Wednesday, August 17, 2011

A Child's Pain, and Her Parents' Hope

There's our Teresa, playing with Josefina. Teresa is eight years old. She is the lively, cheerful mischief-maker in the house. She is also thoughtful, sympathetic, and affectionate. She considers things carefully and feels things deeply. Lately she has been worrying about a lot of little things.

But in the last few days, she has been afflicted.

She lays on the bed, with vacant eyes. She looks at me like she doesn't know me. Then she starts screaming. And she won't tell us what's wrong. We ask her and she screams louder. She scared us so much the other night that the only thing we could think to do was to take her to the ER. I know, obviously, that mental illness runs in the family. It runs right through me. But at a certain point one throws assumptions out the window and starts to think, "Is my child having a seizure? Is this going to get worse? Is she going to hurt herself?" Going to the ER is sort of the modern equivalent of calling the doctor in the old days (except you go to them instead).

So now she has seen several doctors and had blood tests, and we are trying to keep her comfortable while we wait to see what comes next. The work of keeping her calm has been exhausting for both Eileen and me. Of course, there are many possible causes for this, and we have to let them look at different things, but I think I know what's going on.

In my book I talk about a range of illnesses which are beginning to be classified as neurobiological disorders--these are "mental illnesses" that are rooted in chemical imbalances in the brain or the failure of the brain to carry out properly its delicate and complex operations. We know that neurological disorders can cause people to have chronic "tics" or muscle spasms. Well, it appears that on a more subtle and "invisible" level the same kind of disturbances in brain functioning can cause "mental spasms"--quirks, repetitions, or distortions in the imaging, impressive, and expressive activity of the brain that accompanies our thinking.

Thinking is fundamentally spiritual, but in the human being who is a mysterious union of soul and body it is something that is done in conjunction with (and is therefore affected by) physiological processes. We all know that drinking alcoholic beverages affects the brain and thereby inclines us to perceive things differently and even to "think" differently. Surely it is possible that all kinds of circumstances that we do not yet understand may affect (and afflict) the brain in more subtle ways. These circumstances may even be rooted in genetic factors, which seems to be the case in more obvious, visible neurological disorders.

Certainly all this has become something of a fad in some sectors of the psychiatric field. These kind of problems are overdiagnosed. They are also overmedicated, or many of the medicines made for them are clumsy and ineffective. Having said that, it must be admitted that the great achievement of modern clinical psychiatric medicine has been the discovery of the neurological basis of many mental illnesses. Moreover, advanced brain imaging technology is confirming the clinical evidence. We are just beginning to learn the need for careful and attentive medical care for the most important and mysterious organ in our body, the brain.

We have learned that the brain can't be ignored. Psychoanalytic therapy has many values, but we know it won't help a person with Tourette's Syndrome. Now we also know that it won't help the underlying condition of a person with Obsessive Compulsive Disorder. The same thing can be said for many (though not all) types of depression, anxiety disorders, and that increasingly expanding category of complex conditions called "bi-polar" disorder. Psychotherapy has its place, especially in helping repair the life damage that comes as a consequence of these conditions. Certain types of therapy may even help stimulate healing processes within the brain itself. But what we know for certain is that in these situations the brain, as a physiological entity, needs medical help.

We are also learning that the brain can't simply be nuked with medications that are designed to counteract artificially its chemical or functional imbalances. "Brain medicine" is a delicate art of integrative health care, and here it is especially clear that it is impossible to be effective without treating the patient as a whole, i.e. as a human person.

It is also worth mentioning here the advances being made in the treatment of brain injuries, e.g. "concussions." If anything good has come out of the recent wars (though, tragically, not good for those who have had to endure them), it is the advancement in the understanding of brain injuries, how they can occur, what permanent damage they may cause, and how they may be related to conditions such as Post Traumatic Stress Disorder. Having suffered and recovered from a major concussion in a car accident in 2005, my personal hunch is that "minor" brain injuries--perhaps even on the internal level--probably happen much more frequently than any of us realize.

The brain is, truly, a remarkable, resilient and durable instrument, for all its complexity and delicacy. I believe there are vast possibilities for healing the brain and supporting the overall health of the brain. We are only beginning to discover them.

Meanwhile the human brain remains much afflicted. I am not a health practitioner at all. I am a sufferer. I try to give an account of this aspect of my debility in my book, Never Give Up: My Life and God's Mercy. My own bi-polar disorder--a complex of depression, anxiety, and obsessions--has a long history in my family, and it has afflicted especially those who also have outstanding talents. It is reasonable to consider the possibility that it has a genetic character. It is a curse, but also a blessing, in my family.

I was ten years old when I first began to experience this problem. So as I watch my Teresa suffer and try to help her, I am not surprised. There may be other, aggravating conditions involved in her case (as there are in mine). But it appears that she has the "family blessing"--a wonderful, precocious, creative, intelligent, imaginative mind that somehow is connected to a brain that does so many things well but doesn't get the seratonin and dopamine flowing properly. Why? Who knows. Perhaps with fallen human nature, these kind of things come as a "package."

Still, we endeavor to heal the sick. And we can have a measure of success. And people who suffer in this way can be helped to live without fear and darkness and the self-condemnation that it can generate. So I have hope for my Teresa.

Her road to healing may be long, though I pray not as long as mine. I am still on the road.