Co-Dependent, Munchausen by Proxy, or Mom?

When does taking care of other people become destructive?

I have an adult son with a major mental illness. Two years ago, by some kind of miracle, he was granted a housing subsidy.

At the time it was offered he was homeless; in and out of hospitals, jail, crummy hotels for vagrants, and a hidey-hole under a pedestrian bridge where he kept a sleeping bag and a black plastic bag full of miscellany and mildewed clothes; being “cared for” by a treatment team that was mostly psych students with more clients than they could handle who quit after a few months; and alienated from almost all his family and friends.

Once the subsidy was granted, he had six months to find an apartment. If he didn’t find one, it would be withdrawn.

When your help is definitely helping

I’ll admit right here that my memory is vague and I’m not sure of the exact sequence of what happened next. But I know I sat in a conference room in the psych ward of a hospital and argued with a table full of doctors and nurses who wanted to conserve my son and place him in a locked psychiatric facility for another year.

“He has to be released. He has to be given this chance he’s been offered to try living on his own. He has to do it now or the subsidy will be rescinded. A year from now will be too late.”

I know I took him to the courthouse to get a printout of his record and that both of us were stunned to see 17 charges listed. I remember sitting on the edge of my chair in the HUD office, desperately afraid the subsidy would be withdrawn, explaining how the list didn’t represent what truly happened.

“If a policeman asks you to move off a bench you’re sleeping on and you don’t move right away, you can be charged with refusal to obey an officer. If the officer puts his hand on you and you brush it off, it’s called battery. If he pulls out his handcuffs and you run away, it’s resisting arrest. So one interaction with a policeman while sleeping on a bench becomes three charges on your criminal record.”

I went to back to the courthouse and sat on a witness stand to argue against the conservatorship the doctors were recommending, promising the judge that I would help my son find an apartment and support him in keeping it.

I met with the mostly-ineffective “specialist” assigned to help him find housing who was going at a snail’s pace, then scoured Craigslist for apartments that accepted subsidies and dragged him from open house to open house, practically begging the property managers to accept him as a tenant.

I bought the property manager who finally did accept him a cherry pie.

I drove him to IKEA and Goodwill to furnish the apartment with everything he needed for indoor living from a bed to two spoons.

And I felt wonderful and hopeful and full of optimism after all those events. We both did! There was no question that my help was necessary and good.

When your help is probably helping

After he was ensconced in his new apartment, we got into a routine. I live about 20 miles away and would drive down once a week or so to have fun, socialize, help him clean his apartment, and try to work out any problems he might be having like the Internet not working, or the heat. Sometimes we’d go grocery shopping or out to lunch. Because he’s on a small fixed income and I have enough to share, I gladly treated. Other times, he’d come up to the City and we’d go swimming in the Bay.

Often, he wanted me to buy him something, and giving this help felt nothing but good. I love my son. I was beyond happy to see him looking healthy and making a life for himself in his new apartment. I wanted to make stable, indoor living as comfortable for him as possible. I figured the better he liked it, the more motivated he’d be to stay on track.

Now and then, he would ask for something expensive, like wireless earbuds or an iphone, and I would provide it. How could I not? I had the money! And his life had been hard enough in the 15 years since the onset of his illness; anything I could do to make it easier was for the best.

When your help isn’t helping

Then one day he announced he no longer wanted to take his medications as prescribed, but as needed. I told him I thought that was a bad idea. So did the rest of his family. So did most of his treatment team. His psychiatrist, though, was a bit of a lunatic himself (which could be why they got along so well), and he thought it was reasonable goal.

So I took my son to the health food store to get the special supplements he thought he needed. I paid his electric bill when he fell behind, and his rent. I hoped and prayed that he would be able to control his illness.

But soon enough, he stopped being fun to hang out with. He was irritable, hostile, more disorganized, and making bigger and bigger financial requests — no, demands — getting angry if I failed to buy him what he required.

We argued in the health food store when I said I had $100 to spend and he wanted $200.

We argued when he asked for $500 worth of lights for his apartment that could be controlled by his computer. I said no, I wouldn’t buy them, but I would reimburse him for other bills and he could spend that money how he pleased. It was a cheat, on my part — a way to pay for something frivolous and expensive and be able to say I hadn’t. A way to avoid a fight.

But I didn’t feel good about it. I knew it wasn’t right.

Then he fixated on a full-length “yoga mirror” that had a kind of hologram instructor and besides a hefty original outlay required a monthly membership fee. I managed to rein in my inner Santa.

Meanwhile, our relationship got worse and worse.

