Sunday, April 5, 2009

Planned Parenting

I can honestly say that there has never been a single moment in my life when I wanted to become a parent. Because of specific choices I have made since I turned 21, I've had the incredible freedom to enjoy a life of my own, choose my challenges, fail on my own terms, and enjoy the kind of great and wonderful solitude that comes from living alone. I am blissfully content with my contribution to zero population growth.

No one has demanded my attention on a constant basis. No one else's perceived flaws reflect on me in such a way that I would let others think I'm a bad person. I never had to wait for my nest to empty to follow my passions or enjoy peace and quiet. I am now and always have been a free agent. My status as a childless individual obviously colors my reaction to two plays seen this week about families dealing with the stressors of children with special needs. 

Why?

The kind of freedom I enjoy has no place in the lives of people whose children need constant attention or have been challenged with mental or physical disabilities. The never-ending struggle to simply get through one day after another becomes all-consuming and exhausting. Whether the disability ranges from blindness to quadriplegia, from Down syndrome to multiple sclerosis, caring for a child with special needs takes priority over everything else.

Along with the special needs of the child, there is often a tidal wave of parental confusion, desperation, guilt, and shame. Is the child's condition hereditary? If so, which side of the family did it come from? While a great deal of information might be available about the genetic causes, symptomatology, and clinical course of something like Tay-Sachs disease, the literature available about neuropsychological conditions is often conflicting, sometimes unproven, and not always indicative of a patient's true diagnosis.

Then, of course, there is the whole "nature versus nurture" argument. The world in which we live has changed dramatically since many of us adults were children. Fifty years ago people didn't have anywhere near the number of entertainment options with which they are now bombarded on a regular basis. Music was not personalized and portable. Radio was fairly benign (no shock jocks dominating drive time). Many families had clearly-structured lifestyles wherein children learned early on to understand limits and consequences. Television offered a vastly different experience from what we have today.


In today's world, attention spans have been dramatically shortened by the explosive presentation style of our media. Whether one watches cartoons, news, or action films, the amount of physical violence we witness is astonishing. People who leave their televisions on in the background are often unaware of how overstimulated they may be. If you don't believe me, try these exercises to see what you're being subjected to:
  1. Watch 15 minutes of CNN and pay careful attention to how the media is being aimed at you. Notice the ticker at the bottom of the screen competing for your attention with the person who is speaking. Listen to the music that is used to introduce any new thought and think about how it resembles the soundtrack of an action movie.
  2. Watch a cable news show like Hardball with Chris Matthews or a talk show like Fox & Friends or The View. Pay careful attention to how people insist on interrupting each other and often talk over each other's voices.
  3. Watch a series of pharmaceutical commercials and think about how those ads are telling viewers that they need drugs and should take action to get the drugs by contacting their physician. Watch other commercials aimed at pushing product toward consumers and see how quickly and intensely the ads fill up a 3-5 minute period of time.
  4. Go to YouTube and watch the trailers for five new action films. Pay careful attention to the fast editing cuts, the number of explosions, collisions, and acts of violence. Listen very carefully to how the soundtrack provokes tension.
  5. Then watch this news coverage of the 1960 Presidential election and keep in mind that, back in those days, news was not formatted as entertainment.  Note the complete absence of swooping CGI effects, music cues, visual distractions, and multiple inset screens with people talking over each other's voices: 

At the same time that the media is bombarding us with stressors, it has become increasingly easy to build an electronic moat around one's self. Just look at the people on the street who are so busy concentrating on their cell phones (or absorbed in listening to music from their iPods) that they have become oblivious to what is happening around them. Think of how many people are now screening their telephone calls and not responding to email solicitations as they try to resist the constant onslaught of demands for their attention.

* * * * * * * *

The "noise factor" in our daily lives plays a critical role in Lisa Loomer's play, Distracted.  Upon entering the Mountain View Center for the Performing Arts for Saturday night's premiere, the audience was greeted by loud music blaring from the sound system as videos of at least 20 different television and computer programs were projected onto the multi-paneled drop. Whether one's eye was caught by Oprah Winfrey, CNN, Bill O'Reilly, Family Guy, or any other number of programs, the preshow delivered an exhausting barrage of multimedia stimulation. Loomer notes that:
"We are bombarded with computers, cell phones, call waiting. It's likely none of us has gotten through a conversation without an interruption.  Is all the technology that's supposed to help us do things faster getting in the way of real communication? The play asks if we are forgetting to pay attention to what's more important."
The other question lurking underneath this new production from TheatreWorks is whether anybody these days really knows how to listen. To some, the simple act of listening has become a lost art. I used to have a brilliant friend whose mind worked so fast that he couldn't bring himself to listen to the people with whom he was conversing because he was too busy concentrating on what he wanted to say next.

