Mental illness drawing.
Mark readily produced an anticipated picture of mental illness. The initial stage of analysis seemed straightforward and self-explanatory with respect to his knowledge and acceptance of his father’s illness symptoms as an explanation of abnormal behaviors. The only exception appeared to be the stop sign, which prompted the facilitator to ask for clarification. She was probably concerned for Mark’s welfare, thinking he was talking about his own feelings (having been directed to draw “what [mental illness] is like for you”) and his hope that the illness would come to an end. This interpretation is aligned with expectations that children of parents with mental illnesses are negatively affected by the experience and have difficult emotions and multiple stressors that put them “at risk” of future mental illnesses (Gladstone et al., 2006).
Mark’s commentary also invites an alternate reading. Mark’s image may be as much about his father as it is about Mark, because, as he explains further, the illness “stops him [the father] from doing normal things.” The words added to Mark’s image contravened instructions to add a one-word title. However, the extra text in addition to the explanation given to Martha is central to understanding Mark’s overall picture of mental illness as something that has overtaken his father due to a lack of control over the “monster” that obscures his father’s real self. The viewer might then also understand, as Mark explains, that his father cannot behave like everyone else. Mark’s drawing might be taken as a strategy to talk about his father, maybe even to his father, even though he is not present in the setting. The image may not explicitly refer to “what it [mental illness] is like” for Mark, but it does create an opportunity for Mark to talk about what he believes “it is like” for his father, and, indirectly, to tell us something about what it is like for Mark as well.
Having a say about what “it is like” for his father and himself, and being able to negotiate this connection through drawing and explaining his image, allowed Mark to represent something that mattered to him, on his own terms. Children’s vulnerabilities can be compounded in the absence of their voices on issues that affect them. However, as a generic concept, “voice” represents children’s views in so far as they become part of a multifaceted relational process that can also involve adults (Alasuutari, 2014), and should be subject to thorough-going analysis that considers human communication as dynamic, context-bound, and interactive and recognizes the always present ambiguities in adult/child encounters (Komulainen, 2007, p. 22). As someone labeled “parentified” because he worried too much about his father, Mark transgressed normative expectations about child/parent interactions in his desire to take responsibility for his father’s well-being (Gladstone et al., 2014). Mark’s image and the words he inserted “tell” his father that he understands (“not yourself,” “bothering, annoying monster,” “no control”) and helped him distinguish between his father and the “monster/illness” that overtakes him. The stop sign may well reference the illness itself, placing the blame on the illness and not the father, which is significant in the full picture of Mark’s responses throughout the study (Gladstone et al., 2014). Mark was protective of his father. His enthusiasm for learning psychoeducational material was owing to a desire to better support his father. In the final group discussion, Mark described how the information helped him understand his father “more.” When pressed to elaborate, Mark described using what he learned to shield his father from blame and teaching other family members about the illness and, tangentially, about the “real” culprit responsible for their difficult circumstances.
Mark wants his family to understand and accept this differentiation between the man and the illness, so they do not “add to the problem” by misinterpreting his father’s behaviors. His drawing represents what he knows about mental illnesses and what he hopes to achieve by talking about it with different audiences, particularly his family, even though they are not present in the group setting. This is why Mark’s drawing and his explanation about why he included the stop sign may tell us indirectly not only what it is “like for Mark” but also what he believes it is like for other members of his family. And it is important because we know Mark wants to prevent what he says he fears most, the progressive deterioration of family relationships due to his father’s illness.
Concluding comments: implications for research and practice
In this chapter, I considered an earlier challenge to recast how we think about children in families where a parent experiences mental health difficulties (Gladstone et al., 2006). Since that time, there has been significant conceptual progress in the field, leading to new and innovative lines of inquiry (see, for example, Alasuutari and Jarvi, 2012; Drost and Schippers, 2015; Trondsen, 2012).
