Introduction
The 2008 film The black balloon reveals the problems associated with raising a child with a developmental disability in a modern community. Depicting the chronic stress experienced by all the members of the family caring for Charlie, an 18-year-old autistic teenager, the movie reveals the deficits in the healthcare system of Australia. Due to the lack of formal and informal social support, Charlie’s mother Maggie who is also in the final stages of her pregnancy is overburdened with the responsibilities of taking care of her autistic son and managing the household at the same time. With the enormous overload and lack of knowledge on the existing coping strategies for reducing her distress and anxiety, Maggie experiences extremely high levels of stress and even develops preeclampsia which puts at risk her and her baby’s safety. This paper will discuss Maggie’s personal development from the points of view of Erikson’s and Hendry and Kloep’s theories, analyze the main predictors of Maggie’s stress and the gaps in the current healthcare practices which need to be narrowed for supporting the Mollisson and other families caring for autistic children.
Maggie’s personal development and traits
Maggie is a married woman in her forties raising two sons and carrying her third baby. Devoting all her time and energy to the management of the household and rearing her children, Maggie has difficulties juggling the demands of her family with her own needs for rest.
Applying Erikson’s theory of human development to Maggie’s case, it can be stated that she is in her middle adulthood, the stage of generativity versus stagnation (Barkway 2009, p. 44). This stage is characterized with contributing to the next generation by caring for children and/or making a career. The stage of Maggie’s personal development can be interpreted as generative in terms of raising her children and managing a household. On the other hand, Maggie is a housewife and may have a sense of stagnation regarding the aspects of her self-realization as a professional and a bread-winner. Though parenting an autistic child can be compared to full-time employment, Maggie still may feel bound with managing her household. According to the estimates of the Australian Institute of Health and Welfare (2003, p. 1), the unpaid assistance of family is equivalent to the work of 1 million full-time employees. Taking into account the fact that Maggie cares for an autistic teenager Charlie and is in the final stages of pregnancy, it can be stated that her current unemployment is forced and almost inevitable. Maggie tries to overcome the problem of her relative social inactivity by participating in committees. Her husband Simon with irritation admits that Maggie is involved in two committees (The black balloon 2008). Even though Maggie is overburdened with her household and care for the members of her family, she allots time to visit committee meetings even when she suffers from the symptoms of preeclampsia. Additionally, Maggie’s desire to control everything in her household can be explained by the woman’s attempts to compensate for her inactivity in the professional domain through activity in her family. In general, according to Erikson’s theory of human development, Maggie’s personal development can be characterized by generativity in one aspect and stagnation in others.
Hendry and Kloep’s theory of lifespan development can be applied to the analysis of Maggie’s personal development. According to Hendry and Kloep (2002, p. 99), individuals in their middle adulthood can either accept their conventional life pattern which can result in stagnation, or add new experiences and consider new possibilities, continuing their development. Analyzing the family dynamics of the Mollisson family, it can be stated that parenthood in this couple is marked with traditional gender roles because the main burden of caring for children and managing the household is put upon Maggie. Due to Maggie’s pregnancy and preeclampsia symptoms, she and Simon renegotiate their family roles and arrangement of family chores to comply with Maggie’s need for good rest (The black balloon 2008). However, Maggie cannot accept a new role and makes attempts to control everything and everybody in their family. Finally, the Mollisson decide that it would be better for Maggie to stay in a clinic for some time so that she could have a good rest. Therefore, Maggie prefers to follow the accustomed life pattern, and the function of excessive control over her family and household is comfortable for her. Thus, according to Hendry and Kloep’s theory, Maggie is bound with her accustomed life pattern and lacks flexibility for changing the gender roles in their family to trust her husband with at least a part of her responsibilities.
Therefore, according to Erikson’s theory, Maggie’s personal development can be defined as generative in domestic domains, but having some features of stagnation in professional aspects. Hendry and Kloep’s theory can be applied for explaining Maggie’s difficulties with renegotiating and sharing family responsibilities with her husband.
Charlie’s autism as a stressful factor for Maggie
Taking into account the fact that a child’s autism is an important predictor of stress in other family members, it can be stated that Charlie’s developmental disability gave rise to a complex network of stressors for his family. Maggie, who due to the peculiarities of her personal development and gender roles in their family takes the largest part of family responsibilities upon her, experiences high levels of stress because of her son’s developmental disorder.
According to the findings of Hastings and Beck (2004) and Meadan, Halle and Ebata (2010), parents raising an autistic child report higher levels of stress than their counterparts caring for children without disabilities. Moreover, Tehee, Honan and Hevey (2009, p. 34) admitted that the levels of stress in parents of children with autism are even higher than in parents caring for children with other developmental disabilities. The formal (healthcare professionals) and informal (family members) social support can become an effective moderator of parents’ stress. Therefore, the analysis of Maggie’s stress caused by her experience of caring for a teenager with autism requires consideration of the multidirectional relationship within the Mollisson family and the level of social support received by Maggie from her husband Simon, a child without disability Thomas and health professionals.
