Guidebook on Helping Persons with Mental Retardation Mourn by Kauffman Jeffrey;

Author:Kauffman, Jeffrey;
Language: eng
Format: epub
Publisher: Taylor & Francis Group

HANK

I met Hank, who lived in a supported independent living situation, about three years after his father’s death. He was referred for treatment because he had begun to break residential and workshop rules, to spend rent and food money impulsively, to act out sexually in self-destructive behaviors and to have fits of temper. These behaviors started just after his father’s death, but subsided soon after. There had been a series of recurrences of this behavior. The recent outbreak of these impulsive, disruptive, and angry actions was more intense, and staff, after a team discussion about Hank’s behaviors, thought that Hank’s behavioral disturbances were expressing continued grief over his father’s death, and referred him for an evaluation for grief therapy.

Hank’s relationship with his father was a complicated, powerful, disturbing undercurrent throughout his life. His father, an alcoholic prone to fits of rage, was emotionally abusive to Hank. Hank’s self-loathing was a legacy from his father, who violently cursed and insulted him. But, his father also spent close and very special time with Hank, sharing his love of the railroad with Hank. They rode the local commuter trains, and played with father’s model trains. These continued to be Hank’s favorite activities. Hank identified with his father, and was very connected to him. I asked Hank how he felt about his father. He said, “I hate my father and I love my father!”

A couple of months after the acting out that had precipitated treatment started, it stopped. This had been the pattern that had been occurring since his father’s death. When he stopped acting out he felt ashamed of himself for his bad behavior, and he was anxious that he would be punished. Hank begged for reconciliation with his residential support staff, and urged that he be forgiven for “making a mistake.” In the repentant aftermath of his acting out he was strongly engaged with staff and demonstrated a clear and confident sense of purpose. He was filled with the hope of reconciliation with staff, and was committed to make this happen. When we tried to understand Hank’s grief behavior we needed to look at both parts of the grief enactment, the destructive acting out and the reconciliation.

Hank behaviorally 1) acted out the inner turmoil of his grief and then 2) sought forgiveness. He enacted a self-destructive drama, felt the disapproval of staff, felt guilt and abandonment, and then sought reconciliation. His ambivalent relationship with his father compelled him to repeatedly enact this guilt drama. He was deeply ashamed of himself for being so bad and destructive and out of control, and sought to repair the damage he had done. The drama was motivated by a persistent guilt and shame. Each time he went through the acting behavior and the seeking reconciliation behavior, he got staff disapproval and then staff acceptance. Afterward, he did well for a while, then repeated the pattern. Why did he not succeed in really achieving reconciliation ?

I think that it is because the acting out was also an expression of anger at his father.

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