What the Heart Knows

Tightness pulls across my chest as I wrap up documenting progress notes for the last few patients of my day. Documentation is, by far, the part of my job that I love the least. I’ve always said that I love what I do, but I’d love it even more if I didn’t have to write about it. My mind struggles at the end of the day to dump out information in a logical manner. Even more so when I have a deadline that I must meet.

With the last punctuation mark placed, I power off the computer, wipe down my workspace, my badge, and tennis shoes before hustling off to the time clock. Swiftly moving down three flights of stairs and up another to the ground level, I race across the parking lot to open a steamy hot car and turn on the air conditioner. As I sit, I remove my mask and allow myself five deep breaths before pointing the car toward home. My thoughts overpower the music that plays through the speakers, increasing agitation, so I hastily turn it off.

Every four to six weeks we have an appointment with my sons’ psychiatrist. We usually drive an hour and a half out of town to attend the appointment so the telehealth option, from the comfort of home, is a welcome reprieve. Although home is only fifteen minutes away, developing traffic and the pressure of arriving on time adds to the tension in my chest.

Walking into the dining room, I notice my husband and son seated at the table with an empty seat next to them. Talking to his doctor, my son delays the end of his story to tell me hello and offer a hug, while my husband leans behind him to offer me a kiss. There is so much goodness in this moment.

For the next forty-five minutes, the four of us discuss the highs and lows of the past six weeks. From behavior to therapy, quality of sleep to activity levels, water intake, appetite, and medication side effects, we cover it all. Sitting there, listening to my son bravely share about himself, I remember times early on when we had to request to talk separately with our psychological team when discussing sensitive details of our daily life.

From the other side of a computer screen I witness the joy on our doctor’s face as she celebrates the progress that has been made. As the conversation shifts to the uncomfortable lows, I watch as that same face meets ours with curiosity and kindness. This time, we only have one example of concerning behavior. One. Recounting the details, my husband, son, and I bounce off one another in hopes that between the three of us, an accurate story will be conveyed. Satisfied with our recollection, we settle back in our chairs awaiting the doctor’s response.

Her eyes are sympathetic; her words filled with hope. We have come so far. Her reminder has taken up space in the forefront of my mind. When parenting children with mental health challenges, so much time is spent noticing, recording, engaging, and reporting on behavior. In the last fifteen months, we have gone from reporting destructive behaviors, physical violence, suicidal ideation, and threats to one example of concerning behavior. One.

This time it is one. Next time, there may be more; there may be less. When we were first introduced to the protocol used to treat the mood disorder our son has, we were surprised to hear that children can go from daily meltdowns at home and in public to one meltdown a year. We have seen our son’s meltdowns decrease as he becomes more stable on this protocol.

I am seeing with my eyes what my heart has always known to be true.

My son is a highly sensitive young man. He was created to be intimately integrated with his body, his environment, and those around him. He is quick to express discomfort and injustice and fights for what he believes. He is brave, and he is tender. He does not mince words and wears his heart on his sleeve. To expect him to do an about face on his behavior would be to expect him to abandon who he is at his core, and I am not here for that.

I am, however, here to contain a child who falls outside of every box. I have been given the unique opportunity to create a place where he can experience his most difficult emotions with someone he trusts. It is not my job to change him but to help him learn how to self-regulate and self-advocate within a safe space. In this space, may he be celebrated and enjoyed for who he is, not what he does.


Bethany Cabell, a lover of simplicity, is often inspired to write by the relationships she holds as a wife, mom, and a physical therapist. Bethany, her husband and their boys returned to life in Texas after wandering off to the Midwest for a season. What she once pictured her life to look like has forever been changed by her two sons. Navigating this messy and beautiful path of parenting two children each with their own unique challenges, she finds grace and beauty in the gift of each moment.