Sing for Your Life

by Daniel Bergner

  The standard for “fortunate” was functioning, which this woman was doing in a fragile way. She lived in the town, though she’d grown up elsewhere; she hadn’t made it far since getting out. We met at a coffee shop along the road that ran between the two hills, below the old and the new centers. Everything about her—her constrained voice, her deliberate gestures—spoke of tenuousness.

  “Sometimes it was quiet. Sometimes there was someone running naked, yelling. Sometimes someone was smearing feces on the walls. The first day I came in it was screaming, banging—someone in seclusion. I see a girl around town lately. She’s in a community program. She would hurt herself with a hairbrush. Gruesomely. In her vagina, tearing herself up. Then she would put that on the walls.

  “There was a guy who vowed either he was going to murder or rape me. I had taken a liking to this lady at the nurses’ station. The door at the station had a top part and a bottom part, and one day she didn’t have the bottom part locked while she dispensed medication. This guy barged in. I saw him bash her head against the floor. So later on, I said something to him about it. When I said that, it flipped a switch. Now I was his target. He was in four-point restraints. Ankles, plus his wrists hooked to a belt. But it didn’t matter what he had on. He was chasing me down the corridor, yelling what he was going to do.”

  In Ryan’s time, the setting was different, but the kinds of kids were the same. It was a place, I was told by staff whose years at the facility spanned back to when Ryan was locked up, where no staff member could ever really feel certain about what to do. Every crisis was confusing, and the crises were relentless, routine without their constancy leading to clarity about how to respond. A few days of inexplicable calm might go by on a unit, but almost as inexplicably it would be shattered.

  “Banging with everything, their fists, their heads. Spitting at staff. So many of them are hostile. They externalize the turmoil they feel on the inside,” one employee said. “It can easily become a group contagion, three or four kids at once. Sometimes eight or twelve. Throwing chairs across the dayroom, slamming doors with tremendous force. Slamming meal trays. People who work in youth facilities like this are more prone to be victims of violence than people who work with adults. My kneecap was broken. A woman I worked with, her hair was yanked so hard her nerves were permanently damaged. She lost sensation in her face.”

  A state investigation of the facility—spurred by the escape of a teenager who’d earlier been charged with walking into a bank armed and ready to commit a robbery—was made several months after I visited. The report described an unmanageable mix of purely psychiatric and criminal kids. “Staff stated that higher-functioning adolescents from correctional settings often preyed on the more vulnerable…and often brought a gang mentality to the setting, which in some cases resulted in gang-related rivalries being acted out in the facility.” There were no security guards at the site; the funds weren’t available. In dire emergencies, the staff called the security team from an adult psychiatric facility down the road, or they called the police.

  The unit where Ryan was placed, for kids around the age of puberty, might well pose the most risk, a former staff psychologist said to me. The pubertal ones were big enough to do harm and even less easy to reason with, to talk down, than the older adolescents. But reason ran scarce on all of the institution’s four pods, and deception compounded the staffers’ helplessness: “Some use the center only to escape the correctional facility,” the psychologist said. She talked about a gang member who was cutting himself. Was he inventing his distress? Was it as real as the agony of the others who slashed their bodies?

  And the techniques for aiding anyone, for transforming anyone, were limited. In the late nineties—and to a fair extent still—the prevailing method was operant conditioning. The staff bestowed points for positive behaviors. Brushing your teeth or taking a shower—some resisted even these basic acts, and a few were too depressed to carry them out, so even the simplest steps were rewarded. Making your bed. Attending Anger Busters. Demonstrating cooperation. Gradually, point by point and day by day, you could climb a series of levels, claiming privileges like watching a movie or playing a video game. But a slip into defiance could mean not only stalling in your rise but tumbling to the bottom, all your points revoked by the staffer who witnessed your refusal, your rage, your failure. You would have to begin again.