• Somewhere in the midst of this burgeoning belligerence, his psychiatrist disappeared and he was assigned a new one whom he immediately mistrusted.
• Two visits in a row ended up with me driving off angrily after heated arguments.
• The property manager called to say the neighbors were complaining because he was playing his music loudly at 2 a.m.
• I called him more than once to say the med vacation wasn’t working, asking him to take whatever was necessary to rein himself in.
• And he had two full-blown manic episodes within six months: two 5150s, which are involuntary holds in hospitals for observation, brought about when I asked police to do a welfare check.

What Moms Do

Then my husband, his father, asked me to draw a line in the sand. “Tell him you won’t talk to him or help him or hang out with him unless he takes his meds,” he advised me, and this time, after a lifetime of resisting his “tough love” recommendation, I agreed.

I agreed now because our son is so close to getting on a path to some kind of recovery. He has an apartment, an income, a treatment team — all the tools he needs to build a sustainable life. I don’t want him to lose those things! And I agreed now because nothing else is working.

But, but, but…

Mental illness is not the same as drug or alcohol addition (though drug and alcohol use are in the mix). Mental illness is not the same as bad behavior. And cutting off a “bad” child is wrong. It’s against the Mom code — against everything my culture has taught me I should be, not to mention my human instincts.

Do you remember Runaway Bunny? I loved reading that classic children’s book to my three kids when they were small. It’s about a mother’s enduring love. It’s about how, no matter how far her little bunny tries to run away, his mother will always find him. If he becomes a fish, she will become a fisherman. If he becomes a rock on a mountain top, she will become a mountain climber, and so on. If he runs away, she will never stop looking for him, Mom assures him, “for you are my little bunny.”

I remember saying something similar to my grown son just recently, something about how I would never give up on him. But aren’t I giving up now? No. Not at all. I know that. But does he?

Co-dependence and Mental Illness

During the first few weeks after cutting off my son, he called a few times asking for financial help. He’d mistakenly bought $400 worth of vitamins he didn’t really want, and he couldn’t return them. Consequently, he couldn’t pay his phone bill. This is exactly the kind of thing I would have tried to help him with in the past. But now, I didn’t. Our conversations were short.

“Did you decide to start taking your meds?” “No.” “Then I can’t help you. That’s the criteria.”

When I was describing my overwhelming anxiety about this tactic to a friend, she suggested I read the book Co-dependent No More: How to Stop Controlling Others and Start Caring for Yourself, a classic in the Al-Anon community. And though it’s written for family members of alcoholics or drug users, I found many sections in the book that applied to my relationship with my son. Also, my relationship with my husband. Because like many women, I was raised to be a caregiver, and that conditioning is at the root of many tough problems in human relations.

Here are a few words of wisdom from Co-dependent No More that stood out to me. This first is the theme of my current impasse with my son.

“There is a thin line between helping and hurting people, between beneficial giving and destructive giving. We can learn to make that distinction.”

I’m glad to hear that. But how?

Remember whose feelings you’re in charge of

Of course it’s necessary to be a caretaker when your children are small, and it may also be necessary if they grow up to be disabled. Then again, it may not. You have to be discerning. Because unless there is an extreme impairment, each person is capable of being responsible for themselves.

“Many of us spend our lives fussing about other people’s feelings. We try to fix people’s feelings. We try to control other people’s feelings. We don’t want to hurt people, we don’t want to upset them, and we don’t want to offend them. We feel so responsible for other people’s feelings. Yet, we don’t know what we are feeling. If we do, we don’t know how to fix ourselves.”

Accept your true responsibility

One problem with devoting yourself to taking care of other people is it usually involves dishonesty. If you suppress your true thoughts and feelings in order to make others happy, you’re deceiving people, including yourself. You’re pretending, putting on a show, and unless you are a professional actor, it’s probably not even a believable one.

The antidote for that repression and deception is to honor your own thoughts and needs. That may sound selfish, but it’s a difficult quest.

“To honor the self is to live authentically, to speak and act from our innermost convictions and feelings.

“To honor the self is to refuse to accept unearned guilt, and to do our best to correct such guilt as we may have earned.

“To honor the self is to be committed to our right to exist which proceeds from the knowledge that our life does not belong to others and that we are not here on earth to live up to someone else’s expectations. To many people, this is a terrifying responsibility.”

Step Forward/Step Back

Another concept the book discusses is under- and over-functioning. When I race in to solve every problem my son creates, I am over-functioning. In response to that, he under-functions. Why should he try to solve his own problems if I’ll do it for him? It’s logical to sit back and let someone else do the work, if you can.

This reminds me of an instruction we’d give when having group discussions in the high school where I taught English for 17 years. We called it Step Forward/Step Back. We asked students to notice if they were doing all the talking. If so, they should step back and give other people a chance to participate. On the other hand, if they noticed they weren’t saying a word, they should try to step forward take a risk.

