The good is often the enemy of the best

 By Michael G. Brock, 

MA, LLP, LMSW
 
This week I received a call from an attorney regarding a case we did together. It concerned a young man with a rather serious alcohol problem. I had done a substance abuse evaluation for the client prior to trial and sentencing. He had one of those cases where he was able to turn a small matter into a felony charge by getting into a scuffle with police.
 
In my evaluation, I pointed out that the young man had serious alcohol issues, and would probably be unable to quit drinking and remain sober without inpatient therapy. Even that would be no guarantee, but I’ve been doing this work long enough to know that someone his early twenties who drinks a fifth of liquor in an outing is probably not going to stop without intensive help. It also seemed likely that he had underlying psychological problems.

There are, of course exceptions to the rule, but they are the unusual people who recognized they have a problem early, and usually they are voluntarily seeking help, not being referred by others in a crisis. This client did not fall into that category. Moreover, even those who are self-motivated need to aggressively seek out therapy and attend a lot of AA as well, to be successful. There was no evidence that this young man was going to do that. He was angry and defiant, and seemed determined to get himself into more trouble.

I wondered what could have happened to make this person so angry and self-destructive. Usually it’s the parents, cliché as it sounds. Children amplify their parents’ defects, and if their parents drink heavily when they are very young, they will typically drink and use drugs with much more devastating effects when they begin their teenage acting-out years. There is now clear research evidence that there is much more brain development and personality formation during the early years than we had previously thought, Freud notwithstanding.

But this child seemed to have concerned and stable parents. It didn’t add up. As it turns out, he was adopted from an orphanage, and not at birth. It is unlikely that he obtained the kind of nurturing necessary to enter adulthood as a basically secure adult, and God knows what negative experiences he was subjected to. Parents who adopt these children, like those who take on the role of stepparent, usually expect to be able to provide the child with enough love to remedy the past, but this is rarely the case.

There are so many ways for this scenario to go wrong, for the child to continue acting out against the previous parental figures regardless of how much love he is experiencing now, and to disrupt the lives of other children in the household and even the adoptive or stepparent’s marriage, that one wonders why anyone takes on this responsibility. The job literally takes the patience of a saint, and few of us have that quality.

That being said, this was our situation and my job was to evaluate and try to be helpful. So I recommended inpatient therapy — preferably at a long-term facility like Dawn Farm — because I was concerned that anything less would not be successful, and the client would experience a sense of failure and possibly more problems with the law. From a mental health standpoint, that was the best alternative. If that were not possible, I recommended sobriety court, therapy and 3xs weekly AA.

Lawyers tend to see things differently, however. Getting the best legal deal typically means keeping the client out of jail and having him jump through as few hoops as the court is willing to accept. I’ve seen this dichotomy many times in the courts. His lawyer was able to get him a better legal deal. I understood why, but told the attorney at the time that I doubted he was doing his client a favor.

This week he called me back to tell me his client was again in trouble. This case will be coming back to me, with the dual responsibility of preparing him for court, and also trying to get him the help he needs. But it will not be helpful to continue to address his legal needs without addressing what is causing them. All the principals involved need to see that his best interests are not always served by making someone’s life easier. His parents, attorney, PO and the judge need to see that the good is often the enemy of the best. A crisis is an opportunity to get someone help who might not otherwise be open to it, and we must use that opportunity to exercise the tough-love the person needs if they are to survive, build a life, and become a contributing member of society.

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Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; 313-802-0863, fax/phone 734-692-1082; e-mail, michaelgbrock@ comcast.net; website, michaelgbrock.com.