Even if Jen recognized the sandwich for what it was, her eyes teared, in part from the diagnosis’s starkness, but also from the acknowledgment that she was a good parent. The proof tended to be in the pudding with child-rearing, and people looked at Abe and assumed that Jen and Paul, let’s face it, mainly Jen—if it’s not one thing, it’s your mother—was asleep on the job.
But Dr. Shapiro, dressed in an expensive-looking fringy black-and-white sweater-blazer, assured Jen and Paul that they were up to the work ahead. There would be a lot: weekly individual therapy, possibly group therapy, all designed to bolster Abe’s empathy skills, which were, well, not the strongest she’d seen. Ditto his impulsivity.
He had a pattern of lashing out when things didn’t go his way.
“Having two involved, caring parents puts Abe in the minority, unfortunately,” Dr. Shapiro said. “Many kids with this diagnosis come from serious abuse.”
“What if Abe was abused?” The words emerged from Jen’s mouth in a panicked rush. “He’s been bullied. What if someone—”
Dr. Shapiro shook her head decisively. “This has been noticed from Abe’s earliest interactions. The fact that he’s grown up in a loving environment and still struggles with empathy makes me think this is about brain wiring.”
“But no one in either of our families has anything like this,” Paul said.
“Does anyone have anxiety or depression?”
There it was. From the stories he told about his childhood, Jen always suspected Paul’s mother had undiagnosed bipolar disorder, and she was about to voice this when Paul spoke, his voice hopeful.
“Jen’s mom is really anxious,” Paul said. “You don’t think it’s just anxiety?”
Jen bit her tongue rather than subject Dr. Shapiro to an argument about whose mother was more emotionally stable.
Plus, she understood why he suggested it.
Anxiety was like the white wine of the diagnostic world: ubiquitous, assumed to be fundamentally harmless.
Abe suffers from anxiety, Jen would confide to friends, family, other parents at playgrounds and birthday parties （back when the entire class was invited）。
Everyone would be right there with Jen—sharing how their own kids cared too deeply about grades, or got homesick on sleepovers, refused to eat any food that wasn’t white.
Yes, Jen would nod, it’s exactly the same. We’re all having such identical experiences.
“He’s never been violent with us,” Paul objected. “I mean, he’s never gotten physical.”
“Which is good,” Dr. Shapiro said. “But the behavior he’s exhibited with others—squeezing a hamster just because, stabbing a classmate who he feels has wronged him—”
“But she did wrong him,” Jen said. “If we’re talking about Harper French. She was awful to him.”
Dr. Shapiro nodded at Jen in a way that made her somehow feel both heard and dismissed before continuing.
“—challenging the teachers—we can see a cluster of aggressivity, an indifference to consequence. Talking with Abe, it was clear to me that he lacks remorse for this behavior. How is he with his chores?” Dr. Shapiro pressed gently, “Unloading the dishwasher, taking out the trash, mowing the lawn?”
Jen and Paul exchanged a guilty look. They never made him do chores. Getting through each day seemed to be enough of a burden for Abe.
“He might be so pleasant around the house because you guys are easy to manipulate,” Dr. Shapiro said matter-of-factly.
So maybe they weren’t such good parents after all.
“Give him chores and reward him for the effort with points that allow him to earn something.” Dr. Shapiro glanced at her notes. “Like that giant gaming monitor he mentioned to me approximately three million times. Most kids with these traits can learn to manage them, even grow out of them.”
The HVAC hummed peacefully and Paul absentmindedly rubbed his beard. His eyes looked glassy as they once again met Jen’s. She had a wild unhinged need for someone to tell her how to feel. Luckily, Dr. Shapiro was up to the task.
“Have hope, Paganos,” she said. “Have hope.”
Maybe it was Dr. Shapiro’s kindness that made Jen want to meet her halfway. Accept it, she challenged herself. Don’t fight it like you always do.
* * *
When they stepped into the empty elevator, Paul grimaced at Jen. “What’s up next,” he said, “couple’s root canals?”
“Colonoscopies first,” Jen said. “Then the root canals.”