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Philip

Age at interview: 59
Brief Outline: Philip thinks his son started cutting himself when he was about 20. He lives at home with his parents and has had several years’ contact with mental health services. Philip describes the difficulties of the situation and advises other parents not to give up.
Background: Philip, 59, is married with one son aged 23. He has worked as an accountant and computer consultant, and is now a self-employed handyman. Ethnic background: White British.

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Philip’s son had a happy childhood, but was bullied at school and became unhappy and nervous in his first year at university. He saw a counsellor, who became alarmed when he expressed suicidal thoughts and would not promise never to act on them. He was immediately admitted to a psychiatric hospital under section, but was released a few days later to the care of Philip and his wife. He went back to university, but decided not to return after the first year and has lived with his parents since. He sleeps during the day, getting up at about 6.00 p.m. and going to bed around 8.30 a.m. Philip thinks this lack of outside stimulation is making the problem worse.

Philip is not sure when the self-harm started as his son hid the cuts under his clothes, but then Philip’s wife noticed scratches on his face and neck. They were horrified and immediately started looking for help. Their son continues to cut himself intermittently, and keeps a kitchen knife in his bedroom for this purpose, but Philip says that the scratches are fairly superficial and soon fade. Philip is resigned to this cutting as ‘part of life’. His son says the self-harm releases tension and helps him tolerate his constant misery. Philip thinks he has a need to punish himself. He has threatened to kill himself on several occasions, which is frightening and worrying for his parents, but they try to persuade him that suicide is difficult and unpleasant, and hope that the intelligent side of him will respond to this. His son usually signals his suicidal intent very clearly so that he can be stopped: Philip thinks it is mostly play acting, and takes comfort that his son probably does not really want to kill himself, but is expressing an extreme cry of pain.

Philip and his wife investigated treatment possibilities for their son before he went to university. He is seen regularly by a Community Mental Health team and has tried Cognitive Behaviour Therapy, mentalisation, family therapy, the complex needs service and a range of different medications, but Philip says nothing has made much difference. Various diagnoses have been suggested, including depression and Asperger’s syndrome, and recently he has shown signs of obsessional compulsive disorder. Philip suspects that he has researched this online as he is very fluent with the terminology. They have found it hard dealing with many different agencies which do not communicate well with each other, and with psychiatrists who use jargon and don’t explain clearly what they mean.

Philip himself has mild depression, which responds well to medication, and there is a history of depressive illness in both sides of the family, so Philip thinks that his son may have inherited a genetic predisposition to mental ill-health.

Philip describes his son as a very sweet, highly intelligent person, with two or three close friends, who remains emotionally dependent on his parents, to the extent that they don’t feel they can leave him for 24 hours. This has a great impact on their life – the family therapist has encouraged them to remember their own needs as well as his. They had a family holiday recently for the first time in four years, but although they had a delightful time their son went into a prolonged down period on their return. Philip is self-employed and able to work flexible hours – he says it would be very difficult to have a conventional full-time job in their current circumstances. Their son’s physical presence in the house is a constant reminder of his problems; when he is not with them ‘radiating gloom and despondency’ they are always aware that he is sleeping upstairs so avoid noisy activities like housework and decorating.

Philip thinks his wife is more upset by their son’s self-harming than he is. She is very protective of their son and Philip sometimes feels deprived of her company and the future they had planned together for retirement. Although he appreciates that their son’s problems are tragic, he says ‘after four years, it’s not the tragedy that strikes you, it’s the boredom.’ He is tired of living with the emotional dependency of his son, but hopes that in future his son will overcome his difficulties and be able to live an independent life.

Recently the Rethink charity has helped Philip and his wife negotiate the system and provided a volunteer mentor for their son. Philip has used the internet to find general information (although this often gives more questions than answers), and attended local talks organised by the mental health trust. He and his wife have a number of very supportive friends with whom they can talk about mental health issues and their son’s problems.

He advises health professionals to remember that not everyone can understand jargon. To parents he says: ‘Stick with it. You can’t throw them out. You have to look for help, you can’t handle it yourself.’
 

Philip talked about a 'genetic predisposition' to depressive illness in his son.

Philip talked about a 'genetic predisposition' to depressive illness in his son.

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You mentioned that you had some sort of depressive tendencies. Is there anyone else in the family who’s had mental health.

I think

Issues?

I think, unfortunately, it looks as though this may be a genetic predisposition, which my son has inherited the worst of. My wife, I think, is mildly depressive but not very much so. Her mother was diagnosed with depression in her old age. My father has clearly suffered. My brother is receiving very similar medication to me.

My sister was very depressed for oh, five, maybe ten years but it but she found someone to marry, who she’s still with. They’re happily retired in South West France, lucky things, and that seems to that seems to have given her a balance and she can she can deal with things. But her, both her sons have talked of depression. My brother’s eldest I think isn’t a sufferer but his two girls are. 
 

