Rebecca, like Theresa, is a psychologist and a personal friend. She and Bill have two children, now adults, from his prior marriage. Rebecca adopted Sarah and Joe when they were very young after she and Bill married. Their mother, who was mentally ill, had relinquished parental responsibility, and Rebecca was delighted to call Sarah and Joe her own. Up until mid-adolescence, Sarah seemed to be a happy and energetic child, and Rebecca wrote off some of Sarah’s compulsive behaviors, like color coding her note cards for school assignments, as selective perfectionism. “Her room could become a disaster in no time flat. That hasn’t changed. She will live in a complete sty and clean it up perfectly, but then it’s a sty again.”

Like Jesse, Sarah’s moodiness and obsessive behaviors didn’t alarm Bill or Rebecca until Sarah was in college. She began withdrawing from friends, drinking alcohol in excess, and alternating between bingeing on high fat foods, exercising compulsively, and eating only “perfect, organic” food. After several intensive treatment programs, Sarah was finally diagnosed with bi-polar disease.

Ever the psychologist, Rebecca battled with the sense that there was more she could do: “All through those years she wasn’t home, I had the sense that if I could be with her all the time, I could have provided the right kind of structure to even her out.” Yet when Sarah did live when them, as an adult, for a year, Rebecca felt torn between her desire to help her daughter and her frustration at the energy it took to be around Sarah: “She sucks the air out of a room.”

Evenings became an extension of their workdays, as she and Bill tried to soothe Sarah through the crisis du jour. During moments of teary contrition, Sarah would promise to make dinner the next night. But they soon learned that, for all her good intentions, she couldn’t handle it. I recalled Erin’s panic at the thought of trying to find her classes at the college, and leaving her job in the middle of her shift at the small video rental store downtown, overwhelmed by a responsibility that seemed so simple to me.

Not only has Rebecca readily given of her time, she is also one of those people who can never do enough, and you could never do too little in return. She will show up for a dinner party with three bottles of wine, an assortment of cheese and crackers, and a bouquet of fresh flowers, but if I bring her a homemade cake for her husband Bill’s birthday, she apologizes for all the time that must have taken. Needless to say, Rebecca is one of the most giving and thoughtful people I’ve ever known. So when she brought up her frustration about how much she and Bill had poured into Sarah financially, I was both surprised and relieved to hear this paragon of generosity also had her limits. Maybe my difficulty with stolen money and purged food, and finally drawing the line at how much inpatient treatment we would self-pay, wasn’t over the edge, after all.

“We were hemorrhaging money,” Rebecca said. Sarah’s irresponsibility around money was a stark contrast to the frugality Rebecca had grown up with and modeled for her children. At one point, Sarah came home from living on her own with a large credit card debt, despite all times they had warned her to be careful about her spending. She persuaded Rebecca and Bill to take on that debt because the interest was out of hand, with the agreement that she would give them her paycheck. The paychecks didn’t last. Another time Rebecca was riding into town with Sarah to get the oil changed in her car. “I gave her my credit card to pay for the oil change, and when she came out she had charged four hundred dollars for new tires,” she said.

Rebecca acknowledged that even though she had been such a devoted and attentive mother to Sarah, she would question her own reactions and excuse some of Sarah’s behavior because they didn’t have a biological connection. “No one has ever prompted such anger from me. It was very hard not to be able to think or problem-solve my way out of each conflict…It was hardest when I doubted myself as a mom. I had always felt I loved the kids as much or maybe even more than if I’d had them biologically.” She admitted to being frustrated that Sarah didn’t seem to benefit from all the time, money spent, and attention, and, in her understated way, said, “It was hard to feel loving when she was hammering me in some argument and physically cornering me.”

Knowing that someone so ever-loving and generous as Rebecca got ticked too consoled me, albeit ten years too late. To find out that I wasn’t alone in my frustration with the financial and energy drain of Erin’s behaviors was a soothing palm on the brow of an anxious heart. “Am I normal? Do other people feel this way?” These are the questions my clients often ask, pleading for reassurance that there isn’t something fundamentally wrong with them. Without a “reality check”—someone else who was struggling with where and how to draw lines and when to let go—I questioned whether missing food from our pantry and the purged leftovers meant for another family meal warranted the aggravation I felt.

I was also reminded of why Andrew and I believed we didn’t have a choice other than to find Erin her own place, when Rebecca said, “It became impossible to separate Sarah as a person from her disease. It was always work to be around her.” And yet, as with Erin, there were moments of apology and appreciation: “One time she sobbed about how sorry she was for all that she’d put us through,” Rebecca sighed, and went on to say that despite brief moments of insight and awareness, Sarah’s lying, stealing, and inability to function returned full force the next day.

Setting limits becomes even more complicated by not knowing what is real or true. When Sarah was in yet another hospital, Rebecca said, “I took the advice I’ve given other parents, and told her she wasn’t allowed to come home. I needed that time to see whether, under the right care, she was able to take care of herself…I still don’t know if it was ‘can’t or won’t.”

Rebecca also noted multiple levels of loss when she couldn’t count on Sarah to be truthful with her. Not only did she feel used and violated by her behaviors, but she also grieved what that lack of honesty meant in terms of the kind of relationship she could ever hope to have with her daughter. “The distortion of the truth and lying felt manipulative, but then I began to think she doesn’t know what the truth is—her reality changes from one time to the next. I gave her permission in a store to buy one red shirt, and when I came back to where she was, she was about to charge the same shirt in nine colors.”

Through her work as a therapist, Rebecca found some healing for herself: “The adoptive parents have done many of the same things as I did, trying extra hard to compensate for early unknowns.” She realized that some of her excessive patience with Sarah, as she saw with some of her clients, was compensating for not being Sarah’s biological mother. The double burden she, Theresa, and I shared of being the parent who is also a therapist, and should therefore “know better,” was relieved for Rebecca when she saw parents whom she admired have similar struggles. Also, through her own therapy, Rebecca was able to give herself permission to shift her priorities: “Before that, almost everything was determined by what was best for the kids.” Though her marriage to Bill was always strong, she believes he was shortchanged by all the energy she devoted to her daughter.

Finally, when I asked Rebecca how her experience with Sarah had changed her, she replied: “I used to think enough love could solve anything. I see the world as more complex and myself and others with smaller problems as incredibly fortunate…If we hadn’t had the money to help her, I would have always thought that would have made all the difference. But it’s bigger than all of us, and we can only do our best. I am humbled before the power of genetics…a humbling that made me less judgmental of others.”

At the time Rebecca and I spoke, Sarah had been living for several years in a group home in the Southwest, receiving Social Security Disability, going to Alcoholics Anonymous meetings regularly, and was under the care of a psychiatrist. With Joe happily married and working in California, Rebecca and Bill enjoy coming back to their quiet home in the woods after a long day, knowing they have no one to take care of besides their cats.