Opinion | When the Parenting Never Stops

Jessica Grose: I was so struck by the point that you made about how for mothers of children with mental illness who are in danger, that often their only option is to call the cops. Most parents do not want to call the police on their children. You also talk about the very limited options in the United States if parents are not able to take on the work of housing and protecting their children anymore. What’s the low-hanging fruit of what we can change to help these parents in the near term? I know this is a decades-long, complicated, multipronged problem.

Judith Smith: I think the advocates for parents of adults with severe mental illness are hoping for something they call “housing that heals” — supportive housing, group homes for people with severe mental illness that also have treatment. I think housing has to be a priority. There also need to be more psychiatric beds available for when people need them in the short term.

This is a political battle within the advocacy for severe mental illness. In terms of the people who advocate for the rights of the person with mental illness, and the families who would like there to be more options for temporarily taking away the rights of the person and having them be protected and hospitalized when they are really aggressive and a danger to themselves and their families. But it’s a horrendous decision to say, “Right now, my child will have to be homeless.”

Jessica Grose: Reading about mothers in your book grappling with that decision was just awful. And I think part of why it was so awful for them is because of the blame that society tends to place on mothers. You quote the psychiatrist Stella Chess, who said, “There are very few jobs in which one individual will be blamed for anything that goes wrong, and fewer still in which what can go wrong, and the feeling of being blamed, is so devastating.” Can you tell me a bit more about how that ends up playing out, in terms of the guilt and shame that these mothers feel?

Judith Smith: I think we assume that women should be able to do everything, and we should be able to produce perfect kids. So I think for all parents, when our kids aren’t doing well, it affects our self-esteem. We feel bad and then we experience the conflict of ambivalence. Rozsika Parker wrote a wonderful book, “Torn in Two,” more than 20 years ago. She’s a psychoanalyst. And she really talks about how shameful it is for women to acknowledge their mixed feelings, which we all have.

If you want to take a shower and your kid won’t let you take a shower, you’re angry, but then you feel bad for being angry. And society doesn’t allow women to have mixed feelings. Parker named the conflict of ambivalence as what is keeping mothers imprisoned and so isolated and feeling so bad about themselves — but that in fact, ambivalence is a part of all relationships. That’s a lot of what we do with clients, is allow them to express negative feelings about their parents or about their spouses and be able to live with it without feeling like they’re bad people.

Jessica Grose: I’ve heard most concepts in terms of the caregiving literature, but I hadn’t heard of “chronic sorrow,” before your book, which is something these mothers experience, and which is defined as “the long-term periodic sadness the chronically ill and their caregivers experience in reaction to continual losses.” I would love to hear you talk a little bit more about chronic sorrow — the hopes these parents once had for their kids that are now gone.