In Distracted, parental concerns are focused on nine-year-old Jesse (Gabriel Hoffman), who remains offstage for most of the play but whose voice loudly introduces each new scene.  Jesse knows how to whine, stall, beg, and refuse to cooperate like any other moody adolescent. His parents are having trouble managing him. His teacher accuses him of constantly being disruptive in the classroom. 

Following a recommendation that Jesse be tested for Attention Deficit Hyperactivity Disorder (ADHD), his parents start making the rounds of medical consultants, dietitians, homeopaths and other experts while getting plenty of advice from neighbors who have already put their children on Ritalin and other behavioral drugs. It's a little like watching Alice go down the rabbit hole and try to find her way around Wonderland.

Jesse's father (Robert Yacko) feels that a diagnosis of ADHD is ridiculous. Like Jesse, he was a hyperactive child (even as an adult, he can't listen to his wife without turning on a television to see what's "on"). As far as he's concerned Jesse is just "being a boy" and will do fine.

Jesse's mother, who is more vulnerable to suggestion, is quick to start researching her child's potential diagnosis on the Internet as she bounces from one referral to another. Along the way she gets dubious advice from her neighbor Sherry (Tara Blau), who has already had a gastric bypass as a means of dealing with her eating disorder and placed her son on medications. Then there is Vera (Suzanne Grodner), who displays strong obsessive-compulsive traits and does not communicate easily with people. And let's not forget Jesse's babysitter (Sherry's daughter Natalie), an overly energetic teen with severe mood swings who has taken to cutting as a means of self expression.

While trying to find out why her son might have ADHD, Jesse's mother (who was trying to work on an interior design project) keeps getting distracted from her work. Eventually, she loses a valuable freelance contract because of her own inability to concentrate and meet deadlines instead of shopping online for shoes. As she juggles an endless array of doctor visits, arguments with her husband (about whether or not he could be satisfied with a blowjob on their date night), and pressures from her nosy neighbors, it becomes obvious that Jesse isn't the only member of the family with an attention deficit disorder.

Rebecca Dines, Suzanne Grodner, and Tara Blau
(Photo by Mark Kitaoka)

The audience follows Jesse's parents as they bounce from visits to his schoolteacher to sessions with a tearful psychiatrist (who has her own problems to deal with), as they ricochet from consulting a homeopathic practitioner to checking out a pricey clinic in New Mexico. Along the way, the audience receives a fairly intense education about the effects of various drugs (Ritalin, Adderall, Concerta, etc.,) that are currently being used to "manage" children. Simultaneously, Loomer attempts to offer insight into the wide variety of dietary toxins, allergens, and other environmental stimuli that might provoke a child's hyperactivity.

Some things, however, get passed over. Looking at a subset of parents who obviously have not dealt with their own neuroses, it's easy to see why their children are acting out. In some ways, the determination of Jesse's parents to find the right treatment modality for their son becomes every bit as desperately competitive and consumer-oriented as the way some parents try to fast track their children for entry into an exclusive prep school or college. 

Little attention is paid to the ongoing financial costs of all these elaborate wild goose chases, the constant lack of stability in the family's life, or the dramatic upheavals the child faces each time his parents opt to try a new treatment methodology. The medical profession is occasionally portrayed as dangerously irresponsible in its layering of diagnoses as an excuse to write more prescriptions (rather than pay attention to a child whose natural ebullience is being obfuscated by clinical terminology).

Rebecca Dines, Robert Yacko, and Cassidy Brown
(Photo by Tracy Martin)

As the evening progresses, it becomes apparent that some parents and teachers turn to drugs like Ritalin in order to manage their lives better, despite the drugs' effect on their children. Even when done with a sense of helplessness and hopelessness, their willingness to drug their children is an admission that some kids do indeed go through periods where they are unmanageable brats.

