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!

Monday, May 30, 2011

Therapy Direction Meeting

E-mail I sent to Kitty's EMDR therapist, attachment therapist, skills trainer, and MHMR case manager:

We had a very tough EMDR session with Kitty on Friday (crying, screaming, cussing, threats - suicidal, homicidal, withdrawal of love, and running away…) that has made me want to rethink how we’re approaching therapy – at least for the Summer. It feels like everyone is telling Kitty that she’s basically “normal” with some issues and that if she can just control her behavior then she can be like other teens (even if this isn’t exactly what she’s being told, it’s what she’s hearing). This is causing a lot more meltdowns and issues on her part, because she is NOT a normal teen, and we usually cannot treat her as such (which makes her mad and triggers her abandonment issues – SHE feels that we’re treating her differently because she’s bad and believes that “bad” kids are unworthy and unlovable so she’ll be abandoned again). Plus, she is unable to actually control her behaviors all the time (which makes her feel like a failure and a bad person in addition to being terrified that it means she will be rejected).

At home, I work hard to keep her life as age appropriate (her emotional age vs her chronological age) as possible, because when we raise our expectations, Kitty tends to respond with an increase in meltdowns and stress. Actually I feel we have to provide even more extreme assistance with emotional regulation at home, to counterbalance the stresses and anxieties of her everyday life. At school and in public the expectations of all are of course MUCH higher and she is responding as best she can. She HAS learned a lot of self-control over the last year. The problem is that while Kitty does her best to control outbursts, the stress and anxiety are not actually being dealt with (merely internalized, ignored/ denied, and delayed), neither are we usually dealing with the reasons she’s having so much difficulty dealing with “’normal’ life and it’s stresses.”

When Bear went to {RTC} for residential treatment, he was a very angry, messed up kid. It took 6 months to get him on the right med combo to help him with his bipolar and other medical issues. Once he was on the right meds we were able to start making progress on his emotional issues. I won’t say that he’s made a complete turn around and I definitely won’t say he’s “healed” or “normal,” but we seem to have found the right combination of meds, supervision, and therapy to be moving in the right direction and allow him to emotionally mature as well.

Maybe because Kitty had farther to go, or maybe we just have higher aspirations for her (because she does seem capable of emotional attachment), but it really feels that Kitty is not progressing at anywhere near the same pace. While the two children have almost identical diagnoses, it is becoming increasingly evident that Kitty’s issues are not going to be resolved in the same way. Meds, supervision and support seem to have taken us as far as we can go. I have to wonder if there is more brain damage (FAS?) preventing her from going any farther.

The difference in Kitty’s chronological age vs. her emotional age is becoming more and more evident as she gets older and the gap gets wider. I believe she stuck around 7 or 8 years old. The problem is she perceives the others around her as getting to do what she wants to be able to do, and she’s externalized the reasons why she can’t have what the others do as because we are “mean” or “don’t love her” or think she’s “bad.” Possible solutions (like more restrictive school environment) feel like punishments to her. The younger children in the family (who are basically “neurotypical” and did not have the traumatic childhood) are rapidly passing Kitty up. It is traumatizing for her to see them getting to do things she knows she’s not capable of, but is jealous of nonetheless (little sister Bob will begin driving this Summer when she turns 15).

It feels like now that she’s out of school, that if we play it safe and keep just teaching her behavior management and calming techniques, then we’d be just applying bandages and all that is doing is delaying healing or any forward movement. Kitty is NOT a functioning member of this family or society in general and doesn’t seem to be moving in that direction. Plus, the family is so busy applying CPR to her that everyone else is not functioning. It seems like if we’re going to go through this torture anyway then we might as well be trying to achieve a goal, but I’m not even sure what goals are achievable at this point.