  “If you’re you or me,” an administrator said, “you work with the system. But most of our kids, they get wiped back to zero, they feel like they can’t possibly get anywhere. They feel like, That’s it, screw it. Or they’re on level four and feel they can’t conceivably get to five—you feel you’re going to blow it, you know you’re going to, so you say to yourself, I’m going to blow it on my own terms.”

  The explosions, whether catalyzed by the impossibility of rewards or by surges of other despair, took all sorts of forms. “It’s fine until it isn’t,” the administrator said about the rhythms of the place. Above his words a hoarse cry came through the cement walls from one of the pods, units whose communal walls were decorated with displays featuring curious animal facts: a rhinoceros’s horn is made of compacted hair; a crocodile is incapable of sticking out its tongue. The cry resembled the protest of a giant bird. “Our kids are, it’s true, kids, but they have problems of a magnitude that is so much greater. Otherwise they would never get here. When they lose it, they lose it huge, in incredibly self-destructive or other-destructive ways. Sometimes it’s a period of psychosis—they’re not connecting with the reality the rest of us are connecting with. And sometimes it’s a level of anxiety or depression so much more intense than what the rest of us experience that it causes a fundamental breakdown of self-control.

  “Pounding my head against the cinder block and then cutting myself until my arms are just flayed open. Or ‘I want ramen noodles. You better find me some ramen noodles or I’m going to beat the shit out of you.’ Or I’m ripping out clumps of my hair. There are patches missing. And I’m ripping out the hair of staff, because there’s this porous boundary between myself and you, and I want to meld. If you’re working on that unit with the hair-ripping kid, you’re coming to work in a hoodie. Or I’m tearing stuff off the walls and hurling whatever I can and flipping over tables that are too heavy to throw and yelling that I’m going to fucking kill you if you come anywhere near me.”

  Ideally, the blowup abated before staff had to close in. “We don’t want the physical confrontation. It’s dangerous for the kid and even more for staff—it’s almost always the staff that gets injured in a situation of trying to physically restrain. And it’s traumatizing for the kid. And the kid has been traumatized his whole life.”

  The decision to close in wasn’t always rational. “When you’re threatened? Working in this environment?” the staffer whose kneecap had been broken said. “I’ve been hit upside the head with as much force as you can imagine. I said something I thought was helpful, but the kid misperceived. That happens with kids who’ve been mistreated. And we all have a fight-or-flight response. Sometimes it’s easy to apply more force than necessary to contain a kid’s aggressive impulse. The job is to figure out how to minimize, how to respond therapeutically, but—” Sometimes, too, confrontation was triggered by more than a kid’s aggression. “People drawn to mental health work are often damaged themselves.”

  “Staff might be dealing with trauma issues of their own,” the administrator agreed.

  When they closed in, it was frequently in pairs or groups. Groups could be more gentle. “We would literally lay down on them. I would lay my upper body across the kid’s lower legs,” a former employee remembered, “and someone else would lay on their upper legs, and someone else was on the upper body, and someone was up at the head, trying to make sure the kid didn’t hurt himself, banging his face against the floor.”

  In pairs or alone, they used a system of holds, maneuvers designed to immobilize, to pin the arms, to render the hands useless, to contort the body. No phys
ical injury was inflicted. The physical pain was brief. But to be overwhelmed in this way, to be a kid and to find yourself suddenly and completely helpless, paralyzed, taken in one instant from a state of frenzied autonomy to a position of absolute futility, was a journey of infinite emotional violence.

  On the platform of each kid’s bed, along the rim, was a set of slits. If need be, staff bound a kid to the bed. More often they shut the kid in one of the seclusion chambers: empty of everything, just the floor, just the walls. “It can be intolerable,” the administrator said. He was trying, years after Ryan’s time, to persuade the staff to rely less on punishment, less on seclusion especially. The persuasion wasn’t easy.

