Back to life via the clinic

Viola's hands are shaking, she slides restlessly back and forth on her chair, strands of hair stick to her face and her make-up is smudged. She is on drugs, drunk. Her mother sits next to her, her face in her hands, on the verge of tears. «We can't take you like this,» says the psychologist, cancelling the admission interview. That was on 19 June 2014.

A shock, because: «What I had back then was no longer a life,» says Viola Danner*. They admitted the teenager to Clienia Littenheid, a private clinic for psychiatry and psychotherapy in Littenheid TG, on the same day.

I was like dead inside. I never showed any emotions because I just didn't feel anything.

Viola Danner

Idyllically situated on the edge of the forest, 22 buildings nestle in the Littenheide valley and form a clinic complex in which adults, but also children and adolescents aged 10 to 18 with the entire spectrum of mental disorders, such as depression, psychosis, self-harming behaviour or borderline syndrome, are treated and treated. These are mostly cases where years of outpatient therapy and treatment have been unsuccessful and where parents no longer know how to help themselves out of fear and worry.

Teased and bullied

Viola is 12 when the world around her plunges into darkness. A quiet, reserved girl who has problems coming out of her shell and talking to others, who prefers to immerse herself in novels rather than socialise with her peers.

«Viola is different, kind of weird,» they say. But you can't be different when you're going through puberty. Viola is teased, ostracised and bullied . At the time, nobody suspected that social phobia was the cause of her reserved behaviour. She simply suffered, became even more withdrawn, hardly spoke and became depressed. Even her parents could no longer get close to the girl.

«There's something wrong with Viola,» fears her mother. «How can you say that about our daughter!» Manfred Danner* doesn't want to hear about it. «I started to doubt myself,» remembers Karin Danner*. A psychologist advises a change of location. The family moves. Viola makes a friend at the new school. But things don't get any better. Only different. «I behaved the way the others expected me to,» she says. A glass of wine, a bottle of beer. «Viola, you're so funny when you've been drinking. Can't you always be a bit drunk?» She carries on. Party. Crash. Party. Crash. In an endless loop.

«Then the scratching and vomiting started,» remembers Karin Danner. Just a suspicion at first. Then the signs increased. At some point, the girl threw up four times a day. By the time she was 16, Viola had hit rock bottom.

Worrying about her daughter alone

«Mrs Danner, come quickly, Viola is lying on the floor and is no longer moving.» Karin Danner has saved the phone numbers of Viola's friends in her mobile phone. It lies next to her pillow every night.

She hardly sleeps any more and looks to her husband for support. «Karin, we all let off steam at that age, it's not that bad.» A few weeks later, Manfred Danner moves out to be with another woman. It had nothing to do with Viola's behaviour.

I'm afraid that I'll find my daughter dead at some point.

Karin Danner

Karin Danner is alone with the worry about her daughter. «I didn't know what to do. Lock her up? Accompany her everywhere?» She knows Viola would run away. «I'm afraid I'll find her dead one day,» she tells her GP.

He advises inpatient treatment in Littenheid. Afraid of a stay in a psychiatric hospital? «No, it was the straw that broke the camel's back - we both couldn't go on, neither could Viola and neither could I,» says Karin Danner. They were lucky. Three weeks after their initial consultation at the clinic, Viola was able to start therapy.

The clinic's therapy concept

It's 7.15 a.m., wake-up time in the Linde D therapy group. Viola's room is decorated in warm orange tones, light falls through the large window and posters hang on the wall. Nothing is reminiscent of the images of psychiatric wards depicted in horror films: no white coats, no straitjackets, no locked doors. Instead, there are bright, friendly rooms and a garden with a fish pond and sports facilities. Behind this is a special interior design concept that is intended to promote the healing process and reduce the young people's potential for aggression.

What have we done wrong? This question torments many parents.

Five other young people are accommodated in Viola's therapy group and their day is tightly scheduled: school, individual and group therapy, physiotherapy, sport, joint games and hobby evenings. This integration into the community is part of the therapy concept, as is the inclusion of parents in the healing process.

The hardships of parents

Clinical psychologist Margitta Backes knows the hardships of parents whose children suffer from emotional instability. She heads the psychotherapy ward at the Centre for Child and Adolescent Psychiatry at Clienia Littenheid and knows that a normal family life is hardly possible. Out of desperation, parents put away knives, scissors and razor blades and no longer let their teenagers out alone. «There is hardly anything more challenging for parents than a child who is self-harming or suicidal,» she says. The question «What did we do wrong?» torments many.

In addition to regular parent and family discussions, mothers and fathers are invited to group evenings once a month, where they are informed about the clinical picture and its treatment. Margitta Backes: «In a second part, we address their questions and try to meet them where they are.»

«We told the people around us that Viola was going abroad for a language course,» says Karin Danner. She parks her car in the clinic's visitor car park and walks along the street towards the main building. It's Saturday morning and she picks Viola up for the weekend.

«How are you?» The psychologist holds out her hand to Karin Danner. She is going to discuss the weekend with her. What should she look out for, how can she react if Viola falls back into familiar patterns of behaviour? Margitta Backes: «We have a discussion like this with all parents.»

When Karin Danner brings her daughter back on Sunday evening, there will be another short conversation, and a longer phone call on Monday if there are any problems. «I was always really looking forward to seeing Viola and was very nervous at the same time,» says Karin Danner. She never knew what kind of atmosphere to expect.

A relapse with consequences

Viola becomes more stable as the weeks go by. She is allowed to take the train to Lucerne on Saturdays. But you also have to expect setbacks, say the therapists, andViola is to spend 1 August with her father. «Manfred, you have to be careful,» warns Karin Danner. She won't see her daughter again until Monday at a parents' evening. Karin Danner: «I just had to look at her to find out what had happened.»

«Viola, how much?»

«A bottle of wine.»

«A whole bottle? You have to tell the treatment team!»

«No! Then I'm out.»

Karin Danner says so. Because otherwise everything would have been in vain, because she wants Viola to really make the most of this opportunity. The girl is beside herself, angry, screams, cries - and shows her feelings for the first time. A big step.

«The years before that, I was like dead inside. I never showed any emotions because I just didn't feel anything,» Viola recalls. That changed in Littenheid. Viola learns to express her feelings through writing and role-playing. She likes life in the community and the therapy sessions are successful. But she relapses again. The third time, two days before her release from the clinic - she has to leave. Those are the rules.

«I was so angry that I refused to pick her up,» says Karin Danner, looking at her daughter. «But the train journey to Lucerne takes hours, so when she was with me, I was very happy.»

As parents, finally take a deep breath and let go

For Karin Danner, the hospitalisation was a blessing. She has finally learnt to let go and hand over some of the huge responsibility to professionals, she says. Take a deep breath, sleep. Not all young people can go home after a stay in hospital. «They need these institutional structures,» explains Margitta Backes. For example, they are placed in therapeutic residential groups. This is initially disappointing for many parents, «but most of them accept it». For the good of the child.

How is Viola doing today? She no longer drinks at all during the week. Smoking pot is still a problem, she admits. But being drunk at the weekend is okay. She thinks so. Her mum sees it differently: «All the symptoms are still there - just in a milder form.» She is certainly worried that it could get worse again. Viola's inner turmoil is still noticeable. But Karin Danner believes in her daughter.

Viola nods, she is a pretty young woman today, her gaze is clear and confident, her hands rest calmly in her lap.

* Names of the family changed by the editors