I’d like to sit down with the key members of Kitty’s team and decide what is she really capable of? At least try to get all of us heading in the same direction as no one seems to have the full picture. Sometimes it feels like she’s attached and working on the trauma, and other times it feels like I’ve just lowered my expectations so much that it seems like she’s making progress when she’s really not. Some see the totally damaged and draining kid with traits of Borderline Personality Disorder with a meltdown always simmering just below the surface waiting for any spark.. The school seems to be seeing a quiet teen that’s doing “fine” now that she’s not dealing with side effects from the med changes. What do you see?

Direction for therapy for the Summer?
· Helping Kitty see her capabilities, gain a realistic understanding of her diagnoses and face her limitations without blaming others.
· Do another psychological assessment to decide if she has FAS? the capability of functioning as an adult? Does she have borderline personality disorder? If she does have BPD, we know she isn’t capable at this point of handling the normal treatment (12 step program). So what are next steps?
· Should we “poke the bear” to restart progress? Ripping off the top layer and getting to the festering wound(s) and cleaning it out vs. keeping her calm all Summer.
· Going ahead with family therapy using the EMDR/trauma therapist who has worked with all members of the family, with Kitty and Bear in the knowledge that it’s probably going to help him more than her and will probably set her off (meaning she’ll most likely need residential treatment)
· Looking at her attachment therapy as a support (for making sure we don’t break/damage attachment too badly while we’re focusing on this other therapy). Ditto for skills training, trying to give her some coping techniques for dealing with this as well.
· Do we want to try to find a residential program that can take care of her (giving us respite) or possibly even help her? Do we need to decide if is she capable of living in a family?
· Should we be looking at more funding options for intense outpatient/ partial day hospitalization or similar programs.
·



Mary

Thursday, May 26, 2011

THANK YOU!

(This is actually me putting names on certificates of attendance at the ACT seminar)


Thank you guys!! I now have 100 followers! I want to write each and every one of you a certificate of appreciation, but I have no time. I want to go to all your blogs and give you comment love, but for some reason I CAN'T COMMENT ON ANYONE'S BLOGS!!! It's making me nuts. I hope Blogger gets it figured out soon.

Tuesday, May 24, 2011

I am not alone!

(This is not the image of my stone, but that of one of my blogger friends)




I've been feeling quite overwhelmed lately. The kids are officially out of school on Friday and I have almost no plans for the Summer. Plus, for some reason Blogger isn't letting me comment on anyone else's blogs! I want to connect and comment, but I can't!! It's SOOOOO frustrating! I hate it!

Yesterday I was feeling particularly down when I opened a package in the mail (I was pretty excited since I rarely get anything but junk mail and bills nowadays. I slit open the end of the envelope and this warm stone slid into my hand (it's in the 90s outside, but I prefer to think it's love and warm understanding that heats the stone). I have to tell you that I didn't want to let it go. I typed several e-mails with it clasped tightly in my right hand.

Thank you Corey!

After along time I decided I needed to really type so I could finally get to bed so I dropped it into my bra in a "special pocket" close to my heart. I've been wearing it there for 2 days now. Don't worry, I've gained so much weight, no one will notice a little extra. *sigh*

This is me working at the ACT Seminar a couple of weeks ago. I saw this picture and it really hit home how much weight I've gained over these last 4.5 years dealing with RAD kids. Did you know the average RAD parent gains 20lbs a year?!


I've met a lot of good people lately, and most of the time I do know I'm not alone.



Not only was this a good seminar (check out Lark Eshleman's presentation), but I met a lot of great people to whom I owe e-mails.



I finally got around to joining CABF - Child and Adolescent Bipolar Foundation and taking advantage of their frequent chats (Mon, Wed, Fri and Sun evenings!) and the support groups (I belong to one for teens and one specifically for adoption). (Check out the link to their blog too - I've put it on my sidebar). If you're already benefitting from their many services by the way, they could really use some financial support. They support 27 different support groups and don't charge any membership fees. The big Pepsi grant they got recently is allocated for specific things so they have some other areas that need a little more support.