My own feeling is that some people (who were probably unfit to be parents) have children for incredibly wrong reasons. When their child -- who, like any adolescent mammal, is naturally energetic -- can't be tamed to a point where the adults feel as if they've got the situation under control, the tendency is to blame the child and look for all sorts of external solutions to the family's problems. 

Introspection might be a whole lot cheaper.

Here's the bottom line:  You wanted a child?  You got a child (and all the obstreperous behavior that comes with that package)! If a child is too easily excitable, parents may need to think about what kinds of stimuli the child is constantly being exposed to. They might also need to think about what kind of behavior he is modeling from watching his parents.

At the end of Distracted, when Jesse's mother finally gives up on all the "cures" and allows her son to come out onstage, what the audience sees is a fairly normal, hyperactive child who is happy to have some attention from his mother. 

Gabriel Hoffman and Rebecca Dines (Photo by Mark Kitaoka)

Does Jesse have a short attention span? Yes.

Is he easily amused? Yes.

Does he suffer from ADHD?  Maybe, maybe not.

Should Ritalin be thought of as a gateway drug?  You betcha!

I was particularly impressed by the flexibility of Melpomene Katakalos's unit set (this artist continues to do magnificent work for a variety of Bay area theater companies).  Under Armando Molina's astute direction, the cast (especially Jayne Deely as Natalie), delivered solid performances. Dena Martinez, Elizabeth Carter, and Cassidy Brown appeared in numerous small roles as teachers, care providers, and waitresses.

* * * * * * *

In July of 2008, conservative radio host Michael Savage ignited a firestorm with his suggestions that:
  1. Autism is an overdiagnosed medical condition.
  2. Many families seek out a diagnosis of autism for their child in order to get money from the government.
  3. 99% of autism cases result from lax parenting wherein a father is not around to tell a kid "Don't act like a moron, you'll get nowhere in life. Straighten up. Act like a man. Don't sit there crying and screaming, idiot."
  4. Every child with autism is merely "a brat who hasn't been told to cut the act out."
For parents with autistic children, his comments added insult to injury. carolyn Doyle's new one-woman show about the challenges of raising an autistic child recently had its premiere at The Marsh. Although she still needs some time to settle into the narrative, Ms. Doyle offers a very humble and sober description of her family's struggle to cope with the challenges of autism.


As with Lisa Loomer's DistractedConfessions of a Refrigerator Mother often feels like a lecture as Doyle explains some of her son's symptomatology, some of the challenges she faced in learning about the disease, and the sense that her husband was a passive partner in managing their son's care on a day-to-day basis. Here's a typical note she received from the daycare staff:
"Joaquin had an OK day.  He pulled down his pants 11 times.  He had a tantrum over his goldfish crackers and bit me on the cheek.  This was a little strange.  First, he gave me a kiss but then decided to bite me. It was not a malicious act. He seemed rather happy. Also, he loves tart Bing cherries from Trader Joe's. He ate some of mine today."
Without meaning to minimize the emotional pain depicted in Loomer's play, the realities of an autistic child's behavior are far more brutal and challenging for the parents. As directed by Susan Evans, Doyle's presentation keeps the physical reenactments of her son's behavior to a minimum. The refrigerator which contains most of the stage props used in her show occasionally leads to some delays and clumsiness in setting up various props. Yet, in its own way, it demonstrates the size and rigidity of the obstacles she has faced.

First used in the 1940s, the term refrigerator mother was based on the assumption that a child's autistic behavior stemmed from the emotional frigidity of its mother. Leo Kanner, the Austrian physician who originated this theory, described refrigerator mothers as "just happening to defrost enough to produce a child."

Doyle's narration touches on more painful decisions a family must face. As Doyle and her husband succumb to the realization that they are too exhausted to take care of their son as he grows stronger, they must slowly confront the reality that Joaquin would be better off in a group home. Painfully aware that their son might outlive them, they must reach a point where they relinquish their child to the care of strangers.

Doyle is all too aware of how many parents eventually stop visiting their autistic children on weekends and worries that she will eventually follow them down that path.  Questions about the disease's course, and the toll it can and eventually might take on her marriage make Confessions of a Refrigerator Mother an extremely poignant experience. 

Raising an autistic child has been a long hard slog for Doyle and her husband. The occasional slides of her son Joaquin's face, with his deep, questioning eyes, will continue to haunt you.

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