Thursday, January 22, 2015

DSM V, tell-tale interviews, and piecing together truth

This evening, I took a deep breath and conducted an hour and a half long interview with my mother about her impressions of my childhood. In order to truthfully address the topics I want to cover in my CNF class I felt it necessary. From an objective standpoint, the behavior she described does not meet the criteria for early onset Bipolar Disorder, ADHD, Oppositional Defiance Disorder, or Conduct Disorder as from her earlier hyperbolic descriptions may have been assumed problems. With the aid of the DSM V, I've identified my onset of mania at age 13, following my mother's decision to medicate my normative childhood behaviors with Ritalin. Clinicians would classify this as Medical/Substance Induced Bipolar. Although since that time I've manifest many hypomanic and depressive episodes, there is a direct correlation between medication or substance use and each of my true manic episodes. The diagnostic criteria for Bipolar I, affective states ranging from manic to depressive episodes, is not met without those underlying factors, meaning that, properly labeled, my affective disorder symptoms fall within the Bipolar II category. 

My mother is still asserting that she believes that I was molested by my biological father, while not recognizing the repeat instances of sexual abuse that I reported to her by a cousin, my next door neighbor boy, and a boy who lived down the street. The molestations I recall coincide with the years that I began to exhibit depressed affect from time to time. 

The interview looked roughly like this:

Did I throw tantrums? If yes, how often?: Yes, but not often. Not more often than other kids.
How early did I manifest irritability/anger?: No. You weren't angry or irritable.
Was I argumentative prior to adolescence, or just passive aggressive?: You argued some, but not a lot. You never asked for permission. You would say okay if told not to do something, and you still did it.
Did you note behavior that we classify as affective prior to Ritalin use?: Doesn’t recognize that there was.
What was the behavior I exhibited that lead to the ADHD diagnosis?: You were not good at finishing homework, or things I asked you to do. Mainly cleaning your room.
Talk about my resisting boundaries: It began when you were 3. I allowed you to ride your bike from corner to corner. I walked you to one corner and said, "This is a corner." I walked you to the other corner and said, "This is a corner. You may ride your trike from one corner to the other." It was clearly delineated. I would go back inside and work in the kitchen. I'd come to check on you later and you'd be gone. 
How long would I be gone?: From the time I discovered you missing until I found you. Over your entire childhood that added up to hours. But no, not hours at a time. Just until I found you once I realized you were gone. When you were four you started visiting the Durrants [an elderly couple three doors down]. I found you there enough times that I asked them not to let you in unless you had a note from me that gave you permission to visit. It worked until you started saving the notes and reusing them. It was on that same street your tricycle started to squeak. I could always tell where you were by the squeak until another neighbor oiled it for you. Then you went missing again. Do you remember taking A— to school?
A— my sister? No. Tell me about it.: I think you were in the second grade. She must have been at least a year old, maybe two. You were riding the bus, and you snuck your sister on to the bus and took her to school. Imagine what it was like for me to find two kids missing. [Did this woman EVER pay attention to her children? Really, how does a seven year old leave for school with a two year old and their mom doesn't notice?]
Yeah, I had totally forgotten that. [It's still just a fuzzy recollection.] 
What other boundaries did I have trouble with?: You got into my drawers. That started when you were 5. You'd steal things and later I'd find where you'd hidden them while I was cleaning your room.
What things did I take?: It's been so long. I can't remember everything. You know, things like nail clippers. I can't remember anything else. But you were always stealing my stuff, getting into my drawers. Not your dad's.
I remember getting into dad's stuff too. It wasn't just your drawers I got into. Can you remember anything other than the clippers?: Oh, and my jewelry.
Did we ever play with your jewelry together?: No, we never played together with it. You took two of my rings; my high school class ring and a ring a friend gave to me. If I remember right, you said they're plastered into the ceiling in the dining room of that house.
Yes, I just wrote about that. I'd forgotten which jewelry it was. Where there other boundary issues?: I learned there was never anywhere I could hide money that you wouldn't find it. In my bedroom drawer, my wallet, the freezer.
What else?: You mutilated toys. You stuck pins in the breasts of dolls. You destroyed the rubber stamps to a printing press we gave you. You had a bride doll that started out as mine but I eventually gave it to you because you damaged her dress.
How did I damage it?: I don't remember. I just know it was irreparable, so I gave it to you.
Where had you kept it?: I kept it in a box in the closet.
Had you got it out to show me?: No, I don't think so. But my sense was that there was nothing I had you didn't know about.
Were there other boundaries I crossed?: I saw your lying as boundary issues. You were generally untruthful.
In order to avoid punishment?: It got to the point I never knew to believe anything you said or not. Do you remember telling people you thought you were a cat?
Yes, I had a heightened sense of fantasy. I remember telling people I was a horse and a mermaid. What about behaviors that might be classified as creative?: I remember one day I came in from gardening and you had all of the spices out and were mixing them together. I think that's when I started referring to your kitchen messes as concoctions.  
So I largely played on my own?: Yes, you played by yourself until we moved to the house on Main.
When I was six.: Yes. Then sometimes I tried to arrange playdates, but most kids your age had siblings and they wouldn't want to leave their siblings at home to come play with you. So you played alone.
Did you play with me?: No, you were good to entertain yourself. The only time I began to worry was when it got quiet. 
[Meaning I was either gone or was concocting something.] What about other creative behavior?: I wouldn't call it creative. This behavior I classify as breaking boundaries because I'd tell you not to do things and you'd still make messes, long after other kids had stopped.
I have 17 and 18-year-olds who still make creative messes. It's part of raising artistic kids.: Is it? You destroyed a lot of things.
Destroyed or repurposed? That's what my kids do.: Oh.

The interview paints the picture of a child severely neglected, while my recollections lend support to emotional and physical abuse. My mother also ignored the sexual abuse I reported to her. Mr. PNU overheard most of the discussion, and is as befuddled as I am. "If you'd lived in a city, or the suburbs we wouldn't be having this conversation," he said once I'd hung up the phone. "Because you'd be dead." 

I haven't consulted the DSM V with my mother's symptoms yet, but I'm almost certain she has a personality disorder. (And she's a clinical psychologist. Go figure.) I'm also almost certain that I was a delightful child. In fact, tonight I'm feeling pretty badass as a mom, and a human being in general. Funny. Usually when I get off the phone with my mother I'm a wreck for days.

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