I am aware that I'm stretching myself a little thin (unfortunately it doesn't apply to my figure!). There is so much I want to be able to do need to get done:



  • (newsletters for NAMI and ACT),

  • keeping up with PCT and trying to get some support groups and get-togethers organized,

  • hooking up with parents I met at the ACT seminar,

  • trying to get to the NAMI support group (haven't been in months because of the issues with Kitty),

  • gotta get the house clean for my dad's visit next week (I finally get to meet my new little brother!),

  • over a hundred blog posts to read (and hopefully comment on),

  • all the appointments the kids need to get Bear started at DARS/ Goodwill job training and Kitty needs to get stable (CRCG, skills trainer, pdoc, case manager...)

  • drive Kitty to school and home and supervise her while we finish up school on her abbreviated schedule

  • write a thank you note to Corey for my "I am not alone stone"

  • finish researching and getting the Power of Attorney stuff for Bear (who turns 18 in July)

  • get the states (NE and TX) to agree that Bear's TX Medicaid needs to be extended to age 19

  • keep pounding away on getting Nebraska to consider paying for Kitty to go to partial day hospitalization (aka intensive outpatient)

  • finish researching and moving to new pdocs (Bear turns 18 and the funding for Kitty's telemed pdoc runs out in July)

  • ...

  • and need more than a few hours of sleep a night!


Going to bed now!

Monday, May 23, 2011

Follow Me!!



Only 2 more followers and I'll have 100 followers!!! You like me! You really like me!


__________________________________________________


School is out on Friday. I have nothing planned for the Summer for the kids except for Bear's part-time job with the Goodwill Job Training program through DARS *EEEKKK!!!*


Well that's not entirely true. One of my favorite cousins and his wife will be visiting early in June, with my dad and step-mom who will be here the first full week of June with my new little brother! I finally get to meet him! I'm trying to make the kids call him Uncle, but they refuse to call someone younger than they are Uncle. (He just turned 14 so only Ponito who is 12 is actually younger than he is). Bob is distressed that while he's here they'll be the same age (she doesn't turn 15 until July).


The following 2 weeks the kids will be working at vacation bible school (Bob helping teach crafts and Kitty helping with theater. Not sure what Ponito will be doing. He got left off the list. Bear is really disappointed that he won't be able to participate this year).


I'm hoping to organize some PCT support get togethers with parents and maybe kids too.


Well, better wake up Kitty for lunch and school!


Hugs and prayers and a big THANK YOU!! to all my readers. I don't know why you read, but I really appreciate it!


Mary

Friday, May 20, 2011

Family meeting



I sent out this e-mail on May 8th:


Bear has been crying and moody a lot lately (both at home and at school) and isn’t sleeping again. He says he is upset about his sister’s issues and girlfriend trouble, and “everything.” He seems very depressed and I’m a little worried. Also, he’s still "fidgeting,"{when Bear's meds are not right he gets what we call "twitchy" - uncontrollable body movements, including adjusting his shoulders like he's trying to
"settle in" to his chair continuously, can't keep his hands still...}, but it’s not as bad as it was.

{Info about meds deleted}

Mary


Over a week later I received this e-mail:



Hi Mary,

{Kitty's skills trainer} and I have discussed your email and wondered if you would be interested in having a family meeting (Bear and Kitty and whomever else you think is being affected by the current situation) as well as {Kitty's skills trainer} and myself. It seems that with all of us present it would allow us to be on the same page and hopefully with clear direction as to what we can hope for with the upcoming summer.

Thoughts?

{Bear's skills trainer}


The next evening was the "Sock it to Stigma" support meeting and both skills trainers were there. I told them both that while I think Bear would benefit from this, and we've discussed doing it in therapy, we had decided that Kitty was not ready. I mentioned to Bear's skills trainer that in addition to all the other reasons we had, Kitty had only met her skills trainer 3 times so I did not feel they had established enough of a relationship to help Kitty feel safe.