Rushing in to rescue their under-functioning loved ones is common in co-dependent people. And as far as I can tell, it’s the chief activity they are advised to stop.

“Practice non-rescuing behaviors: Say no when you want to say no. Do things you want to do. Refuse to guess what people want and need; instead insist that others ask you directly for what they want and need from you. Begin asking directly for what you want and need. Refuse to assume other people’s responsibilities.”

By rushing in to help my son with every problem he created, I was preventing him from managing his own life. I was also sending the message that I didn’t think he was capable of being responsible for himself.

Munchausen’s by Proxy?

If you aren’t familiar with this medical condition, it’s defined by Merriam- Webster like this: “a psychological disorder in which a caregiver and especially a parent induces the symptoms of a disease or injury in their child, falsifies the child’s medical history, or tampers with the child’s diagnostic specimens in order to create a situation that typically requires medical attention.”

The parent does this because he or she enjoys the attention she gets as a caregiver.

I know that I don’t really have Munchausen’s by Proxy. My son is legitimately ill. But I also realize that a large part of my identity is wrapped up in being a champion for him. I’ve been his staunchest ally for close to 15 years. And prior to the onset of his illness, when he was “just” a difficult child, he still took up a major portion of my brain, while I tried to figure out how to respond to his problematic behaviors.

This draw on my attention had negative consequences on the rest of the family. How could it not? If I was spending the lion’s share of my time worrying and strategizing over this child, how much time did I have time for my other children? How much for my husband? How much for myself?

But there’s no question that when things go right with this son, it’s extremely fulfilling. There’s no doubt that I feel deeply proud of how long and hard I’ve been fighting for him. So if I take away the primary and most meaningful endeavor in my life, my bravest and most steadfast deed, what will I replace it with?

If this separation from my son — this cutting off — goes on for a long time, what’s going to fill the blank spot it’s leaving in my mind and heart?

That’s something I still have to figure out.

The Burden of Love

About 10 years ago, New York Times contributor David Sheff wrote a book called Beautiful Boy about his son, who was a meth addict. It was a powerful and moving book. You could feel the father’s love for his child emanating off every page. And looking it up just now to provide the link, I see that it also has been made into a movie.

Later that year, Sheff’s son also published a book about his experiences, called Tweak. That was also a powerful book. But what struck me most about both, what I remember most clearly, is that now, after recovery, the father and son live a continent apart: one on the West Coast, and one on the East.

Is it possible that the father’s BIG love imposes some kind of burden on his son? Is it possible that the weight of his good expectations, his hopes and dreams, his trust and belief in his son somehow stresses the young man enough that he needs to live apart to stay calm and steady — to stay clean? I think maybe it is.

And by the same token, I have to wonder if my own BIG love is somehow crippling: creating pressure, or momentum, that my son feels compelled to struggle against.

I don’t pretend to understand it, but I know when I was still smoking cigarettes, and a certain loved one often told me I should quit, it only hardened my resolve continue. And later, when they stopped mentioning it altogether, that created enough space for me to make the decision for myself.

So is it possible that without me on hand to bear witness to his disasters, to increase their drama and importance with my alarm, my son might find them less compelling? Might even clean them up?

Perhaps.

I wish I had a strong conclusion here — a final paragraph that could neatly wrap everything up. But in truth, I’m still in the midst of this crisis — I may always be. And I have no idea how it’s going to end.

But I did see something funny when looking for the Runaway Bunny cover: a humorist who suggests that the mother in that story isn’t comforting, but obsessed.

Here’s Daniel Mallory Ortberg’s version of the opening lines as they appeared in 2014 on the The Toast (where you can find the full version) in a segment he charmingly calls Children’s Stories Made Horrific:

Once there was a little bunny who wanted to run away. So he said to his mother, “I am running away.” This was his first mistake.

“If you run away,” said his mother, “I will run after you. I would swallow my own heart before I let you escape.”

That made me laugh. And I’m glad for some laughter. Meanwhile, I’ll keep you posted if and when I figure out the mysteries of the universe, including how best to interact with an adult offspring who against all your good and passionate advice is going off the rails.

For further reading…

My writing is free to readers who follow my links from Twitter, Facebook, and LinkedIn, but if you’d like to browse more, click here to join Medium for $5 a month and they’ll give me some of that money. (Yes!) For an email when I publish a new story, click here. Find more stories about mental health on this List. And for more of the good stuff, follow Fourth Wave, where we’re changing the world for the better, one story at a time. Got one of your own? Submit to the Wave!