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Lost in the Darkness

Paul Raeburn casts a wide, dark shadow over his latest book in its first few pages, when in the introduction, he admits that his eldest son, Matt, wanted nothing to do with the project. He attempts to explain why his son did not want to be seen as supporting the account of his family's struggle with mental illness among his younger siblings, but the admission leaves a lingering aftertaste, a suspicion that there are parts of the story that are being withheld from the reader. As the book reveals itself to be not a helpful and enlightening portrait of childhood mental disorder as we might at first expect, but a sad portrait of a disintegrating family, the real story becomes as muddled for the reader as it seems to be for Raeburn himself.

The Raeburn family's trouble began when their middle child, Alex, was hospitalized after a violent outburst in his fifth-grade classroom. Several hospitalizations, alternative schools, psychiatrists, diagnoses, and medications later, Alex was eventually diagnosed with bipolar disorder. Medication finally seemed to stabilize his condition, at least as far as the explosive episodes of anger were concerned, but as Alex's situation began to calm, his younger sister, Alicia, began exhibiting signs of severe depression -- signs that included self-mutilation and multiple suicide attempts. More hospitalizations, alternative schools, psychiatrists, and medications followed.

Blame is a central theme of Acquainted with the Night. Raeburn is intent on tracking down the individuals or institutions responsible for the turmoil his children face. Unsympathetic teachers, uncommitted psychiatrists, image-conscious school systems, and greedy insurance companies are obvious culprits, but Raeburn is not above looking to his children's parents for culpability, even if he doesn't look very closely. He confesses that his marriage was a shambles throughout the ordeal, and that the frequent fights between him and his wife may have had an adverse effect on Alex's and Alicia's development. His wife was lax and irresponsible in her parenting, he claims, and he himself was prone to bouts of unchecked anger from time to time.

Raeburn's indictment of the family's home life, however, seems distressingly one-sided. He accusingly points out his wife's tendency to let the children watch television and eat convenient food, but he never explicitly admits that parental battles over TV and macaroni and cheese might be more harmful to an observant child than the illicit items themselves. His depiction of his wife is extremely negative, and although it would appear to an outsider that she was suffering from depression herself, Raeburn is never sympathetic. His description of his own parental missteps -- his angry explosions, his disciplinary wrong turns -- are often euphemistic and vague, and he never satisfactorily addresses Matt's reluctance to contribute to the book or Alex's and Alicia's intermittent estrangement from him.

The health care industry is, presumably, a primary target of Raeburn's disquisition. He facetiously refers to the children's various psychiatrists by number rather than name, and the bulk of the narrative surrounding the hospitalizations revolves around wrangling with insurance companies over coverage. It is undeniably disturbing that children with mental illness can disappear into the cracks of the giant and lumbering bureaucracy of the health care system, but given the slippery nature of the Raeburn children's cases -- there is still disagreement in the mental health community over the occurrence of bipolar disorder in children, and both Alex and Alicia suffered numerous relapses and did not respond consistently to treatment -- it is perhaps also understandable that the system was skeptical. Even Raeburn wonders, when Alex continues to struggle with drug addiction and misbehavior in school even after his disorder has ostensibly stabilized, how much of the problem is clinical and how much is purely behavioral.

And it is the question of the behavioral versus the clinical, the environmental versus the physiological, that forms the frustrating core of Acquainted with the Night. Raeburn focuses most of his energy on the institutional apparatus surrounding his children's problems, and very little on the problems themselves. Once diagnoses have been made and disorders identified, one would hope that Raeburn and his wife would take action to help their children recover. But they don't. Raeburn is quick to point out that his wife was unwilling to take responsibility for Alex's and Alicia's mental health, but he, perhaps inadvertently, admits that he, too, gave up. He is powerless to act, he claims again and again, against a belligerent spouse, oppositional children, and an unconcerned system. As a result, Alex and Alicia are left on their own, and they suffer.

Acquainted with the Night is no doubt intended as an inspirational and hopeful gift to parents of mentally ill children, as concrete evidence that they are not alone in their fight against mental disorders and institutional behemoths. In this goal, the book is unsuccessful. It lacks a hopeful resolution, and it is anything but an admirable example of how a family can handle the trials of mental illness. There may be a worthwhile story in Raeburn's ordeal, one that could be pieced together by a disinterested observer, but Raeburn himself does not tell it -- or at least not all of it.