  “Every minute alone in there can be discombobulating. Unbearable for different reasons, depending. Take a common cognitive error that a depressed person makes: My life was always this bad, it is always like this, it will always be like this.” Time in the cell felt eternal. “Or take the kid with PTSD. She copes by pushing away whatever it is. But alone, she can’t push it away. Or the kid with a horrible sense of self: I’m a horrible human being. There’s no escape from that in seclusion.”

  But now and then, no matter what they would have liked to do, staff couldn’t intervene at all to quell a situation. The psychologist recalled a huge teen who, one night, seemed too dangerous to subdue. “Everything on the unit—down, demolished. It was like a tornado.” Other kids on the pod locked themselves in their rooms, using the button locks on their door handles that only staff could open. Taking flight, staff members bolted themselves into a miniature courtyard adjoining the pod. The courtyard, with high brick walls, was where a kid could be given thirty minutes of fresh air if he couldn’t be allowed outside. From there, staring in at the teen, the staff phoned for rescue.

  * * *

  “Ryan was observed without incident on this shift.” This is the way Ryan’s record from the facility begins. The log runs shift by shift, hour by hour. “He interacted well with peers and staff.” This was his first afternoon and evening. “He was cooperative and polite.” He woke in his room in the middle of the night, the immense structure of shelves and cubbies leaning over his bed, each empty section a gaping hole.

  He discovered a game during his initial days. A TV and a set of Nintendo controls sat on a black metal stand in the common area, and the staff permitted him to play for short periods, though he hadn’t yet accumulated much in the way of points. The screen filled with a radiant blue sky and a bank of puffy white clouds. His plane, an old-fashioned propeller rig with wings stacked one over the other, was painted bright red. Cheery electronic music played softly, the notes like a high-tech version of a carousel’s singsong. He piloted into the blue. Clutching and tapping his controls, he steered above a desert and aimed for a landing strip up ahead. Three bursts of triumphal music sounded when he touched down. “Great Landing” flashed on the screen. He planned, he told the staff, to earn tons of behavior points. He made his bed, brushed his teeth.

  Yet over his initial days he deteriorated. Familiarity with the center seemed to remove fear and restraint. “Cooperative and polite” gave way to “borderline rude.” He was “a bit argumentative.” He made “inappropriate” comments with “sexual undertones.” He was “loud and overactive.”

  On the fifth day he heard his mother’s voice. This was not a reward for however many points he’d earned. The facility’s policy was to try to keep the kids in contact with their families. His mother couldn’t make the long trip to visit. She didn’t have money for gas, she’d told the social worker who phoned her. She couldn’t afford the bus; she didn’t have anywhere to stay. But this wasn’t the only issue. Ryan didn’t want her to visit. He refused to have anything to do with her. He told the staff that he would not talk with her on the phone. He agreed finally to a call—if a staff member was there, not just on the line but standing next to him while they spoke.

  When the conversation with his mother was over, he declared, nearly yelling, “I don’t want to see her. I don’t want to look at her.” He talked about her abuse. All he wished for, he said, was to forget everything.

  If my father was like Arnold Schwarzenegger, he thought, if he cared as much as Arnold, I would not be here. If he was like the man who defeated the T-1000, if he was like the man who triumphed over evil, if he was that big, if he had that heart.

  In his Anger Busters group after the phone call, the kids were given a list of triggers and told to write the letter A beside whatever made them angry. Ryan wrote “AA!!” beside “someone breaks a promise.” He printed “AA!!” next to “someone is nice to someone else.” He pressed his marker doubly hard—“AA!!”—alongside “someone reminds me of my past.”

  The staff parceled out what compliance points they could during the days following the phone call, when his deterioration accelerated. He played as much of the Nintendo game as he was allowed. He piloted the propeller plane, controlled a skydiver, manipulated a man strapped into body rockets. He soared over the desert, over a green peninsula, over wide water. He swooped toward runway after runway, toward circular landing pad after circular landing pad. Sometimes the screen flashed “Landing Failure.” More regularly it beamed “Great Landing.” Told to relinquish the controls, that his time was up, he ignored the voices. Ordered to obey as he tried to go on flying, he railed at the staff. “Jackasses!” he shouted.

