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Trapped in His Own Skin

Esther Ilana Rabi

His mental health has been shaky for a while, deteriorating as his baffled parents look on helplessly. He’s not a rebellious teen, just overcome by social anxiety and depression. What now?

Thursday, April 20, 2017

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TRAPPED INSIDE He refused to leave the house, spending days in his room in pajamas and popping out only when hunger pangs overcame him. He’s not a rebellious teen at risk but a shackled young man overcome by social anxiety and depression. Appointments with mental health professionals proved futile. But what if someone could meet him on his own turf?

"I don’t know what to do with Danny. He’s been sitting in his room, in the dark, for weeks. He’s hostile and controlling, and we’re all afraid of approaching him because he sometimes flies off the handle. Can you help us?” It was a plea from Danny’s brokenhearted and confused mother to Rabbi Gavriel Hershoff, director of Aish Tamid of Los Angeles, an organization that helps teens at risk and young adults find themselves and become productive members of society.

Rabbi Hershoff, a social worker and substance-abuse counselor, braced himself. He had a lot of experience with such holed-up teenagers, some of them trapped by their own social anxieties, others with at-risk behaviors who’ve dropped out of school, and still others hit with all-too-common teenage depression, to the extent that they’ve basically hidden themselves away and have bowed out of life, raging at the world if provoked. If Danny was embarrassed to be seen in his present state, not having showered for weeks and wearing pajamas, would he rage at him? Would he slam the door in his face? Would he scream at him, angry at being seen as a “project”?

Reb Gavriel always tries to be there for kids who need him and for their families, who feel like hostages in their own homes. So he said, “I know your son. Would you like me to come over and see what’s going on?”

Danny’s crisis wasn’t a new story, just a new episode. His mental health had been shaky for a while, but left untreated, it began to deteriorate, as his baffled parents looked on helplessly — it’s always hard to see a downward slide when you’re in the middle of it. And social phobia — sometimes called a silent disorder because it can affect children for years before being diagnosed, is a gateway disorder to depression, substance abuse, and lifetime impairment.

“Usually there has to be a crisis for a social worker to get involved,” says Reb Gavriel, who’s become known as an expert in home visits, a sort of first-step intervention when reasonable communication with family fades. “That’s why I prefer to work in a less formal setting, so there’s a relationship going before there’s a crisis. But just because a counselor comes on the scene doesn’t mean a kid is going to open up. Besides, a lot of kids have been going to therapists for years, and by the time they’re old enough to actually do the work therapy demands, they’ve already ‘been there, done that.’ ”

A Little Different

“When Shauli announced, ‘I’m not going to yeshivah tomorrow,’ that was okay with me. Sometimes I need a day off, too,” says his mother, Ita. “But his vacation extended to three days, and then two weeks. It took a while for us to realize we had a problem. He’s been home for four years now. He doesn’t talk much, and we’re at a loss.

“Go slow,” says Rabbi Simcha Feuerman. “A child’s decision to reach out is like a little fire. Even a splash of gas can put out a little fire if it overwhelms it”

“He’s brilliant and did well in school, but we always knew he was a little different,” Ita continues. “I took him to speech therapy and OT for years. My friends laughed. ‘You keep finding problems just because you’ve got a degree in special ed,’ they said. Even one of his therapists said, ‘Sensory issues are just a fad.’ But while other kids hang upside down from the couch for a few minutes, Shauli would do it for an hour. Then he became a teenager, and refused to keep going, saying ‘I’m normal. I don’t need it.’ That’s when it all fell apart.”

Zelda’s description of her son Moish’s withdrawal was similar. “It took us a while to realize that it was as bad as it was,” says his mother, who explains that Moish was diagnosed with high-functioning Asperger’s, which never seemed to interfere on a drastic level with his everyday life. “At first, Moish just stopped going to classes that didn’t interest him. He knew he could pass the English exams with no trouble, so he didn’t go to English. Then they started mixing enrichment courses into the school day. He might have gained a lot from the Dale Carnegie course, but he had no interest in it. I couldn’t force him to go to the first-aid class, either. He was still going to his math tutor and his Gemara rebbi though, so in my mind, he was still in school, just not going to classes.” Moish has been home for three years.

Finding help for these young people can be a huge challenge, and wrong diagnoses are common; a child who interacts well with adults in one-on-one situations can get lost between the cracks.

“That’s too bad, because there are ways to teach young kids skills, even those with anxiety issues,” says Akiva Harrow, a social worker and family therapist with Kav L’Noar in Israel, who makes home visits to try to reach these broken young people. Some of these kids, he says, have low-level Asperger’s and although they’ve functioned pretty well until now, at a certain point they need help learning social behaviors most of us take for granted — and if they don’t “get” their social environment or feel overwhelmed and unable to grasp behavioral nuances, it’s just easier to give up.

“Not everyone is ready to be helped,” Akiva says. “But just because we don’t click in the short term doesn’t mean we can’t lay the groundwork for a relationship at some time in the future, when he’s gained the maturity to pull himself together and do something.” (Excerpted from Mishpacha, Issue 656)

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