I don’t know how aware my parents were of Lou’s drug use. Certainly there were times he seemed drugged, as I look back on it. In one instance, he crashed the family car into a toll booth on the parkway. Yet my parents did not seek help at that point. Perhaps because that isn’t what you did at the time, or because they just didn’t understand what was happening. They were embroiled in a battle that overwhelmed their resources.

Family secrecy still ruled the day. This was before “Oprah” and the willingness of individuals to confess to substance abuse or mental illness. Rehabilitation facilities were essentially non-existent. Fright paralyzed my parents, and as a result they did nothing. They pretended that the problem did not exist. Meanwhile, Lou continued to self-medicate with drugs and alcohol.

Remarkably, during Lou’s senior year in high school, there were moments of normalcy at home. Family dinners could be enjoyable. Lou and my father were both extremely witty, with erudite, dry senses of humor and remarkable literary sensibilities. I enjoyed their verbal jousting, as did they. Just a child at the time, perhaps 11 years old, I was dazzled by it. Their cleverness was something we all enjoyed together.

At 17, the decision was made that Lou would attend New York University. My parents sent him off with pride and possible trepidation. They were about to encounter some very difficult issues with their son and the “help” they received from the medical community set into motion the dissolution of my family of origin for the rest of our lives.

Within the Hippocratic Oath lies the promise that doctors will “do no harm and avoid injustice” to patients. We trust and hope that those in the medical profession will use their knowledge and skill to save our loved ones. Yet the 1960s were marked with psychiatric theories that would ultimately harm families and do irreparable damage — for example, by blaming mothers for being “refrigerator mothers” who “caused” autism or schizophrenia. Families at a loss for how to deal with their loved ones’ genetically-based mental illness were treated as perpetrators by the psychiatric establishment. They were blamed for poor parenting, left feeling hopeless and guilty.

Sometime during his freshman year at NYU, when I was 12, my parents went to the city and returned with Lou, limp and unresponsive. I was terrified and uncomprehending. They said he had a “nervous breakdown.” The family secret was tightly kept and the entire matter was concealed from relatives and from friends. It was our private and unspoken burden. Even at 12 I knew to keep silent, and I did.

My parents finally sought professional help for Lou. I heard only the superficial pieces of what was going on. My mother came into my room and told me that they thought he might have schizophrenia. She said that the doctors told her it was because she had not picked him up enough as an infant, but had let him cry in his room. She sobbed. “The pediatrician told me to do that! He said that’s how you teach a baby to go to sleep.” It was a belief and a burden she took to her grave.

Lou was not able to function at that time. He was depressed, anxious, and socially unresponsive. If people came into our home, he hid in his room. He might sit with us, but he looked dead eyed, non-communicative. I remember one evening when all of us were sitting in our den, watching television together. Out of nowhere Lou began laughing maniacally. We all sat frozen in place. My parents did nothing, said nothing, and ignored it as if it was not taking place.

He did not improve. Despite their misgivings, my parents took a deep breath and brought Lou to a psychiatrist. Who knows what happened in the therapy setting? I only know that the treating psychiatrist recommended electroshock therapy. Did that doctor take into account the possibility of the impact of Lou’s substance abuse or any familial context? Did any sort of family therapy get offered to process what was happening?

My parents were like lambs being led to the slaughter — confused, terrified, and conditioned to follow the advice of doctors. They never even got a second opinion. Told by doctors that they were to blame and that their son suffered from severe mental illness, they thought they had no choice.

I assume that Lou could not have been in any shape to really understand the treatment or the side effects. It may well be that he was fearful that he would be committed to a psychiatric hospital and not allowed to remain home if he did not agree to the treatment. Thus, informed consent from him would have been obtained in a rather questionable fashion.

Was he suicidal? Impaired by drugs? Schizophrenic? Or a victim of psychiatric incompetence and misdiagnosis? Certainly no one was talking about the impact of depression, anxiety, self-medication with illegal drugs, and what all that could do to a developing teenage brain. Nor was there any family therapy, involving us in understanding him and his needs.

My father was attempting to solve a situation that was beyond him, but it came from a deep love for Lou. My mother was terrified and certain of her own implicit guilt since they had told her this was due to her poor mothering. Each of us suffered the loss of our dear sweet Lou in our own private hell, unhelped and undercut by the medical profession. The advent of family therapy unfortunately was not yet available to us. We were captured in a moment in time.

It has been suggested by some authors that ECT was approved by my parents because Lou had confessed to homosexual urges. How simplistic. He was depressed, weird, anxious, and avoidant. My parents were many things, but homophobic they were not. In fact, they were blazing liberals. They were caught in a bewildering web of guilt, fear, and poor psychiatric care. Did they make a mistake in not challenging the doctor’s recommendation for ECT? Absolutely. I have no doubt they regretted it until the day they died. But the family secret continued. We absolutely never spoke about the treatments, then or ever.

Our family was torn apart the day they began those wretched treatments. I watched my brother as my parents assisted him coming back into our home afterwards, unable to walk, stupor-like. It damaged his short term memory horribly and throughout his life he struggled with memory retention, probably directly as a result of those treatments.

Lou Reed (center) performs at Syracuse University (via Syracuse University Archives)

But Lou did get better. After he recovered, he and my parents decided he should go off to Syracuse University and begin again. And he did. The rest, as they say, is history. His musical genius, his poetry, and his legacy have had an impact on many people and will continue to do so for generations to come.

Would it have happened if my family had received better psychiatric care, support for the family, reframing vs. blame, encouragement and education in communication, awareness of the impact of drugs? Could my parents have been spared their guilt, encouraged to do better than they did? Would Lou have become the artist he became without the furious anger that the treatments engendered? Did Lou use the treatments as a source of artistic fuel, a means to create an illusion of an abused individual? Who knows?

Despite the fact that Lou returned home additional times seeking nurturance and support through other breakdowns, he harbored incredible rage, particularly towards our father. Lou’s accusations towards our father, of violence and a lack of love, seemed rooted in that time. The stories he related — of being hit, of being treated like an inanimate object — seemed total fantasy to me. I must say that I never saw my father raise a hand to anyone, certainly not to us and never to my mother. Nor did I see a lack of love for his son during our childhood. Like his son, my father could be a verbal bully but he was loving and inordinately proud of Lou and bragged about him in later life to anyone who would listen.

Remarkably, Lou managed to live a full and vibrant 71 years, despite the many emotional issues that pursued him though out his life. His charisma, his charm, his wit, his intellect were undeniable and seductive to everyone who knew him well. And, yes, his rage was lethal and unforgiving. But through it all I loved him, tenderly and without reservation. He and I remained brother and sister right to the end.

Merrill, Lou and Toby at the wedding of Merrill’s daughter

The lessons of that time helped me to create my own family, with a loving husband of 43 years and three wonderful children. It made me a more compassionate family therapist. And it made me sensitive to the plight of so many families, criticized and left without support through such difficult times. Do no harm indeed.