Monday, October 10, 2011

Too Far Gone

DISCLAIMER: I rarely write about specifics at work, but this is really, deeply bothering me. There are two cases that are very similar, so I am going to combine them, change all the identifying and non identifying details while still leaving it accurate, and sigh deeply over this.

So, there’s this kid, B. B ended up on my case load because B’s guardian threw up his hands and said I can’t do this anymore. B is a danger to me and my family. I’m looking at B, who is still single digits in age at the time, thinking okie dokie. B seems like a sweetie to me. And you know what? B is a sweetie.

Until a switch is flipped, and suddenly, B goes from happy go lucky, kind, and loving to angry, withdrawn, and then violent. Really, truly, glass breaking, table flipping, punching bag violent. These episodes can last minutes, or hours, or even days. Then, all of a sudden, sweet B is back, devastated at what happened, and is begging for help. Why do I do this? Why can’t you help me? What do I do to make myself stop? How do I get better? Then, B is so devastated at the answers, or the lack of answers, or how the answers don’t seem to help, or how slowly B makes progress, that then there’s the self harm problem.

B was exposed to all kinds of highly controlled substances while B's mom was pregnant with B. Then, somewhere along the way, B was neglected and abused, but we don't know when, how, or by who. B's parents are little fizzy on the details of B's life, oh say from birth through the age of 5, when they finally cleaned up. B’s behaviors are classic, textbook perfect symptoms of some of the worst kinds of abuse. But, given the circumstances B grew up in, we will never know what exactly happened to B.

Now we’re approaching puberty, and all those deee-lightful hormonal changes. Now I am seeing B with less sweet moments, and more anger, more outbursts. But even still, when B has those moments of calm, it’s like clarity descends, and B is begging for help again. Why do I do this? Why can’t you help me? What do I do to make myself stop? How do I get better? …I don’t want to be like this.

What’s scarier for me, and for B long term, is now I know B is having auditory hallucinations. B is getting paranoid. I am trying to move as fast as I can to B evaluated and into a placement that is good and helpful for B—because B’s current guardians can’t help B anymore. And they’re right—they and their family are not safe with B in the house, given some of the things B has tried recently.

So we’ve landed here. B’s school is offering a referral to a placement in a therapeutic setting, and B’s insurance is going to pay for it. I just don’t know if it will help. I mean, I know it will help, but can B ever be… I don’t know what words I’m looking for. Normal? Functioning? A productive member of society? They all seem too much, too trite, and not enough for what I want for B, all at the same time.

B has been on my caseload for years now. I can’t help but think that on some level, B is looking at all the adults in B’s life, and is thinking, all of you have failed me in some way, because I am still the way I am. And who’s to say that B’s wrong? I’m not sure I can.

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