The interactions between Maggie and Simon are important for explaining the stressors and resources available in the marital subsystem. Marked with traditional gender roles, this family puts the main burden of not only managing the household but also caring for an autistic child upon Maggie. Maggie worries about giving medicine to Charlie and preparing him for the school concert. Mother is the only person except for the health professionals at school who can influence Charlie’s behavior. Simon lacks involvement in the process of upbringing his autistic child until the moment when Maggie suffers from preeclampsia and being unable to cope with her traditional responsibilities has to be hospitalized. On the one hand, Maggie does not allow Simon to participate in Charlie’s upbringing because she is afraid that her husband will not cope with it. On the other hand, Simon has difficulties with caring for Charlie because he lacks experience in communicating with his autistic son and does not show much understanding of Charlie’s developmental disorder. Displaying the lack of his awareness and indifference, in one of the episodes, Simon exclaims that he does not see the sense in organizing a concert for autistic children (The black balloon 2008). The infantile and selfish behavior of Simon makes Maggie take the main responsibility for their son with a developmental disability as well as the rest of their household. According to Lee (2009, p. 96), mothers parenting children with autism demonstrate better adaptive skills compared to their male counterparts. Therefore, the distribution of responsibilities between Maggie and Simon is typical for families raising children with developmental disabilities.
As to Maggie’s care for Charlie, she manages to find the most appropriate strategies to influence her son’s behavior, but it seems that she acts intuitively. Maggie invents a game and rewards Charlie with stars for good behavior and punishes him by taking back his stars. She plays with Charlie’s hair during bath time, adapting to the level of his development. The bath time in this family had a slightly unusual significance of uniting the members of the family on a new intimate level. Maggie says to her younger son Thomas that he should play with Charlie to gain his understanding. Regarding Maggie’s interaction with her son without disability Thomas, it can be stated that she cherishes hope to receive support from him and even overburdens him in certain situations. Understating the level of Thomas’ stress, Maggie asks him to care for Charlie and even to influence his father’s infantile behavior when Simon speaks to his toy Rex. Therefore, regardless of Thomas’ stress, he becomes an important source of informal social support for his mother.
As to the formal support, there is no evidence showing that the Mollisson have access to the necessary healthcare resources in the film under consideration. Only in one of the episodes, a health professional from Charlie’s school calms a boy after his conflict with students without developmental disabilities (The black balloon 2008). Thus, the Mollisson lacked formal support of health professionals which could be helpful for meliorating the levels of their stress and creating their awareness on the existing coping strategies and proper care for Charlie.
Charlie’s autism has become a predictor of stress in Maggie due to the peculiarities of her personal development, the bidirectional relationships with her husband and sons and the lack of formal social support which could be valuable for reducing her stress.
Symptoms of preeclampsia in Maggie
In the final stages of pregnancy, Maggie has developed preeclampsia which can be preconditioned with the lack of social support in the second and third trimesters and become an influential stressful factor at the same time.
According to Black (2007, p. 419), preeclampsia can have serious consequences, including those of perinatal morbidity and mortality in 6% and 8 % of all pregnancies. Therefore, preeclampsia is associated with high-risk pregnancy which has become another predictor of Maggie’s stress. Additionally, Maggie worries about the development of the child she is carrying because of Charlie’s autism. She criticizes Simon’s denial to sterilize with her voice full of reproach (The black balloon 2008). Therefore, the stressful factors of raising an autistic child and experience of high-risk pregnancy overlap and lead to extremely high levels of stress in Maggie.
The symptoms of preeclampsia include headaches, gastric pains and vision problems, and their severity can vary within days. However, even suffering from these symptoms, Maggie makes attempts to continue managing the household and taking care of all the members of her family because of the lack of her flexibility required for renegotiating gender roles, the trait which is characteristic of some individuals in their middle adulthood (Hendry & Kloep 2002, p. 99). Though the exact causes of preeclampsia are unknown, it is traditionally associated with genetic abnormalities, dietary deficiencies and inflammatory changes during pregnancy. According to Coussons-Read, Okun and Nettles (2007, p. 345), the perceived lack of formal and informal social support in the second and third trimesters of pregnancy can give rise to inflammatory changes which in their turn can lead to preeclampsia.
Therefore, there is a bilateral relationship between the levels of Maggie’s stress and her preeclampsia symptoms. On the one hand, the stressful situation of caring for an autistic teenager Charlie could become a predictor of Maggie’s preeclampsia. On the other hand, preeclampsia, high-risk pregnancy and forced hospitalization contributed to the levels of the woman’s stress.