The next day, Kitty's skills trainer met us for Kitty's weekly skills training session (which I'm considering dropping, or at least not allowing the trainer to meet with Kitty alone, because the trainer has unrealistic goals and keeps getting Kitty wound up with entitlement expectations that make her angry and resentful. After meeting with Kitty, the trainer tried to talk me into letting the meeting with Bear et al go forward.

These are the reasons I gave her for saying no:




  • With more than one or two adults present, it would feel to the kids like we were ganging up on them and they would just shut down (this always happens during IEP meetings) - doesn't matter how many times we tell them they're not in trouble. It's a strong defense mechanism.



  • Bear already feels like Kitty going into psych hospitals is his fault (for whatever reason) and this would just solidify this in his mind.


  • Kitty is physically afraid of Bear (and everyone bigger than she is). We keep the two of them apart most of the time for this reason so that she can regulate. Consciously she may know that he won't hit her, because he hasn't in 3 years, but subconsciously I know she remembers Bear hurting her when they were little (he has choked her, punched her, and rough housed with her). They're only a year and a half apart in age so he was only acting like unsupervised, abused kids with no boundaries would... but he was a BIG kid and she was little. He's NEVER hit me (although he's gotten violent with Hubby), and even I flinch when he gets angry. Bear is not allowed to physically touch the other kids, beyond a mutually agreed upon hug. He doesn't know his own strength, and has roughhoused or even just run into Ponito and seriously hurt him. He has justified his aggressive behavior with the fact that the other person started, or he perceived that they started it, and this scares all of us. Bear is NEVER left unsupervised with any of the kids for this reason. I just can't trust him.




  • Kitty is intimidated by Bear. When they first came to live with us, she catered to his every whim (offering him her seat, the best of everything, and asking him if she could get him anything). It's only been in the last year or so that Kitty has been able to stand up to Bear at all and tell him no. When Bear is confronted, he tends to get defensive and angry. If my husband is unable to attend this meeting then it will be a bunch of women - who Bear rarely has a problem letting them see him at his patronizing, intimidating worst. Even if he holds it in because he hasn't let any of these women see that side of him, Kitty knows he could go off at any moment and there is no one there to keep her safe (well, there's me, but that doesn't always feel like enough).




  • She also has only recently (in the last couple of years) begun to be willing to say or hear anything negative about him. It is still hard for her to hear even implied criticism or to want to criticize him. This could set her off. Kitty still subconsciously believes that if Bear is in trouble then he will be kicked out of the house and within months she will follow (this is historically how it has happened throughout her life - she lost biofamily this way and her first foster home).




  • This is something that needs to be addressed in therapy! With skilled therapists who know the kids, know the history, and know the parents. We've discussed this with the therapists already and we agreed that while Bear might benefit from the different perspective that Kitty can provide on their childhood, that Kitty is nowhere near where she needs to be to handle it emotionally.





I do want to have a meeting with Bear’s therapist this weekend, but instead of bringing Kitty, I want to bring Grandma. In talking with Grandma I believe we’re missing a lot of what’s going on when we (the parents) aren’t around. He is a lot more intimidating and threatening to women and kids, especially when he believes he’s unsupervised. This really concerns me in that I think this will really effect his future employment, I would like to be able to leave him unsupervised at some point in his future, and I’d REALLY like to address this during this last year we have with him as a “child.” Also while we have a few months left with the skills trainer who can provide yet another opportunity and perspective to helping him learn how to handle this appropriately.

Thursday, May 19, 2011

Sock it to Stigma



Watched this video today. We've talked about removing the stigma from mental illness a lot this week, and I think this group did a great job by presenting it in a funny, entertaining way. Check it out!


Tuesday night we went to a parent support group at our MHMR. They decided to have a theme - Sock it to Mental Health Stigma and asked everyone to wear silly socks. I was the only one in my family to wear silly socks though.


