Self neglect

We're still struggling with issues around severe, chronic burnout, withdrawal and self isolation (mostly within just one room) in our adult son.  The thought occurs to me, especially given that this has led to very poor personal hygiene, absolute refusal (or inability) to engage with services or even, for much of the time, with family members, does this all at some point become more than self neglect and turn into more of a safeguarding issue for which we, as parents are responsible?  

If so, what on earth should we be doing for someone who has capacity but who uses this to refuse all help, especially understandable since his experiences with services have been entirely negative, even leading to a worsening of issues in the past?  We would hate to (once again!) enlist the help of any service which isn't autism friendly, approaches issues clumsily then leaves us in a worse position with well intentioned but ultimately useless suggestions like getting back in touch when he's willing to engage (this just isn't going to be happening any time soon) and comments such as, "We've never met anyone so unwilling to engage.  If only he would engage then ..." - i.e. simply echoing our difficulties back to us, withdrawing from the situation and leaving us without any support.  

This all feels very much like a stalemate situation but one in which we could be, while emotionally exhausted and trying to do our best, colluding with the neglect and thereby failing in our responsibilities and duties to our son.  

Parents
  • Tell him that girls won't fancy him unless he changes his ways.

  • Unfortunately already tried some years ago.  He is very much of the belief that anyone who doesn't accept him as he is, isn't worth getting to know.  Plus, of course, having dropped out of college twice some years ago and continuing, over a period of months, to refuse to go out with friends when they called round, he now has nobody outside the family and never joins anything outside the home so that new contacts could be made.  

    Total withdrawal.  Living like a hermit.  Afraid of others.  Anxious and extremely avoidant.  Probably traumatised by experiences at school and college (including bullying).  I don't know what to do but as each year passes it feels more and more like an unreal nightmare.

  • Dear Jenny Butterfly I am so sorry to hear about the difficulties you are facing.

    It echo's some of my family's situation and at the very least I hope you find comfort in that.

    Forgive me if you have tried the suggestions I am making. They have made various degrees of difference for our son depending on his current state of mind and his OCD prevalence at the time.

    Our son found an outlet through a love of music and has studied that online and virtually. The recent pandemic has bought some pluses in that education online has opened up considerably. If your son has a passion for gaming could you enrol him on a virtual online course related to gaming which may involve interacting with people via his computer but may be a good start. Forgive me I am not sure of his age so suitability of that suggestion.

    The sensory approach to bathing works or helps to varying degrees, I understand. You may have done this already but I paid for a full sensory profile to find out specifically what my son's sensory difficulties were. It involved a series of physical tests that were not unpleasant for him and produced a report. The major gold nuggets we found were that he could tolerate baths much more easily than showers so I managed to persuade him to have a bath on a more regular basis now. He also finds white noise comforting. Strangely enough an extractor fan is very similar to white noise but he has a machine to produce this now and takes it into the bathroom with him,

    It sounds as it feels as if you have not made any progress at all and I completely understand that feeling but I am sure with the determination I am seeing in your writing you will. I do hope that the community's  messages and ideas can give you a little understanding and support and my greatest wish for you some ideas that make a difference.

    Happy to continue to discuss/chat on this forum to try and find something to help

  • Many thanks.  Our son hasn't had any sensory profiling done, nor even a proper autism assessment as, after being discharged from mental health services (on the basis that there was no evidence of mental illness, just of Asperger's) he refused to see any more professionals.  Basically the Autism Team came in the front door and he legged it out of the back door, protesting that "I don't have autism!" He's an adult and they're forced to respect his wishes.  

    The difficulty now would be in encouraging him to re-engage, especially as the years with mental health services were so damaging and the suggestion of autism only came at the very end (and after loads of failed attempts to medicate and therapise him, all of which he was against but which were forced upon him to prevent hospitalisation).  

    Anything we can now do would have to come through us and be suggested, very gently, as and when he is open to new ideas.  And quite often I am left feeling like an ogre because when I go into a room, he tries to exit as quickly as possible.  Contact seems to panic him and I don't think we've been able to rebuild trust after all of those mental health appointments.  Now he says,"No" automatically to anything we suggest so we have to cautiously seed ideas and hope that some will take root.  They might not.   

    I'm open to buying in services.  I'm basically so desperate that I'd remortgage the house for anything expensive if I felt it might help.    But we'd need some buy-in from him and this is exceedingly difficult to generate.  I basically don't know how to promote engagement although what we're doing is:-

    - maintaining a calm, cosy environment

    - providing foodstuffs he'll appreciate (I often "speak" to him through food)

    - making only few demands (he probably has a PDA profile)

    - being available, should he wish to discuss or ask for anything

    - leaving him with open ended offers of whatever therapy or support he might choose

    - generally remaining person- centred and respecting his choices.

    I had hoped that this, plus my counselling training, would put us in a much stronger position.  Unfortunately, while it might have helped to prevent things getting worse, we've seen no improvements and I've yet to get to know my own son as an adult (the issues started when he was 15/16 and he's now 27).  

    As it stands I would like a neurodivergent practitioner of some experience to give me some robust advice and guidance (NB. Not so much counselling as the provision of an empathic, understanding relationship without any guidance just leaves me feeling short-changed.  Giving me space and empathy doesn't enable me to come up with my own solutions - they're just not in me to be called upon).  So yes.  Coaching, advice and guidance is what i'm seeking now.  

Reply
  • Many thanks.  Our son hasn't had any sensory profiling done, nor even a proper autism assessment as, after being discharged from mental health services (on the basis that there was no evidence of mental illness, just of Asperger's) he refused to see any more professionals.  Basically the Autism Team came in the front door and he legged it out of the back door, protesting that "I don't have autism!" He's an adult and they're forced to respect his wishes.  

    The difficulty now would be in encouraging him to re-engage, especially as the years with mental health services were so damaging and the suggestion of autism only came at the very end (and after loads of failed attempts to medicate and therapise him, all of which he was against but which were forced upon him to prevent hospitalisation).  

    Anything we can now do would have to come through us and be suggested, very gently, as and when he is open to new ideas.  And quite often I am left feeling like an ogre because when I go into a room, he tries to exit as quickly as possible.  Contact seems to panic him and I don't think we've been able to rebuild trust after all of those mental health appointments.  Now he says,"No" automatically to anything we suggest so we have to cautiously seed ideas and hope that some will take root.  They might not.   

    I'm open to buying in services.  I'm basically so desperate that I'd remortgage the house for anything expensive if I felt it might help.    But we'd need some buy-in from him and this is exceedingly difficult to generate.  I basically don't know how to promote engagement although what we're doing is:-

    - maintaining a calm, cosy environment

    - providing foodstuffs he'll appreciate (I often "speak" to him through food)

    - making only few demands (he probably has a PDA profile)

    - being available, should he wish to discuss or ask for anything

    - leaving him with open ended offers of whatever therapy or support he might choose

    - generally remaining person- centred and respecting his choices.

    I had hoped that this, plus my counselling training, would put us in a much stronger position.  Unfortunately, while it might have helped to prevent things getting worse, we've seen no improvements and I've yet to get to know my own son as an adult (the issues started when he was 15/16 and he's now 27).  

    As it stands I would like a neurodivergent practitioner of some experience to give me some robust advice and guidance (NB. Not so much counselling as the provision of an empathic, understanding relationship without any guidance just leaves me feeling short-changed.  Giving me space and empathy doesn't enable me to come up with my own solutions - they're just not in me to be called upon).  So yes.  Coaching, advice and guidance is what i'm seeking now.  

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