The Call

Your cell phone rings at 7:45 A.M. You are on your way to an 8:15 meeting. Traffic is merging into a single lane ahead. You will be late. The call is from Vermont, a number you know well.

“Hello,” you say, juggling coffee mug, phone and wheel. You feel your heart beating.
It is Tuesday morning and your scheduled call with the Spruce Mountain team about your son is not until Thursday. This must be bad news.

“Dad,” says a cheerful voice on the other end, “what are you up to?” Relief. Caution. Love. Annoyance. A flood of feelings. Tail lights on the cars in front suddenly brighten. Everybody stops. The minutes are ticking.     “I’m driving to work, Tim. What’s up with you?”

“I was just thinking about Rusty. I miss him.”
Rusty was the family’s golden retriever who had to be put down five years ago. He was thirteen and incontinent. Tim was four when Rusty came in his puppy crate. They grew up together. You have no idea why he is telling you this now. You tell Tim that you miss Rusty too. A horn honks behind you. Traffic is moving again. The call gets dropped. You hit re-dial. You hear a busy signal.

Telephone calls from our children at unexpected times always catch us emotionally unprepared. And because they frequently call us on their schedules not ours, we frequently are unprepared. So much is conveyed in the tone of voice. So much is left out in the content. Years of communication are packed into short bursts of words and silences.

In the early days of the Peace Corps, consultants were called in to assess a problem among volunteers. They were crashing. They were getting sick. They were becoming depressed. They were criticizing their host countries and the Corps. They wanted to come home. The consultants recognized a pattern. The breakdown was happening with consistency three months into the assignment. The honeymoon period from Peru to Kenya for volunteers was ninety days.

After discovering the pattern, the consultants made a simple recommendation: staff from headquarters should spend a week with the new volunteers in the field. The results were dramatic, reversing the trend of increasing three-month washouts. With just a little support, idealistic young people feeling alone and overwhelmed in a foreign culture were soon back at work.

The Peace Corps Morale Curve has been used to explain individual behavioral reactions to new social environments.
It may be a helpful model to keep in mind when you are talking on the phone to your son or daughter at SMI and what they are saying sounds like it is coming from another planet: (You want to hear how they are doing, they tell you about everyone else. You ask about the program, they recount a critical event from childhood). Remember they are living in an unfamiliar and foreign culture, even if they have been in residential treatment previously.

Many elements go into planning the individual treatment programs for residents at Spruce. The staff is keenly aware of the calendar. When did someone arrive? When will their restrictions be eased? When does their thirty days start? Can work and school occur simultaneously? What is the discharge date? This calendar provides necessary structure. Each resident also has a personal calendar tracking internal hopes and fears. The community, too, has a collective calendar that is bigger than the sum of the individual parts.

Life at SMI powerfully shapes the thoughts and feelings of every resident individually on a daily basis. It also effects the group which in turn has an indirect but equally powerful effect on each resident. The morale curve for the group is super-imposed on the curve for the individual. It may or may not be ninety days- we haven’t measured it- but it is there.

The take-home from above is that a simple “check-in” phone call from your daughter/son at Spruce is not at all simple. You are being asked to listen to and to sort out multiple messages. You do not have the benefit of context. You do not know whether the cooking crew burned last night’s dinner, three new residents just arrived, or today’s therapy session brought back to life a beloved pet.

From us to you, thanks for taking the call.

(Dr. Richard Bernstein is the consulting psychiatrist at Spruce Mountain Inn.)