How to keep a mentally ill guest safe when she visits?

December 9, 2006 10:01 AM

Need best practices for keeping a troubled young woman "safe" while she visits me over the holidays. Also need recs on things to do, movies to rent, books to borrow from the library, etc. Please see ...

Background:

My 19 year old cousin is going to visit me later this month for 3 weeks. She is 19 y.o. chronologically and she is intelligent but due to bipolar illness, dyslimbia (a.k.a. borderline personality disorder), post-traumatic stress disorder (caused by sex abuse by her stepfather), she is the emotional equivalent of a 14 year old girl.

She takes her meds and she is getting therapy. If you met her you would not think there was anything different about her. She presents herself well but her inner life is tormented. I am careful of what I say to her for fear that I will trigger an abuse memory. Her therapist said she is ok to travel.

About 2 years ago she started using meth. She stopped a year ago and went to rehab. She has been out for 6 months but has used it twice in the past month. She says she does not want to use it anymore and every day when I speak with her she ends the conversation with, "I haven't used! Love ya'."

I want her to visit me to give her a change of scene but I need advice on keeping her safe, comfortable, and busy. She is a college freshman who will resume next semester in mid January.

She will be visiting my home in the DC Metro area from Dec 15 to Jan 5. I have to work through the holidays so I will take her to my office on occasion. She can do filing, etc. It's safe to leave her at home for a few hours so she can sleep late in the a.m. and I will pick her up at lunchtime.

Need recommendations, ideas, suggestions, advice:

1.) Movies/TV Shows to rent

She likes movies like Devil Wears Prada, Bride and Prejudice. She likes light stories without violence, drug abuse, troubled characters, etc. Her stepfather used to show her scary movies like Chucky when she was 8 or 9 years old so those are out. Horror movies are huge triggers for her. She saw the penguin movie Happy Feet and found it a bit juvenile. Her favorite TV shows are SNL, The Simpsons, Family Guy.

2.) Books to borrow from the library

She was a reader before she did meth but now she has trouble following complicated stories. She loved Harry Potter as a kid but she associates the story with her stepfather. The reading level of HP is perfect. She could read DaVinci Code but the albino monk character might disturb her.

3.) Activities / Events

We are going to ice skate at the Reston Town Center and we will be going to the gym regularly. She loves going to the Smithsonian museums. She has been to the new Air & Space one and the Natural History one. She is interested in makeup, fashion, hair so I'll take her to Sephora at Tyson's.

Ideas on the following welcome:

*Events in the DC metro area (example: holiday festivals)

*Museums

*Fairly easy hikes (example: the hike from Gunston Hall to the Potomac. It's easy but it's scenic.)

*Restaurant recs for Christmas Eve dinner and/or Christmas Day brunch.

4.) Safety and health

She tends to befriend dysfunctional people so I will have a house rule that she cannot have guests when I'm not here. She does not have the best judgment in the world so I would appreciate any guidance on other house rules that would be appropriate.

I am considering removing the computer when she is here because I suspect it's a trigger. I have observed her make a beeline to computers and she seems to get entranced by it. Plus she won't let you see what sites she's visiting. I suspect that her stepfather used the internet as a prelude to molesting her.

Any ideas for making this young lady feel safe and comfortable are welcome. Thanks!

posted by Soda-Da to health & fitness (17 comments total)

Wow. My first thought was that your concerns are so grave and specific that, if the stakes are as high as you believe they are, I would be irresponsible to throw in. Either your cousin is as fragile as you think she is, in which case you don't want to guess about any of this, or she is not, and you are over-thinking and want to relax (but what if she is? Da capo). My next thought was that that is true for everyone here -- even if they are shrinks, they're not her shrinks, and that is who you want. Call her shrink(s). Ask them. No general guidelines or "well-I-think..." will serve you here.
posted by Methylviolet at 10:16 AM on December 9, 2006

well-I-think...

You should completely remove the computer, take her to the library to check email and get some books while you're there.

An exploration adventure that visits another world could be good, I'm thinking of a guided tour of a cave. There are a bunch west of you in the Blue Ridge Mountains, don't know if that's too far.
posted by StickyCarpet at 10:33 AM on December 9, 2006

While I concur with Methylviolet's sensible admonition regarding advice of a general nature for such specific concerns, what's notably missing from your list, Soda-Da, are any 12 step or other theraputic support activities you may need to be providing while the girl is with you. But given the high relapse rate of meth users, and the complicated nature of this girl's psychological past, that's got to be a concern for you. You need to clarify with her therapist what, if any, local anti-drug support activities she should be doing while she is with you, and, if possible, locate and visit those resources ahead of time, so that you know about them yourself.