They had several presenters... including Bear! Unbeknownst to me (and if they'd asked I would have said NO since it seems to play into his issues) they'd asked him to present to the group now that he's almost 18 - about how great the MHMR facility was, and how they helped him get better and made. OK, maybe that's not what they asked him to present about, but that's the way it played out.


Bear decided at the last minute that he wasn't going to do it (so they compromised and had his Skills Trainer "interview" him). I was fuming by the end of it. They asked Bear how he felt when he was first diagnosed (wasn't actually his first time being diagnosed, but was his first time in Texas with the adoption etc., and he ended up in residential treatment). Then they asked Bear about how much better his life was now. He has only been with this MHMR program for less than a year. He's lived with US over 4 years and has been out of residential treatment for over 3 years. WE did all the work - not them!

______________________________________________


A group called Via Hope also presented at the support group. They are working on a mental health advocacy grassroots organization for teens and young adults. They gave a presentation regarding a new Youth Mental Health Advocacy Retreat.


What's happening?

Via Hope is bringing together youth for a weekend of fun, learning, and CHANGE. Participants will learn about mental health, proactive ways to advocate for themselves and others, and how to shape conversation around mental health.


Who are we looking for?

14-24 year olds who are passionate about creating change and who are interested in mental health advocacy. You do not have to have a diagnosis. Just the passion!


Where and When?

The retreat will be held at the University of Houston in Houston, TX from August 5th to August 7th, 2011.


Contact Lauren Cohen at (512)693-2000 or Lcohen@namitexas.org for an application packet and more information.

Wednesday, May 18, 2011

Analogies




“How do you know when you’ve hit the “ceiling” on your child’s abilities?”

Answer: I don’t think you can know completely, but go with your instincts. You know your child’s abilities better than anyone, and you’re in the trenches with them daily so you can be flexible about what you work on. I’d say focus on helping them retain what they have, but keep striving to work on the concepts that seem just out of their reach when you find yourself in a teachable moment – they just might surprise you as they mature.

When we got both our kids over 4 years ago (age 11 and 13) they were such concrete thinkers that they could NOT grasp abstract concepts at all. I tend to try to teach using examples and analogies (when natural or logical consequences don’t work). My kids could NOT get it. If we tried to talk about how they handled or could have handled a previous issue then they instantly went into “fight, flight or freeze mode” because they felt they were being punished for this past transgression. If I tried using an example of someone else, like the “boy who cried wolf, ” they just couldn’t generalize it to the situation.








When we first started working with the kids, we quickly discovered that their black and white concrete thinking meant that if we used examples at all, they immediately focused on the examples and got defensive and had a meltdown. If I said, "Remember when you left out the butter on the counter last week..." (planning to discuss how we'd handled that situation, how it applied to the current one, and what we could do differently to prevent it from happening again...) --- then before I could even finish the sentence, she immediately went into meltdown mode because I was "yelling at her, criticizing her..." She was totally focused on the example, and couldn't generalize it to any other situation.








__________________________________________

Recently I used an analogy with Kitty… and she got it! I tried a similar analogy with Bear two days later, and he couldn’t get it. I’ve been working with Kitty on this in therapy for years and we slowly have been making progress (a big part of this is that she’s attached and getting to the point where she can access her emotions! Yea!). Bear though is still very RAD and won’t talk to us about his feelings or talk things through with us. He’d rather hide in his room, keep us at arm’s length and deal with the consequences on his own. I think he’s capable of functioning at a higher level, but he won’t let us help him – so he probably never will.

----------------------------------------------------




EXAMPLE:



Bear and I had a discussion recently (Ok, tried to have) about Facebook, the money he's going to earn this Summer with his DARS job, and his plans for the future. It ended up being a short discussion because I tried to use examples and analogies to explain why we make the decisions we do - as a counterpoint to Bear's argument that I'm holding grudges and am just flat out wrong, mean and trying to crush his dreams.

