Freedom

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One of the greatest gifts that God gave humanity was the freedom of choice. He could have created us so that it was imperative that we performed only certain acts and experienced a proscribed range of feelings. We could have been forced into only one way of being. Everyone has the freedom to choose how they will live and what they want to do with their life. Even though it hurts oneself or those whom they claim to love.

It is the ethical obligation of all mental health workers to encourage self determination of those who have the mental competency to make their own decisions. A common question that arises is how one knows whether or not the mental health consumer is of sound mind and capable of making such decisions that affect their future. For example, take a young man with schizophrenia. While he is taking his medication he can make fairly decent decisions and he may choose to go off his meds. But say that once he does, he becomes completely confused, hearing voices and becoming antagonistic to others. At that point, do you force him to take his meds again, since he went off them knowing what would happen to him? (This is possible particularly for those people with severe mental illness who have had a prolonged course and who realize what happens by experience). Or do you allow them to live on the streets and become a menace?
Many mental health practitioners make the decision to allow mental health consumers to make their own future. Problem is, they often aren't accountable for their subsequent actions and everyone else has to pay for their actions, emotionally and financially. So where is the line between accountability and freedom? This was the question that the existentialists asked: how does one balance freedom and responsibility?

I ask this question of myself these days because Mother informed me today that she went off her antidepressant/anti-anxiety medication and has no intention of going back on it for any reason. Even though I've shared with her how pleased I've been that she went on it and that she was more fun and enjoyable while she was on it than any other time I've ever known her. Now she has become antagonistic, irritable, and roiling in her grief and sense of geographic dislocation. I realized today for perhaps the first time, that no matter what I do for her, it cannot make up for the other three children who choose not to be in contact with her. And even if I give up my job and my relationships and decide to stay with her 24/7, she would continue to be unhappy because she has depression. It is not because I'm not good enough as a daughter, not because I've done something wrong, or because I don't spend enough time with her or do enough things in the community for her to feel proud about.

Her mood is not about me.

And yet I will have to pay for her decision in the long run. It is not appropriate for me as a daughter to neglect her and avoid her. It is very hard to be in her company though as she is because it is very sad to see her in such pain, and it is painful for me to be the recipient of her irritability. She has made the decision herself and I am struggling with the balance of responsibility and freedom. I keep telling myself that I also have freedom and responsibility. My responsibility is to be a good daughter. I only wish I knew how to do that in this situation. She may have also gone off some of her anti-hypertensives, too. She acts as if she has. Mother claims that her medications have given her some sort of rash and she becomes hostile and beligerant if I ask her about which medications she is taking. "I'm not taking any more of those %@#$ medications. They only have given me problems." No they haven't. And if they have given her a rash, she hasn't used the medicated cream that I took her to the doctor to get. Why? I'm not sure except that she feels that she has a better way to treat it (I don't know what that is).

So my mother may have a stroke or be so overcome by depression that she opts to die of her own accord. What a horrible prospect. But I have almost expected that she would take her own life for years now. It has been especially likely in the aftermath of my father's death. I can't stop her. I can't make her pain better. I can't give her what she needs to undo her awful childhood that left her looking for love and approval from everyone--even her children. This is one situation that I cannot control. She does not listen to my reasoning and I'm not willing to have her go on another rant when I try to explain the need for her meds. I wonder why I ever came here (to California) in the first place. I really don't care about anything. I'm sick unto death with... and it goes on and on. Then after awhile she brightens, but I'm left with all the negativity, despair, and anger that doesn't belong to me.

It is impossible to be a therapist to myself or my mother. Any therapist I know would encourage me to set limits with her regarding objectionable behaviors of which I am the target, and to create conditions for spending any length of time with her. This is quite difficult. Even though while she has been on her meds, she had wonderful things to say about me, without them I am either not sensitive enough to her pain or she seems to grovel because I am a busy person and must not have time for her, etc. In any event, I have to pay for her behavior.

My siblings do not know. Two do not care and one would not do anything to help although he does profess to care about her. I'm trying to do what is right for my mother in spite of having no support from my siblings. It is an extremely lonely circumstance and I do the best I can to be connected to everyone in this situation: parent and siblings. Because in a few years I may only have my siblings. But then, after the way I have had to shoulder these responsibilities alone, their disinterest and silence on the issues surrounding Mother's life and care, creates a rift that I'm not sure can be fully bridged. I will try, but this situation is taking a toll on more than just my mother.

I've said before that God wants us to be holy in a very deep place. I still believe this. And that my job is to honor and respect my parents in every way I can. But jeopardizing my own mental health and the happiness of my marriage, is not part of that. It is a time to pray, to be thoughtful, and to balance kindness with firmness. Determination with tenderness. There are not a lot of clear examples of this for me, so I'm making it up as I go along, grateful for the knowledge that I'm doing the best I can and that God will somehow sustain me. My concern is that this will get very bad before it's over. And if it is, I pray that I will remain a loving, hopeful, faithful, warm-hearted and giving person who can set limits and not allow the poor choices of others to limit my usefulness or determining my own emotional wellbeing. That is my freedom to own it, and my responsibility to make it happen.