This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Saturday, September 26, 2009

When is a label a good thing?

We started with a new therapist recently and he has been working with Bear on his Complex Post Traumatic Stress Disorder (C-PTSD). We were required to go over an article about C-PTSD with Bear and discuss it. Bear didn't understand the article, but that didn't matter. What did matter was that he didn't think he had C-PTSD. Actually this was more of a defense mechanism. He doesn't want to have PTSD so he's in denial.

Bear's latest goal is to be a Secret Service Agent protecting the President. We have never told him that with the number of psychotropic meds he takes (and must take since he's bipolar), he will most likely be unable to join the military. He thinks he's eligible for the Naval Academy because he makes mostly As and Bs. We're very happy he's making good grades, but all of his classes are remedial. At this rate when he graduates he'll be at least 2 years behind (he's a sophomore). Oops! I almost took off on a tangent.

So Bear knows that if he has a label like C-PTSD or bipolar disorder he will not be eligible for the Secret Service. Therefore he is pouting about being labeled and upset that his therapist is pushing for this "new" label. We tried to explain that labels are not always a bad thing because they can help you get the right treatment. We also tried to explain it is not us or his therapist that are doing this to him - he already had the problem (and in many cases the diagnosis), we're just trying to expain it to him and help him. We tried to explain labels are diagnoses. They are not judgements or criticisms. They can be a good thing because they mean a child can get help sooner, possibly keep from getting worse or having it effect the rest of their life, and maybe even heal.

Bear doesn't always "get" abstract stories or analogies, but I think this one actually got through to him a little.

Broken Leg

Let's pretend Bear breaks his leg. A doctor diagnoses or "labels" him correctly. Then the doctor treats his leg - cast, physical therapy, bed rest.... Ten years from now Bear goes for a job where he is expected to run a hundred miles a day. The potential employer asks Bear if he has ever broken a bone. Bear says yes, but he's taken care of himself and is 100%.

Bear can't hide the fact that he had C-PTSD from the Secret Service, because it is in his records, but if he handles it now instead of later he can show them he's handled it and maybe they'll take him.

Another scenario. Bear breaks his leg. He's told he couldn't have and didn't break his leg. He is forced to act as though it didn't happen and walk on it. It heals wrong, and will be wrong for the rest of his life. He has trouble walking and other parts of his body don't work right because they are trying to compensate for the broken one. He cannot do things that require a healthy body that works properly. When the potential employer asks if Bear has ever broken a bone, Bear says no. However, he obviously is not able to do the job.

If Bear manages to somehow get the labels off his record, but does not deal with his issues, then he will be "caught" when he takes the psych exams. They most definitely would not accept him in the Secret Service.

Third scenario. Bear breaks his leg. He is misdiagnosed or decides on his own that nothing can be done about it and his leg will just never be right. He might as well give up, and be in a wheel chair for the rest of his life, if he doesn't die.

No matter whether he's labeled or not his leg is still broken. If he accepts the label and works hard in treatment, then he can mend his leg to where it works almost as well as it would have if it had not been broken.

Color Blind

Hubby is colorblind. Let's say that as a child Hubby always wanted to be an ailine pilot. Airline pilots cannot be colorblind. No matter what he does, Hubby cannot change being colorblind.

Hubby has a choice. Be miserable and/or angry for the rest of his life, or figure out what it is he loves about being an airline pilot and build a new dream (if it's flying maybe he could find another job that will get him in the air like maybe a hot air balloon pilot, an airplane gunner, or an Air marshall? or if it's the planes then maybe he could be an airplane mechanic).

Bear's dream is to be a Secret Service agent who guards the president. He needs to decide if he's going to keep that dream or find another one. Either way he needs to work hard to deal with as many of his issues as possible. Guess we'll see if he chooses to try or to continue to deny and throw up defense mechanisms.


Adelaide Dupont said...

The broken leg is more common but it is temporary. Colour-blindness or achromsosia is permanent and it changes the senses or vision. The acromat and the person with the broken leg are otherwise 'normal' if they don't use defence mechanisms.

And eyes and legs are controlled by the brain. But in these scenarios they are held independent from the brain.

And if you never broke your leg but still can't run a 100 miles a day (or at all).

I think with the broken leg scenarios, 2 or 3 are more likely.

And a really good example of the colour-blind scenario is in Little Miss Sunshine, where the boy is mute and he wanted to be an air force person. But he was colour-blind too. He was really into things like Nietzsche's philosophy.

Kristina P. said...

Great post. I teach an educational group to our substance abuse teenagers, many of them with the same diagnoses as your kids, and last week, I had them talk about labels.

And I brought up exactly what you said about sometimes lables being a good thing so that they can get the right help they need.

Interestingly, many of these kids are perfectly fine being labeled as "stoners." But they don't like "potheads." They said that a pothead is someone who smokes pot all day and then does nothing, whereas a stoner is someone who will do drugs but is still productive. Go figure.

Anonymous said...

SS Agent protecting president = acting out the fantasy of being protected (or of repairing a missed opportunity to protect?) The more he heals, the less he'll need the fantasy? It can be a negative catch-22 (won't heal = can't be SS) or somewhat self-eliminating (heal = don't care as much anyway).
But what I wonder is why he needs to buy into the diangosis? If the label really does bring greater advantages (insurance, schooling), then keep it on paper and don't force it on him. If the label is about treatment options, it is his docs and therapists who need to accept it, not him. If you want him to read and learn from stories of others "like him", he can be like someone with a label without accepting the label - is there harm in permitting him to think he is only 80% like the people w/ the label? I get that he needs to accept bipolar 'cause he needs to adhere to his med regimine and understand what will happen if he slips -- but you don't have to be psychotic to have beneficial effects from antipsychotics ... I'd be tempted to look for ways to "give" him this - denial of label, not denial of symptoms.

Bill and Ronni Hall said...

Hey Mary, the Mom, we are being attacked on our blog by a family member who thinks RAD doesn't exist. Could you come by and help out? We need a united, educated front.