The choice of coping strategies
The levels of stress experienced by Maggie exceed her resources and require choosing appropriate coping strategy for adjusting to the situation of living with chronic stress, establishing a positive sense of self and building a harmonious relationship with others. Maggie selects problem-focused coping strategy to manage the demands of her situation and focuses on external coping resources.
Analyzing the plot lines of the film under consideration, it can be stated that Maggie does everything she finds necessary for rearing her children and managing the household and uses a problem-focused coping strategy (Barkway 2009, p. 192). Even when her efforts become harmful for her health and health of the baby she is carrying, Maggie continues to worry about the linen and keeping the house in order (The black balloon 2008). It clearly demonstrates that Maggie’s behavior is not driven with her emotions and she focuses on solving the problems. She finds effective methods for controlling the behavior of her autistic child Charlie and immature husband Simon. Maggie invents games for Charlie and enjoys spending time with him, fully accepting her child with his developmental disorder. She gives medicine to Charlie and wants him to participate in the concert. Additionally, she participates in numerous committees and motivates Simon to accompany her when she goes to the meetings of these committees. Maggie’s attempts allow the Mollisson to avoid absolute social isolation. Therefore, she uses external resources for overcoming their difficulties and meliorating the stress experienced by their family.
Along with formal coping resources, namely the social network, Maggie tries to use the informal support of her family. It may seem that Maggie overburdens her younger son Tom by asking him to care for his autistic brother. However, it can be explained with Maggie’s conscious or unconscious attempts to receive support of her son. Maggie also tries to establish a harmonious relationship with her husband. It can be clearly seen from the episode in which she is going to a meeting of one of her committees and asks Simon to accompany her even though he looks for childish excuses to refuse to go. She tries to be attentive and responsive to the needs of other family members even if their behavior is inadmissible, such as in the scenes of Simon speaking to Rex and Charlie going into the houses of their neighbors.
At the same time, Maggie who shows understanding to everyone’s needs lacks support of her family. She understates the importance of expressing her own feelings which leads to the enormous levels of her stress, development of her preeclampsia and misbalanced dynamics of their family relationships in general.
Implications for healthcare practice
Maggie as well as the rest of the members of her family lack access to the formal support in the form of health care resources and professional consultations. The enormous levels of stress and overload in Maggie leading to her preeclampsia and misbalance in the family dynamics clearly demonstrate the negative consequences of deficiencies in the health care system of Australia.
Taking into account the fact that Maggie gives preference to external resources for coping with her psychological distress, it can be stated that the lack of formal support of health professionals had a significant impact upon her distress and well-being. For instance, Maggie does not believe that Charlie will be able to speak in the future (The black balloon 2008). It means that instead of consulting a health professional concerning the necessary care and Charlie’s outcome, Maggie makes guesses and learns from her own mistakes. Maggie knows about the special needs of her autistic son, but frequently lacks knowledge for providing the necessary care. Therefore, an important step in improving the existing health care practices is to provide families with autistic children with all the necessary information on special needs of children with developmental disabilities.
Another deficiency in the healthcare system can be seen from the fact that Maggie lacks awareness on the existing coping strategies which can be used for meliorating her own stress. She even understates the importance of her psychological well-being in general, focusing on problem-focused coping strategies. Meadan, Halle and Ebata (2010, p. 8) noted that psycho-social well-being of mother can have a significant impact upon the levels of stress in other family members, including the child with autism. Therefore, one of the most important implications of Maggie’s case to healthcare practice is to improve the access of families raising autistic children to healthcare resources which can become an effective mediator of their stress. Creating awareness of the existing strategies might be helpful for reducing the stress of family members and improving the condition of an autistic child at the same time.
Thus, the main implications of Maggie’s case for healthcare practice include improving the access of families raising autistic children to healthcare resources to create their awareness on the special needs of children with disabilities and existing coping strategies for meliorating the stress of other family members.
Conclusion
Depicting the daily routines of a family caring for an autistic teenager, the film under analysis reveals the difficulties faced by family caregivers and the high levels of stress they experience. Applying the psychological theories of lifespan development to Maggie’s case, it can be stated that the peculiarities of her personal development, her son’s autism and high-risk pregnancy are the main predictors of the chronic stress and anxiety the woman experiences. Additionally, the woman lacks formal and informal social support which can be explained with the deficits ion healthcare system and the dynamics of her family. Therefore, along with producing impression upon the audience and evoking empathy in them, the 2008 film The black balloon can have a number of implications for Australian healthcare practice.
References
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The black balloon 2008, motion picture, Neo Classics Film, Icon Entertainment International.