Jack and Bipolar disorder

JACK

Jack is very cute. He is the cutest client in our agency. He has huge dark eyes and long curved eyelashes. He has very tender white skin, dark wavy hair and a charming smile. His older brother and a younger sister look so bleak next to him…….but not many people can see our handsome boy. He lives in a residence for mentally retarded and autistic kids. Jack cannot talk. He has profound mental retardation, cerebral palsy and bipolar disorder. I spent with Jack 3 hours once week for a few years already. Once I met his parents and his mom expressed her surprise what could be done with Jack for 3 straight hours. I tried to tell her that those hours are very interesting and fulfilling. She probably didn’t believe me. Once his grandma visited Jack when I was there and she kept asking me “If he understands anything?”. And I kept answering “He understands everything!” She didn’t believe me either as she almost never comes to visit him, in spite the fact that Jack loves her and looks very happy when she comes.
When I just started to work in that field I heard often that workers become kind of mentally retarded themselves from spending a lot of time in such environment. I feel quiet contrary. For me that environment is extremely stimulating intellectually.
But that is the trick. You should believe that they understand everything. With non –verbal kids nobody can say for sure what a child is able to understand. I asked a few therapists about that. They conformed that it is impossible to know. Officially of course every mentally retarded/ intellectually disable child has certain degree of retardation, but that is  only in papers. We don’t deal with papers. We deal with a real child. So, a lot depends on our attitude. Probably because I believe “He understands everything!” and I behave accordingly…… usually kids behave the way that it supports my beliefs .  Of course if I’d go to college and learned different theories and look at the child through knowledge I’ve learned there , it’d be different. But I chose not to go and every child is a new book to open ,  learn and explore with free mind and every child is just a new exiting adventure.
Unlike a real book where you can peek at the middle of the book or look straight to the end or scrolling through the pages to see if a book is worth to read, with a child you have to go ahead only  page after page of that book. However it’s  possible to go back to the first page and reread the story from the very beginning

IN the BEGINNING

Jack was introduced to me by our manager as a 9 yo boy who is usually very sad (staying on antidepressant)and  often crying. Seems it was all. When I saw Jack for the first time  his sadness was really very upsetting. However with that sadness on his beautiful face his body was surprisingly active. Jack was constantly moving and hitting a ball, nonstop.
 A soccer player !! He didn’t pay any attention to me or different activities I tried to offer and after a few second of distraction which he obviously didn’t like he returned to his ball. So, it was nothing left for me as to join him in soccer play. I saw however that if a ball would stuck somewhere in a closet and between chairs, Jack  didn’t complain but used different inventive ways to free the ball.
It was encouraging!! Later I made some gate and suggested for him to shot a ball in the gate where I was a gatekeeper and he seemed understood and liked the idea. We played “a real soccer” for a while. Then I got a different idea to play with soccer and he liked it as well. And then I decided to try to make a drastic change. In spite of PC which affected the whole Jack’s body, he used his legs pretty well while his arms were not useful at all. He was still spoon-fed and  refused to do anything where hands were involved. So, I took a ball , put it on a high place and hit it with my own arm. Then I offered Jack to do the same…and he did and it was so great that I couldn’t hold a very loud emotional delight. And then for the first time I saw a very clear emotional response.

FIRST EMOTIONAL RESPONSE

 Jack was laughing from joy….he obviously was happy….for the first time…really happy. If before he just cooperated on my different ideas still always carrying that sad expression on his face now it was a different boy. And we proceeded in the same manner.  Although the loudness of my reaction was a little bit disturbing for other workers, but somehow I felt that Jack needed that. He obviously enjoyed his success in hitting and my loud emotional reaction. Slowly sadness started to leave his face. The negative consequences of that activity was that Jack  liked it so much  that he started to smash everything everywhere what was available for smashing. Therapist complained. So we switched to another activity which required using both arms “take a ball with two hands and throw it”. Then “give it to me”. It was obvious that Jack welcomed my tendency of constantly bringing new and new ideas for activities. However he didn’t accept my idea to play basketball. After numerous efforts to make Jack throw a ball into the basketball ring I gave up. As much as Jack liked soccer , basketball was obviously an activity he did everything to avoid. . He seemed hated it and showed very clear his attitude to it.

