Welcome to Max’s World

Max's life has improved in some ways since his early childhood. Manville has given him a social life. He still has violent tantrums at school, but he also has a best friend, a sweet blond boy with a mild anxiety disorder. Last year he won a "Welcome Wagon" award after teachers noticed he was always the first to show new students around. When his classmates have outbursts of their own, he talks them down. "He'll say that maybe they need to take some space, take a deep breath, leave the classroom," says his teacher, Julie Higgins. He has not, however, figured out how to talk himself down, and for all he has progressed as a classmate, he struggles as a student. Technically, Max is in fourth grade—Manville does not separate grade levels—but he is behind in some subjects. He loves science and art, but he has a hard time reading, and although he is creative, he can't put his ideas in a coherent order. Even holding a pencil for more than a few minutes can be a challenge. "Sometimes you can look at him and you know his disorder has captured him," says the school's director, Jim Prince. "But we can't abandon him. We have to be able to hold on to him, sometimes literally, but also emotionally, to help him come out on the other side."

Max also finds it hard to describe his feelings, deep and strong though they are. Jean Frazier, now at Cambridge (Mass.) Health Alliance, has him sketch his worries on a whiteboard. At a recent appointment Max drew a crab: insomnia was making him "crabby." His other therapist, Stuart Ablon, a clinical psychologist at MGH, tries to reach him through play. Max brings Power Ranger action figures to his sessions. "He likes to demonstrate with the characters that there is good and evil, and evil usually triumphs," Ablon says. "He is greatly worried that the evil parts of himself will always get the better of his good side. But you can't ask him about that directly. It's too raw." Once, Ablon tried. Max whipped a toy at him, cutting his leg. "As soon as I started to bleed," Ablon says, "he felt ashamed and shut down."

Max's feelings often move faster than his thoughts. Riding home after he wrote his most recent suicide note, he sobbed, "Please don't send me to the hospital." By the time he had walked through the door he was indignant: he had written the note because his teacher had "treated him unfairly as pre-usual," he said, sending him to timeout. Then he was ashamed for getting in trouble in the first place. "I was scared of disappointing you and Dad because I didn't finish the day at school," he told Amy, knitting his fingers together. "I was sad and scared. I felt like everyone was out to get me." A minute later he was laughing, romping with the family's pet bull mastiff as if he'd never been scared of anything.

Team sports are out of the question; Max is too volatile. But he is learning self-control through therapeutic horseback riding at Challenge Unlimited in Andover, Mass. "We have to teach kids like him to relax," his instructor, Linda Goss, said one recent afternoon as Max rode around an indoor ring. "The trick is to give him choices while also giving him clear directions. He gets a little frustrated, and the horse picks up on that." On cue, Max's horse galloped toward a pair of jumping poles that weren't set up yet. Linda ran, telling him not to jump, but it was too late. The horse made the leap. "I'm sorry," Max said. "I don't have control." But he stayed on long enough to do a few fancy tricks. Last year he won two bronze medals in the state Special Olympics. He wore them for weeks and wanted to keep them on in the shower.

Karate is helping with his self-esteem, although there have been bumps along the way. At a dojo he used to attend, a teacher tried to toughen him up by calling him a crybaby, and Max quit on the spot. Five months ago he restarted karate at Cervizzi's Martial Arts Academy in North Reading, Mass., which makes a point of accommodating special-needs kids. He has already earned his yellow belt. "Sometimes he just assumes he's wrong when he isn't," says Kris Smith, his sensei. "He may need extra encouragement at times. But he knows the blocks, kicks and punches."

It is strange to hear that Max Blake is punching and kicking, phrased as if it's a good thing. He has never acted out in karate class, but he still attacks the people he loves. Jenny Mellor, his babysitter, had a son of her own three years ago, and when she comes over, she brings little Jackson with her. Max is almost always gentle with him. Almost. Last summer, the three of them went swimming in the Blakes' backyard pool, and Jenny found a dead rodent in the filter. Max had heard a lot about rabies at school, and he tore out of the water. Jenny and Jackson kept swimming. Max got angry, hyperventilating and screaming over and over, "Nobody listens to me!" Eventually Jenny became alarmed. She climbed out, went inside and locked herself and her toddler in the family's home office. Max charged the door, shattering a mirror hung on the back of it. Jenny sat behind the locked door, shaking, and dialed a neighbor for help. She was scared for herself and her son, but, she says, she was "crying for Max." She very nearly quit. But she came back two weeks later, and she has been coming back ever since.