All science is the study of patterns. Biology is the study of patterns among living organisms. Chemistry is the study of elemental patterns. Sociology is the study of patterns of human behavior among humans in groups; psychology is the study of patterns of human behavior in individuals.
Human beings are hard-wired for patterns. The first thing that a human infant recognizes is the human face, or any representation of a two eyes over one nose over one mouth pattern, no matter how minimally rendered. We seek patterns, rely on them, create them. Our traffic laws are based on patterns, our worship services, our meals, our education system. Language is built of letters and sounds in patterns, from a baby’s first words to Green Eggs and Ham to booze-fueled late-night philosophy debates to Hamlet. Music, table manners, architecture, the route you take to work, the way I brush my teeth: all patterns.
Mental illness is, at bottom, a pattern disruptor. Healthy people have daily patterns of high energy, low energy, and sleep. A person who is ill with depression becomes unpredictable and may sleep very little or a great deal, and may experience no periods of high energy. Schizophrenia disrupts patterns of cognition; depression and bipolar disrupt patterns of mood and energy; personality disorders disrupt patterns of identity.
Behaviorism is based on predictable human reactions to stimuli, simple cause-and-effect relationships. Parenting a neurotypical child, while not easy, is usually pretty straight-foward until adolescence if parents and other caregivers are reasonably consistent. Humans will repeat behavior that has consequences that feel good; behavior that has results that feel bad will become extinct.
Lay aside for a moment the significant debate about behaviorism, because right or wrong it’s the foundation of most parenting advice in modern America. It’s the thinking behind the vast majority of the criticism that we parents of children with emotional and behavioral differences receive. From the nasty onlooker in the grocery who says, “If that was my kid I’d give his ass a good whipping and straighten him out!” to the sticker charts that books advise to Supernanny’s naughty chair, it’s all based on a fundamental assumption that we can predict human behavior and therefore, shape that behavior.
Carter spits on the stairs sometimes, which most people would call “naughty” or “disobedient.” In general I would agree, and when Carter started with the spitting I delivered consequences. I made him clean up the mess and gave him time-outs. When that didn’t work, I upped the ante and revoked his computer privileges, sent him to bed early, and yelled at him. I failed to recognize my own bias toward behaviorism, the same bias that makes me so angry when other people use it to criticize me.
Carter wasn’t spitting because he wanted to make me mad or because he was testing limits or because he is somehow naturally rebellious. He was spitting on the stairs because his hallucination of little men on the stairs with bows and arrows, combined with a delusion of “super spit,” compelled him. I was punishing him for protecting himself and his family from a threat that was, for him, entirely real.
Even after seven years of living with Carter, 6+ years after beginning the journey toward accepting his differences, 3 years after acknowledging that he was mentally ill, nearly a year after we put the name “bipolar” to that mental illness, I still can’t quite get past my own biases. So as much as I may rant and rage at a world that can’t or won’t embrace a new way of thinking about mental illness and its treatment, I will always have to see myself as one among many subjects of my own anger.
We can’t control everything. That seems obvious on its surface, but the way we live, our cultural attitudes and ideas, say that it’s anything but. As I learn this lesson, this hateful, putrid lesson of my own powerlessness, over and over, Jack London’s stories (especially To Build a Fire) pop into my mind often. Just as humans are at the mercy of nature, the lesson in so many of London’s stories, so Carter is at the mercy of his illness. Not always, of course. He is a person, whole and beautiful under the scrim of disorder on top, and he makes decisions and takes actions that belong to him. But sometimes the illness is so loud and his defenses are so weak that it dictates all of his behavior.
Powerlessness is a bitch.