NEXT STEP

Somehow from activities with a ball slowly we switched to more quiet and less moving activity as puzzles or stocking cups, playing with blocks- using hands instead of feet. Then we started to work with photos. Jack started to pose and giving  a smile when asked. The strange thing was with Jack that for all 3 hours I spent there with him he stared at me. No matter where I go he followed me with his head. It was funny, because if somebody was feeding him sitting at the right and I would be at the left he would not eat turning his head away from the spoon.
He also started “to talk” with me. The guys who were regular staff often asked me “Why he talks to you and doesn’t talk to us?” I answered that I give Jack intellectual stimulation and he appreciates it and wants to participate. Every time I came into residence he started “talking” emotionally with a sound and I answer with words.  At the beginning his tone was very preoccupied, he grabbed my hand and took me to an elevator. In elevator he felt more relaxed and smiling and when we stepped into his room and he sat in his chair he laughed happily and victoriously

COMMUNICATION

Talking to non-verbal kids/adults often can be more satisfying than conversation between 2 regular verbal adults where everyone saying something without any concern of another talker understanding or interest, everyone says what s/he is interested in.  And another person often just keeps up with uninteresting “conversation”. Verbal exchange of two people involving in a small talk, were each one trying to say nothing is also far from real conversation/stimulating communication.
 In talking to non-verbal kids I concentrate on their reaction and try to understand  if they understood me and that is very stimulating kind of  communication. So, for 3 hours we really communicate including a lot of talking
We started to go for a walk to a big alley with many benches. Jack used to sit down on the bench, but then got up and continued walking. I made him a rule to sit on every bench for 2 seconds and no more and then move to another bench. He liked it. Then to sit on every other bench. If he liked the idea, he participated willingly, if he didn’t like it, he resisted. However often it’s possible to persuade him. So it was very close and constant interaction often with compromises he accepted

READING PERIOD STARTED

And then  Jack fell in love with Almo. Some of the counselors showed me how exited Jack became when he started to watch video with Almo. Next time I brought a couple of Sesame Street books with Almo and from that day our “reading period” started. With Jack’s responsibility of turning pages.  A book about Almo and numbers we read maybe hundred times. I kept renewing it in library so many times because he always gave that book preference over others. Overall I noticed that Jack liked to listen about numbers. He made me to read books all the time I was there with him. While other staff still knew Jack only as a “soccer player”, for us soccer was long in the past. He would never play ball with me any more.
Only books !!! Soon Jack lost interest in reading about Almo. Next book he fell in love was what I called “a science book” where a smart Mrs Own explained other animals why there is day and there is night every day for 365 days in a years with demonstration how it worked. I’ve learned some useful information as well. Jack adored that book. Then we switched to Dr. Seuss. And stayed on those books pretty long.
It was many other books he loved and could listen over and over. Some of them he could listen only one time and no more and some of them he rejected after a few words. But….although everybody knows that Jack is a tough guy  and does usually only what he wants he is not that selfish and respect other people’s wishes as well. If he refused to listen some book, but I told him that I’d read it anyway because I missed that book or I never read it and interested to know what that book is about , he yielded  to me  and listened to that book.
When I stopped bringing fresh books Jack invented a new way of reading . He would let me to read a few sentences from a book and then close it and wanted a next one, then the next one and the next one and suddenly one of them he wanted to listen to the end. It was a great amusement for him In our “library” we maybe have around 40 books.
I wondered if he had some specific book in mind to read that day and rejected all others. Or it’s a random book he choose to read. I had no way to check it out. He obviously was enjoying my puzzling with that situation as I expressed it out loud , but insisting on that. I wondered what he would invent next. As I stopped suggesting new and new things to do every time seems Jack took that role for himself and obviously was enjoying it.

JACK"S PRANKS

     Overall his sense of humor and his pranks are well known in the residence. For example he takes me to elevator made me to press the button . When elevator comes and I come in he turns away and goes to different directions….and enjoying the prank. He had many of them and if he wanted something, but couldn't get it then we heard tragic crying as if dome real tragedy happened. Big talent!!!
Jack had Bipolar disorder and took pills for it. Some days he is down, depressed and crying the whole day. If that was my day to come the staff would know- for 3 hours Jack would be OK. Some days he felt up and can laugh and laugh nonstop uncontrollably. But when I’m there and  he started laughing I would stop reading , saying “I’d not start reading for you till you stop laughing” and continued reading silently to myself….very quickly the laugh stoped.
They say Bipolar is a chemical imbalance of the brain and only medication can help. Jack and me-we were not agree with that statement. We had books and other activities instead of medication to deal with Bipolar