Researchers have shown why it is important to consider children’s active agency in their relationship with others, particularly the intricate nuances of child/adult interactions (Alasuutari and Jarvi, 2012). Studies demonstrate why it is important to consider multiple perspectives in the development of healthcare and social-care practices and policies that are supportive of the whole family. For example, Alasuutari and Jarvi (2012) studied how children talk about a parent’s mental disorder during a qualitative research interview, to understand how they conceptualize “the problem,” recognizing that children’s interpretations play a significant role in developing childhood resilience and a concomitant potential to prevent future illnesses. Rather than characterizing children’s knowledge as inherently deficient (a prevalent way of thinking about those like Mark who attend psychoeducational peer support groups), these authors demonstrate children’s resourcefulness and purposefulness in using particular vocabularies as they interact with different adults. They question the self-evident use of medical discourse as the only or even primary source of information about parental mental health problems that is helpful to children. Such an analysis might include examining the kinds of information children (and other family members) find useful and why (see also Gladstone et al., 2011, 2014).
New ways of thinking about children of parents with mental illnesses have informed studies of adult and peer interactions in virtual contexts where online participation focuses on support and educational activities (Drost and Schippers, 2015; Trondsen, 2012). Drost and Schippers (2015) explored an internet-based, password-protected online intervention in the Netherlands that targets young people’s ability to cope with a parent’s illness and find professional help. A rationale for this study was a lack of information from children about their help-seeking activities due to more pervasive studies on risk and resilience. This research begins to address a current knowledge gap about how children actually manage experiences that are well documented elsewhere (Gladstone et al., 2011).
Trondsen (2012) examined social processes and everyday interactions in the lives of Norwegian adolescents living with parents with mental illnesses. Analysis of participant communication in an online support group featured themes raised by young people when talking with each other. Trondsen (2012) considered it important to investigate what children have to say about their present-day experiences so policymakers and other user groups have relevant evidence from those with lived experience that can inform healthcare systems as they are currently organized. Participants talked about managing their circumstances, using terminology to describe taking responsibility in and for their families, and in ways that were both positive and burdensome and similar to other young people (see also Gladstone et al., 2011; Mordoch and Hall, 2008).
One participant described a father who is not her real father but someone engulfed by the illness. She said, “The problem is that I see the man but not my father” (Trondsen, 2012, p. 181). Her description is reminiscent of Mark’s, who saw a “monster” or “not my father,” but directed our attention in his drawing to a father whom he can still “see” because he understands and accepts that there is a difference between the man and the monster that is the illness. Mark insists that we as viewers see this too. The following excerpt is a response to Mark’s image from one such viewer, an experienced sociologist who encountered his drawing during a scholarly presentation on another topic. He wrote to express why he was moved by this drawing, which encouraged me to think about what Mark may have accomplished through his drawing beyond the immediate context of the Children’s Group. He writes,
I was very struck by this picture and particularly by this phrase “not yourself,” which seemed to speak directly to the boy’s father, and thereby address the whole picture to him: as a result of the phrase, the painting became more than simply a depiction or representation of the father. I found this direct address very moving, and also became interested in the eloquence and economy of the phrase. It seems to me that, in just two words, the phrase does the following: it makes a comment on the image, a depiction of OCD, and its relation to the father; it addresses this comment (and the image) to the father, telling him directly that the OCD depicted is other than his true self; and, moreover, it implies that the message as a whole can be received by that part of the father that is the true self: that is to say, it constructs what Foucault would call a subject position from which the message can be read or heard; and the possibility of that subject position (that of someone who can hear the message and see OCD as something external and contingent) is precisely what the author (the boy) wishes to bring about.
The boy has not carefully designed a statement that will construct a desired subject position, even though the statement does bring about this sort of effect; rather, he insists on addressing the (true) father who will be able to hear and understand the message. The message thus embodies and displays the boy’s determination (to be heard by the father) and his faith (in the father and his capacity to hear), to a degree that is profoundly touching. Perhaps this is why, notwithstanding its brevity, it can evoke such an immediate and visceral response in readers or audiences who are completely external to the situation.
Related posts:
Parental diagnosis and children’s outcomes
Parenting and borderline personality disorder
Enhancing depressed mothers’ sensitivity
E-learning professional development resources for families where a parent has a mental illness
Preventing unnecessary loss of child custody
Parental psychiatric disorder: translating The Family Model into practice change
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