And I suspect you may need to limit your own expectations of "success" for this visit. It may not go as well as you envision, but her behavior and reactions need not be optimal for the visit to be worthwhile for both you and her. Partial success is still success, particularly with a person who has such deep issues.

Good luck.
posted by paulsc at 10:35 AM on December 9, 2006

I doubt you posted your question for this type of feedback, but I would like to nominate you for a good old-fashioned AskMe group hug and three cheers for sharing your home and life with this girl. Especially during the holidays.

You sound like a great cousin and a terrific influence in her life. She's fortunate to have you. Good luck and happy holidays to you both.
posted by Work to Live at 11:13 AM on December 9, 2006 [1 favorite]

So if she's used meth twice in the past month, she hasn't gotten 30 days clean yet. You could suggest going to a couple of Narcotics Anonymous meetings and see if she would be into it. If it was me, I might suggest it, but I would be careful not to create any pressure about going to a meeting.
posted by gt2 at 11:16 AM on December 9, 2006

Second what paulsc said, and a note from a PTSD sufferer:

We can't always avoid triggers. We can do our best to avoid known triggers, but at times we will be exposed to even those. Why do you suspect that the Internet is a trigger for your cousin? Perhaps her instincts regarding privacy about the Websites she visits are (1) a natural response by anyone who has had her privacy so blatantly violated in the past or (2) a natural response to any young woman who considers herself an adult.

I don't mean to be harsh, but you need to accept that she is an adult. Having house rules about not bringing guests over in your absence is fine. Having house rules about drug use is also fine -- and clearly necessary.

But telling your cousin that she can't use the computer would probably be an insult to her intelligence, age and judgment. You may feel that she is the emotional equivalent of a 14-year-old, but she is 19 and in college. With some exceptions, (such as horror films) she probably enjoys the same things that any 19-year-old would.

PTSD sufferers need to be able to identify their own triggers and to meet them in the ways they and their therapists identify as best.

You should definitely talk with your cousin's therapist before she visits. That person is best qualified to tell you what kind of oversight your cousin needs.

And please ... treat her like a grownup. She has problems, but so do we all. The worst part of dealing with emotional problems is having people treat you like you are "different" because of them.
posted by brina at 11:19 AM on December 9, 2006 [1 favorite]

Most people I know who have problems of this nature have hobbies/passtimes that others (perhaps justifiably) might label an addiction. Call it self-medication or simply keeping oneself distracted, they tend to do these things excessively and compulsively. I know a girl who's severly bi-polar who has a thing for sex and television. And of course, internet or computer game habits are common.

So it's possible that the your cousin uses the internet as a substitute for meth or simply to keep her restless mind occupied. If this is the case and you force her to go cold turkey, you could be putting her under a lot more stress than she's used to. She might resent it quite a lot.

I think you have to weigh the pros and the cons, here. What if she did spend a lot of her free time on line? Do you feel like she'd use this as an opportunity to hook up with unsavory characters? To score meth? Would it tend to trigger abuse memories? If you have reason to suspect that it would lead to problems like this, then perhaps an outright ban is justified. On the other hand, if it's just a matter of her zoning out and spending a lot of time online, maybe you'd be better off with time limits or some sort of parental website blocking type software.

As far as her not wanting you to see the sites she's visiting... I don't think that necessarily means she's doing something destructive. She could be reading pornographic fanfic, downloading pirated movies, participating anonymously in web forums for survivors of abuse, etc. It's normal for teenagers to beef with their parent/gaurdian about the amount of privacy they get. Her behavior in this area might be normal and healthy.
posted by Clay201 at 11:24 AM on December 9, 2006

Thanks to everyone for the fantastic feedback. I appreciate everything you have all written and I am creating a plan. Part of that plan now includes getting coaching from her therapist and from her mom. She's visited me before and it's been a challenge but when all is well she is a delightful visitor.

I should have clarified why I was thinking of removing the computer. She has used it in the past to hook up with unsavory strangers and/or to contact drug connections. Perhaps parental controls would be sufficient so I'll look into that.
posted by Soda-Da at 11:46 AM on December 9, 2006

She might like Ugly Betty if she liked The Devil wears Prada - the stories are similar in some ways.
posted by concrete at 1:53 PM on December 9, 2006

You're right to be concerned about "unsavory strangers."