  He hovered over the other kids while they played the game that he coveted, watching them hungrily, coaching them belligerently, deriding them for their blunders. A staffer with tawny skin commanded him to settle down in his room. “White Hawaiian bitch!” he screamed. “Racist Hawaiian bitch!” He extended his middle finger. “Suck it! Suck it, bitch!”

  The facility was prescribing him a mild sedative. Policy was to try to avoid powerful, involuntary medications. The drug didn’t seem to dull his sentiments, his reactions.

  The staff erased all the points he’d been awarded. He was at the bottom level. Somehow Mrs. Hughes found out where he’d been sent; she called, and he went to the phone. Her words were reassuring, but he cried afterward, disconsolate for hours, alternately sobbing and silently distraught, awash in shame that this woman who had led him to the Narnia books, led him to Martin Luther King, led him from being someone terrible to being someone almost normal, a kid in normal classrooms, had now discovered him in this locked unit in this locked place.

  The center offered to pay for a motel room to make it easier for Valerie to visit, and she borrowed money for gas. The staff coaxed Ryan to say that he would see her. In the days before her scheduled arrival, he became fixated on a black girl within the pod. She was tall, with very dark skin and an asymmetrical shrub of hair that he detested. It was uncombed, knotty. Her lips were cracked. She never seemed to change her pajama-style pants. He believed that she was tracking him, moving wherever he moved within the tight, windowless common zone, sitting wherever he sat. He warned her to keep her distance: “I’m going to kick your ass.” He announced it to everyone: “I’m going to kick her ass.” He told her, “I’m going to kill you if you’re not careful.”

  After talking with him, a psychotherapist noted down his “preoccupation with thoughts re: killing or injuring this peer. He is angered by her affection for him and her habit of following him around and invading his personal space.” He feels, the therapist wrote, that she is “the source of all his difficulties.” There are strong signs of “obsessive-compulsive symptomology. He reports that he had similar feelings toward his mother” when he threatened her life.

  His mother, at the same time, was irate over a letter she’d received from the facility. It referred to her son as Speedo. The day before her visit, she phoned the facility and insisted on speaking with the administrator who had signed at the bottom of the page. She never wanted her son called Speedo on paper, she told him. He replied that the center usually honored a child’s choice of name. She repeated herself: never on paper, never in a document. “Why would you do that?” she berated
. “Why would you put that in a letter? That’s not his name. I don’t want to see that.”

  Would she like him, the administrator asked, to resend the letter with the name changed?

  She said she would.

  The next afternoon, Ryan and his mother met. The meeting didn’t last long; staff cut it off. In Ryan’s memory, years later, it hadn’t occurred at all. He believed he’d refused to leave his pod to spend time with her. He believed she’d driven for hours, and driven away, without laying eyes on him. He recalled changing his mind, but too late—the staff told him that she was already gone. He remembered the ache of his own regret. He blamed himself for not seeing her, for rejecting her.

  But that wasn’t how it happened. The visit was so painful that he purged it from his memory. His mother did the same.

  “Met with mother today alone, and then with mother and Ryan,” the notes recounted. “She presents as a very angry woman who also experiences depression. She is currently medicated with Zoloft. She acknowledges that she harbors a great deal of anger and attributes it to years of physical abuse in her second marriage. But she has little insight into the ways that her anger affects her interactions with Ryan. During the visit, she was very negative toward him. She criticized. She was very confrontational and punitive toward him. He vented his anger at her. He was taken back to the unit.”

  “I don’t give a fuck anymore!” he shouted when he was back within the pod. He chastised another boy because the bathroom floor was wet. The staff tried to quiet him. “I don’t give a fuck!” he proclaimed again. They reminded him to use his “self-calming techniques,” to breathe steadily. The girl with the horrid Afro appeared. “I’m going to kill you! I’m going to rip your fucking face off!”