"You have no idea how I've suffered. My son was the light of my eyes. He won every award in elementary school. I could show him off anywhere. He was such a pleasure. I was proud of his accomplishments. But now, he is lost to me. Lost. He is disrespectful, stays out late, curses at me. What should I do?"
"You might consider..."
"Yes, but we already tried that. And it's not just marijuana I smell on his breath. I was searching his room and I found Xanax. Pills! Dozens of them! And when I checked the messages on his phone, I learned that he is dealing. Dealing! Can you believe it? After all I've done for him. It's not like he needs the money. I buy him everything he wants. Do you think he needs rehab?"
"What some families in this situation have done is to..."
"Yes, but that won't work. He went to a music festival. The music is horrible. Horrible. And so loud. I don't know why anyone would want to listen to that music. All the children are impaired--drunk, stoned, blitzed. I think my son may have taken Xanax. Do you know other adolescents who have taken Xanax?"
"The first question we might ask is..."
Yes, but I already thought of that. My son just turned 17. But some of the children at the festival are older. Many of them are adults. They have beards and tattoos. I only gave my son six hundred dollars. He asked for eight hundred dollars, but I didn't want to enable him to buy more drugs. That's why I always told him to smoke pot at home. With me and my friends. So he wouldn't drive when he was stoned. I said he could only smoke pot in moderation like my friends and I do. But now I'm worried that allowing him to live on the boat behind our summer home may have been a mistake. Do you think we should have asked him to live in the house with us?"
"I'd like to show you some research that suggests that..."
"Yes, but I've already read some research. He's not getting any better. The psych-stimulant I gave him for his ADHD when he was younger didn't work so I started him on an SSRI when he was in middle school because I thought he might be bi-polar but that didn't work so I tried atypical anti-psychotics and mood stabilizers. You can't imagine how difficult this is. He just gets more and more oppositional and defiant. Do you think I gave him the right medications?"
"Before making a suggestion about dosages, I'd like to ask you if..."
"Yes, but you just don't understand how hard it is to live with him. I had to cut my St. Moritz vacation short to bail him out of jail. He said the 200 ecstasy pills weren't his and that the police were rude to him. I believe him. Do you? Do you think that the 200 ecstasy pills were placed in his backpack by a kid he barely knows who wanted revenge on him?"
"In my experience, it is seldom the case that..."
"Yes, but I know that already. His hearing is next week. I've already paid over $20,000 in criminal defense attorney fees, but at least he hasn't had to spend any time in jail with those rude police officers. Do you think I did the right thing by bailing him out?"
"I feel certain that..."
"Yes, but he's different from all your other patients, Doctor. Remember what good grades he got in elementary school. Well, thank you for your time. You've been most helpful."
I woke up in a cold sweat and was again thankful that I am not a psychiatrist. I still felt badly for the imaginary women described above. Yes, it seems like some of her choices were imperfect--smoking pot with her son, enabling his drug use, over-medicating, parenting by phone--but I don't know everything. I certainly don't judge. Every family is different and what works on the west side of my home on 62nd Avenue may not be effective on the east. What saddened me the most was this mother's inability to listen to or profit in any way from her session with the doctor.
"Yes, but" is as powerful a defense as it is an unfortunate one. The devil we know is indeed preferable to the difficulty of engaging in positive change. I hope this woman is able to open up and at least hear about the experiences of others so that she will have information on which to base her decisions going forward. It certainly sounds like she needs to change the position of her sails because the wind is blowing hard. She can see the storm swelling on the horizon; she needs to make some adjustments or the boat of her family may capsize. Whether or not a health care professional can help her get back on course depends on her ability to stop saying "Yes, but" and start listening.