Kitty and I had had a similar discussion not too long before about why I'm "over protective" with her, and I used several extreme examples (giving her the car keys and telling her to drag race, encouraging her to date known rapists, her sneaking out her window and falling to her death, her choosing to be friends with kids who cut and do drugs...) to explain to her the liability issues we have as parents (I'm responsible for what happens to her whether it's by her choice or not - because she's a minor living in my home). Kitty was in a calm, rational place during this discussion, and she "got it"!! I'm not saying that we won't have trouble the minute she gets dysregulated, but she understood my examples and reasoning.

Bear didn't "get it."






He now thinks I'm accusing him of being a 4 year old drug addict. *sigh*






_________________________________________________






We struggle with how high can our kids go (executive abilities) daily. If I say, “This is it, as high as she/he can go,” then I feel like I’m being yelled at by everyone for being a horrible parent who limits her kids (caseworkers, my kids, the school…). However, if I don’t, then my child feels like a failure, because they’re spinning their wheels working hard to obtain an unachievable goal.







Right now school is telling them they’re going to college and can be anything they want to be. Which was fine in middle school when we didn’t know their capabilities, but they’re in high school now and need to focus on getting skills to help them with what they’re going to be when they start work (which is SOON for Bear who will be 18 in less than 2 months and only has a year left of high school).







Kitty is being allowed/ encouraged to believe that her goal of being a doctor is achievable (she has a poor working memory, below average IQ, is in all special ed classes, stress causes her to have melt downs – recently been in a psych hospital twice in as many months…). When confronted, the school says, “Well she can be a nurse or technician or something.” The reason she wants to be a doctor has nothing to do with wanting to help people, and everything to do with how much money a doctor makes! Obviously that’s not going to happen if she becomes a nurse… which is not a realistic goal either due to her issues.







When I’m honest with my kids, then my kids think I’m a liar (because everyone else is telling them otherwise) and that I’m being mean and “crushing their dreams.” Not exactly how you want your attachment disordered kids to think of you. I try to help them focus on realistic goals and teach and reteach concepts to help them grasp them, but I feel like Cassandra (the prophetess who was cursed by the gods to be totally accurate and never believed).







I’ve structured their home life to be age appropriate (about 8-9 years old), but get absolutely no support and a lot of “your mom is mean for not letting you do what you have a right to do as a teen.” Can’t tell you how many lectures I’ve received on what is developmentally appropriate for teens… but my kids aren’t really teens! My kids need structure and rules to feel safe. When they feel safe they can learn and grow. When they don’t feel safe they have meltdowns and regress. Yet I’m instructed over and over to “give them a chance.” They have major entitlement issues already...








This sucks.

Punctuation Saves Lives




"This writing business. Pencils and whatnot. Overrated, if you ask me."




One of my best friends is a scopist (They're like proof readers for court transcribers - I know, I'd never heard of it either!), and she signs all her e-mails with this:





Let’s eat Grandma.
Let’s eat, Grandma.
PUNCTUATION SAVES LIVES.



Makes me smile every time!






________________________________________






Bear has an A in 11th grade English. Can't you tell?!





Hy mom please remember my project if posibal get all of it on the paty o at gram it in front of popys wood theres a peace of thick drie wall and wood planks and a pecae of pliy wood and the small house that is are ready built LOVE BEAR _______ Thanks
--
•Never approach a bull from the front, a horse from the rear, or a fool from any
direction

BEAR



This is Bear's way to ask me to bring to school the science project that he forgot at the grandparent's house over the weekend. He's building a model of an eco-friendly house. The good news is that he was actually very polite and once I figured out what he was talking about then I was able to read it pretty easily.




"Hi Mom,




Please remember to bring me my project. If possible please get all the pieces that are on the patio at Grandma's house. They are in front of Poppy's woodpile. There's a piece of thick drywall, and wood planks and a piece of plywood, and the small house that is already built.