I read that as finding people who might be able to supply her with meth, although she may not even be aware of her underlying motives.
posted by jamjam at 2:12 PM on December 9, 2006

Terry Pratchett's Discworld novels might be a good read. It's a fantasy world with wizards and magic (so, similar to Harry Potter), usually pretty light and funny. There are a few with themes that might bother her (Thud, a recent one, deals with substance abuse; Mort deals with death) so you could scan a list of them ahead of time to check.

You could possibly see about getting board games to play with her in the evenings. Lost Cities is a fun 2-player card game of adventuring in the jungle that you'll want to play again immediately when you finish one game. Blokus is a geometric game with irresistible Tetris-like pieces, good for 2, 3, or 4 players. Old favorites like Boggle, Scrabble or cribbage can be a whole night of fun. Is she good at arithmetic (cribbage), or dexterity (Jenga or Gulo Gulo), or word play, or drawing (Pictionary), or spatial reasoning (Blokus)? If there will be more people than the two of you, see about Settlers of Catan (3-4 players), a very addictive board game that just about everyone enjoys. Any of these would offer her something to do with her time and mental energy even after she leaves your house. (Origami would be another activity like this; something she can do with nervous hands, and can get good at and be proud of.)
posted by LobsterMitten at 2:28 PM on December 9, 2006

For Harry Potter-esque books, I'd consider the His Dark Materials series by Philip Pullman.
posted by hogweed at 2:57 PM on December 9, 2006

I do love His Dark Materials, but a prominent theme in the first book is (spoiler) _{the organised kidnapping of children to 'experiment on'}, which to me doesn't sound like the lighthearted stories you're after.

(copy and paste the small text to read - I might have gone overboard, but I hate spoilers)
posted by jacalata at 4:59 PM on December 9, 2006

I just reread Anne McCaffrey's trilogy of Dragonsong, Dragonsinger, and Dragondrums, and really loved them on reread. I think they're definitely in the same vein as Harry Potter, though maybe a little dated in the character interaction. Robin McKinley's Beauty (retelling of "Beauty and the Beast") has also always been a favorite of mine, and might be something she'd like.

For activities: The zoo! I used to love going in the winter when it wasn't horribly crowded. And if she likes art and you haven't been to the Philips Collection, I would definitely recommend it for both of you. I think it was my favorite museum in Washington -- it's small enough to feel like you can get a feel for the entire collection, and interesting enough for you to want to. That neighborhood's pretty for wandering, too. She might also like wandering around Adams-Morgan, too, since that seems to be where most of the 20-somethings are.

On preview: It just occured to me there's a bit in the Dragonsong in which the main character is whipped by her father for disobeying his orders. It's set in a kind of quasi-historical time period in which the event doesn't seem horribly shocking, but if that might be a trigger for her, maybe skip that one.
posted by occhiblu at 5:09 PM on December 9, 2006

Since she's in college, if she's declared her major she might be interested in seeing something related to that. It could be something as tangentially related as hitting the art museum if she's into graphic design, or going to the Apple store if she's into computers. Having her concentrate on her future might be benificial.

As far as books go, the James Herriot books are fairly harmless. Of course, since he's a veterinarian there are stories about his animal patients dying occasionally, so if she's that sensitive it might be hard for her to take.

Maybe you can keep her occupied some mornings or evenings by picking up a kit to teach her something new, like knitting or calligraphy.

Good luck!
posted by christinetheslp at 7:34 PM on December 9, 2006

The Chronicles of Narnia might be worth reading. I loved them as a kid (though I hate the Christian subtext now). Maybe you could do some baking or cooking? That's pretty safe.

A quick scan of my DVD collection turned up some candidates, in order, best choice to worst.

Wonderfalls (It really is as good as people say)
Princess Bride
Home Movies (closest to Family Guy/Simpsons)
Shaolin Soccer
Amelie
Office Space
Father Ted (maybe too adult in nature)

Obviously, don't show anything you are unfamiliar with.

My hat is off to you for trying this. Meth is extremely bad news. Recovery is difficult but possible.
posted by chairface at 9:46 PM on December 9, 2006

I think the key (especially if she is emotionally ~14) would be to spend as much time with her as possible. Board games, trips out - anything, but just be there. If you have to take more time off work and can afford to do so - do it.

The more time you spend with her in-person, the better the connection. Even walking in a mall - go to the library, the bookstore, coffee shops.

While my issues were not as severe - I can look back to an uncle who took the time and interest during a two week vacation that changed my 14-year-old life for the better dramatically.

Books - light/funny fantasy might not be bad:

- The Belgariad series - David Eddings.
- The Myth series - Robert Asprin.

Definitely get blocking software for the computer, but do not remove it entirely.
posted by jkaczor at 12:00 PM on December 10, 2006