Philip was scared by his son’s threats of suicide but wasn’t sure if he really wanted to die.

Philip was scared by his son’s threats of suicide but wasn’t sure if he really wanted to die.

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So are you worried that he might go on to commit suicide?

We still are. It’s perhaps a relief that he’s never done it without signalling it loud and clear and really rather making an event of it and I think that’s what gives us comfort that we, that he, it’s probably not really the first thing he wants to do. It’s really, it’s just an extreme cry of pain, in a way.

Yes.

But we can’t discount it, I mean, it’s, to start off with he was talking about throwing himself off bridges but we had a think and realised that the nearest bridges are really quite a long way away and not readily accessible and it’s not it’s not quite as easy as he thought. But he picked up a bottle of weed killer one day and threatened to pour it into a glass and drink it.

And had to be restrained from that. For a long time, I don’t know whether he still does, he carried a rope around. I think he was thinking of hanging himself and it’s ninety per cent play acting I think but it’s our only son.

Yes.

And he had, there’s so much he could do.

Yes, but he hasn’t actually done anything that would seriously harm him.

No. We think he may, I think my wife thinks he may have tried to hang himself at one stage but we don’t know quite the details of that. We’re sort of nervous to ask and it hasn’t happened again and it didn’t work and we hope we’ve persuaded him, actually, killing yourself is pretty much guaranteed to be unpleasant, pretty much not guaranteed to be successful and isn’t as easy as he thinks. And I hope he’s intelligent enough, I hope the intelligent side of him will take that.

But the fact that he’s thinking about it is still deeply scary.
 

Philip and Mary feel their son is ‘always a presence in the house’ and this affects their life together.

Philip and Mary feel their son is ‘always a presence in the house’ and this affects their life together.

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And do you think it’s affected your relationship with your wife, the self-harm?

I think, I hope not but I do, I mean I feel slightly deprived and I feel, I’m sure unfairly, that I come a long way second to my son and I think by the time he’s twenty three, it ought to be the other way round. But fortunately, we’ve been we’ve been together now for just coming up to forty years. Neither of us is looking to change that in the near future. We’re very comfortable together and I can I can see it, my parents are both still alive, although I think my father is in his last couple of weeks. They’ve been married sixty five years so I’m hoping to get close to that. But it is difficult and we, the fact is, he’s always there. He’s always a presence in the house. If he’s not physically with us radiating gloom and despondency, he has very eloquent body language, we’re always aware that he’s up there and we’ve, he sleeps all day so we tend to avoid making noise in the house, which means that housework doesn’t always get done. Decorating certainly doesn’t get done and he’s always in our, he’s always in our minds as a as an immediate problem, not, “Ooh, he’s got he’s got problems at work. I hope he’ll manage to sort them out.” Or, “Oh, he’s lost his job but he’s fortunate his wife is still in work so they’ll be all right together.” It’s a problem now.

Yes.

And it’s a long standing problem. It’s  tragic, in many ways, what he’s what he’s become but after four years, it’s not the tragedy that strikes you, it’s the boredom.

And every time every time he takes a down swing we think, “Oh, not again.” Not, and to some extent, yes, poor poor young man. There’s something wrong. We can’t fix it. We’d love to fix it but it becomes it becomes very much the same old same old.

Yes, yes.

The same old the same old talking about, talking him out of going off to commit suicide, giving him a lecture about how there’s only one person who can do some of the things that he’s being asked to do, which is him.

And there’s no end in sight.
 

Philip thinks it’s important to be open about his son’s problems.

Philip thinks it’s important to be open about his son’s problems.

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And have you found any difficulty in talking about your son’s harming. I mean some people have said, “Oh, we think it’s, you know, we’re ashamed to mention it to anyone.” But?

No, I think we, I mean most of our friends are intelligent and broad minded enough to be able to talk about pretty much anything I think. It’s I think it would be a shame, it would be a thing to be ashamed of if I knew that I’d in some way caused it. Maybe I have, but I don’t know it and it’s I think it’s more important to be open about it in the hope that it will help somebody else to be open about it, rather than hide it. There’s no, we could hide it. We could pretend we don’t have a son at all. He doesn’t go out that much. He lives upstairs in his bedroom for ninety five per cent of his day and we could just pretend he’s not there and, “Oh no, he went off to Australia. We hear, hear of him occasionally.” But it’s rather more use I think to say, well, we’ve got to explain why we’re reluctant to accept invitations and we never seem to go away and rather than make something up, we might as well.

Yes, yes.

Tell the truth. We, I’ve never had anybody say anything unkind to us about it and I’ve, these days I’m relaxed about it. One of the things about it becoming boring is that it is sort of you stop thinking of it as shocking and I, therefore, just, you know, if it comes up I mention it.
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