Here was eye contact. And emotion. I wondered if some of her muddled presentation was due to her medication.

    “But they say I got sick,” she added, seeming to intuit my thoughts, “and put me on all this medication!”

    “Perhaps, it is your medication that helps you be able to live your life,” I tested.

    “It’s ruining my life! I’m coming off it!”

    Ellie described a lifelong struggle with her parents. Her childish and marginally socialized mannerisms were betrayed by her use of forty dollar words, far outside the range of her formal education. By her disclosures, her father increasingly confronted her with her idiosyncrasies and endlessly expressed his regrets at her failure to meet his interests and expectations. Her mother carried out the marching orders of her father. They became embarrassed to have her with them, so she spent her out-of-school time at home, working on her art and her writing. She had little socializing contact with peers, but befriended “another geeky” boyfriend down the street.

    When she got pregnant by him at 17, her parents orchestrated their marriage and set them up in an adjoining residence. Now, her parents orchestrated control over her, her husband and their small children. Oh yes – make that just her and her children, because her husband had recently moved out because he couldn’t stand to live near her parents, and maybe she was crazy after all.

    At the close of the session, Ellie made a disclosure that increased my suspicions about the accuracy of her diagnosis.

    “Wow,” she said, “That’s the longest anybody has ever talked to me.”

    “But, haven’t you been seeing psychiatrists and therapists on a regular basis for much of your life?”

    “Psychiatrists . . . and another therapist I didn’t like because my dad appointed him,” she said. “Psychiatrists only talk to me for 20 minutes, looking for exacerbation of my symptoms, then they sometimes adjust my medication. I want to find out if I am really schizophrenic and that will only happen if I bug-out when I’m off my medication. Then I’ll know what I can do.”

    “What will you know you can do?” I inquired.

    “Leave! Leave my parents, take my kids and husband and go away – far away from my parents. I’ll finally be able to get a job and go to school to study art and writing.”

    The stakes had been raised by the second session. At Ellie’s request, I had called her referring family physician to inform him of her wishes to be taken off her medication. It was a delicate situation, I told him, because her father and her psychiatrist were close friends. But Ellie was an adult now and the bulk of her conflicts seemed to be around issues of becoming her own person. I offered a provisional diagnosis of Schizotypal Personality Disorder, which accounted for her odd, “geeky” schizophrenia-like symptoms – but without the psychosis or dysfunction associated with schizophrenia. It was apparent that, without taking this risk, Ellie would never individuate into her own person. Her doctor volunteered to monitor her medically as she discontinued her meds.

    As she tapered off her medication in the weeks that followed, Ellie began to improve – even on the day her counseling became family knowledge.

    She arrived for the session in a mild panic. “I’m not supposed to be here,” Ellie almost whispered. Clearly drawing me into the scope of her own conspiracy, she excitedly added, “My mother was glad that I wanted therapy, but she didn’t want you. What do I do? She arranged for me to see some big-time doctor in Charlotte.” (God forbid! Not some country counselor!)

    “What do you want to do?” I asked. “From here on, you have the opportunity to express yourself as an adult.” We spent the session reviewing the dynamics of her relationship with her parents – including how her mother had never really wanted her to grow up and how her mother was now raising Ellie’s own children. The terror of her making real choices for herself emerged. We talked about her limited and distorted socialization as underlying factors in her “weirdness.” She wondered – anguished – over what her mother would do to her if she didn’t go to her parent-approved psychologist.

    Over the weeks that followed, Ellie came faithfully to each session, and with each visit, she exhibited marked improvement in her socialization and communication skills. Her husband continued to drive her and pay the modest sliding scale fees, though she yearned for the day when she could be independent-enough to drive and help pay bills. We included a feminist theme in her recovery process and with each session, she increased in insight about her mother’s dilemma and began to extricate herself from the issues of her parents.

    And with each session, as she moved further away from the over-medicated regime that had so defined her life, Ellie presented in an increasingly functional and confident manner. She brought her art and her writing into my office, sharing how her new-found growth had inspired her creativity. Unquestionably, she had potential in the interests of her heart. I was routinely available to her by phone, and she sometimes took appropriate advantage of that. As she improved, communication and intimacy issues with her husband naturally came up. We decided to invite her husband into some sessions and we worked successfully on their relationship. Then, one day, she arrived for her session in a panic.

    “Do you know they are threatening to take my children away from me?” She tearfully described how her parents were initiating the process of seeking custody of her children. “They know I want to leave! That’s why they are doing this – I will never be able to get out of their life!”

    I encouraged her to look at her options, but she insisted she had no power over the influence of her father and his capability to wield medical and legal authority to meet his interests. She felt it was time to leave. We talked until her husband came to pick her up. Everything in me wanted to tell her it was time to go – that she was now an adult and she should make decisions for herself and her family; that maybe she was right about the power of her parents to maintain control if she remained under their influence. But that’s not what counselors do. Our role is to help people make their own healthy decisions.

    “I have complete confidence in you that you will do exactly what you need to do, for your sake and that of your family,” I replied. She looked at me first in shock, then in recognition – the expression of resolve spreading across her face like the sun coming from behind a cloud.

    I never saw Ellie again.

    A letter came a few months later. She and her husband had taken their children to another state – literally moving away in the night. She was now driving and she was in the process of getting a job. Her last letter came a few months after that. Ellie was enrolling in college to pursue her dreams.

Granville Angell © 7/2006

Granville Angell, EdS, LPC, NCC, a licensed professional counselor with 30 years experience, invites readers to submit questions for his column to his web site: www.transitions-counseling.com . He may be reached at his private practice, TRANSITIONS Personal & Family Counseling Services by emailing angell(AT)transitions-counseling.com.

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