Love,



Bear ________


Thanks"



____________________________________________



I love this one. It makes me think of pirates! Aarrr! (He's asking me to look up his grades online.)





Mom What r me graeds
--
•Never approach a bull from the front, a horse from the rear, or a fool from any direction

BEAR


___________________________________________



This one really helps me remember how far we've come. It really stinks that he only expresses his feelings in e-mails, but it's better than nothing.







Hy mom how is {kitty} this is kinda getting to day im feeling alittle stresed out and for some reason Im feeling like it my falt in away because I did this so many times to her and the other grils when they were yonger, The makes me think about some of the stuff im trying to forget about and try to move on with my life. Im feeling like i want to cry but i don't any one to weary about me.


LOVE YOU MOM I realy apreshat the way you have never gave up on us i think this some thing we needed That we realy never had. THANKS love you mom Thank for putting up with all the good and bad stuff i ever through at you

--
•Never approach a bull from the front, a horse from the rear, or a fool from any direction

BEAR

__________________________________________________________

Lately, Bear has been having problems with Biomom talking to his girlfriend via Facebook. Several months ago, I took away Bear's access to FB (changed his password and the password on all his online e-mail accounts so he's limited to the one we can monitor), but the account is still up, and he is friends with ALL of his biofamily (and 250+ of his closest friends). I'm not totally sure how Biomom figured out which one was Bear's current girlfriend, but oh well.


Hy mom {GIRLFRiend} said {Biomom} is talking to her on face book can you ask her to stop Plase Because she asking ? about me and i dont want {biomom} saying some thing rong to her. The worst I dont want her doing some thing to come bettwen us in any way because that would make me mad and i don't
--
•Never approach a bull from the front, a horse from the rear, or a fool from any direction

BEAR

He didn't finish the e-mail. Just sent it to me this way. I'm still debating how to handle it. Although I did send Biomom a message via chat using Bear's facebook account telling her that Bear has requested that she not speak to his friends. No response.

__________________________________

Monday, May 16, 2011

Still Not Out of the Woods





Another letter to the school and other people involved in Kitty's care










I’ve talked to {Mr. AP, the school assistant principal} about the IEP meeting decision to have Kitty assessed by {the special school Bear attends} not happening. {The school psychologist} passed the buck mentioned this was {Ms.P, Kitty's school case manager's} responsibility to arrange, but apparently no one had realized that Ms. P has been out due to family issues, and probably won’t be back until later in the week. Mr. AP said he would make sure the forms would get filled out so that the assessments could get started.

I also want to make sure that Kitty has been re-enrolled in English and World Geography instead of study skills so that she can get credit for the work she’s doing, now that she’s making it to those classes. Mr. AP mentioned this confusion on Wednesday, and I want to officially put it in writing that we’ve agree to this, and make sure the teachers are aware of it as well. (According to Kitty the teachers
are under the impression that she is still enrolled in study skills {and therefore won't get credit for actually completing the classes - just credit for a study skills class, even though she's in those teacher's classrooms doing work for those teacher's class - in addition to her other make-up work).

Also, if someone could give me a heads up on Kitty’s finals week schedule as soon as possible that would be greatly appreciated so I can coordinate this with the other kids’ schedules (Bear needs to be supervised) and move Kitty’s psychiatrist appointment if absolutely necessary (currently it’s Tuesday morning).

FYI, I picked up Kitty early from last period on Friday because she called me with a “sore throat and a headache.” When I asked Kitty why her throat hurt, at first she said she didn’t know why. Then later she told me she’d had a “screaming contest” with a friend. Two days later she told me that she’d made that up, but the hitting contest she’d told Hubby about as having happened Thursday, she said really did happen. {This is unusual as Kitty doesn't normally lie} She claimed she and another girl were “fake punching” each other in the arm and stomach, and that at one point the other girl hit Kitty “too hard” in the stomach. Whichever events actually happened, I think it’s obvious that Kitty’s boundaries and social skills are still a
mess.

Although this last med change has obviously helped Kitty (we’ve all enjoyed actually seeing her smile again!), Kitty also had several severe meltdowns over the weekend -- to the point we almost called the crisis hotline. Luckily, with our warnings and help, she was able to teeter on the edge and pull back just enough to keep us unable to justify the additional overwhelming anxiety and trauma this would cause.

The meltdowns were triggered by the fact that Bear, her brother, is not sleeping well and therefore was in an irritable, intimidating and rude mood. He did not do or say much of anything to Kitty, but he lost his cool with me (in front of her). I was able to get him out of the house with Hubby, but not in time to keep Kitty from being triggered and anxious. We decided that Bear's behavior was not bad enough for him to lose the privilege of spending the night at Grandma’s and he was in a good enough place to be safe with Grandma and the other kids, but that Kitty was so hypersensitive to him that she wouldn’t be able to tolerate being around him. So we
kept Kitty home from Grandma’s Saturday night – which she took to mean that we didn’t love her and that we were punishing her – which led to another serious meltdown. The last meltdown ended with me supervising her until she finally fell asleep under her bed (don’t ask!).

Thanks for keeping everyone in the loop guys!
Mary





We're still hoping to talk the state of Nebraska (where the kids were adopted from) into paying for partial day hospitalization for Kitty (she goes to school and therapy with psychiatric services from 8am to 5pm Monday through Friday at the hospital, and spends evenings and weekends at home. It's like residential treatment, but with less trauma!

Unfortunately, the one in our area doesn't take Texas Medicaid (because our state is one of the worst for mental health services in the country). We had residential treatment services written in to our adoption subsidy (for this reason), but it never occurred to us that the partial day hospitalization program that was covered by TX Medicaid would actually be evil (story for another time if I didn't already write it two years ago), and would eventually close down.

We're also not having any luck getting anyone to return the calls of the post adoption services caseworker who is trying to help us with both this and getting our TX Medicaid extended to age 19 (we know how, we just can't get anyone to fill out and turn in the form).

Saturday, May 14, 2011

Letter from a parent of a hurt child

I saw this letter on other's blogs weeks ago and skipped it. Today I got the urge to view it and I'm so glad I did!




Wednesday, May 11, 2011

Why does my child act differently away from home?

A friend of mine with lots of kids (including 2 year old triplets!), has one of them in Residential Treatment for the first time. She's being told by the RTC that he's doing great and is sweet and wonderful. She knows in her head that he's honeymooning, but it still hurts and makes her question her parenting. I want to share what I wrote to her:

First off, STS is right that how we parent is based on life in the real world... not life as it is in RTC with 24/7 staff and PRN tranquilizers.

Second, parenting styles HAVE to be different than what works for an RTC. Kids are going to react differently too (for all the reasons STS gave). You are a good parent!!!! There is no “right” way to parent our kids (although there are definitely some wrong ways!), but I can tell that you know what works for your son in your home. It’s good that you know that when he plays video games he gets dysregulated, just because for whatever reason it’s different at the RTC, doesn’t mean it’s not true at home. Stick with what you know is right for your child!


Why kids act differently in RTC (or school or anywhere else):

1. YOU are not there (at the RTC). You are the symbol of all mom caregivers, and you dare to try to “inflict” your love on him. In an RTC our children don’t have to deal with the stress of family and emotions, which may reduce their stress to a point where they can handle it better.

2. Some kids are too “broken” to function in a family and do better in RTC. They NEED an environment without emotions and long-term consequences, and need people to keep them, and those around them, safe because they are not capable of doing it for themselves. I’m not saying this is true for your son, but for now he is not capable of being home.

3. My son deliberately acts out at public school until he gets sent back to the special school, because he needs and craves the structure and support provided by the special school.

4. It is not possible to live real life like an institution (although we sometimes come close in our house), especially when you have 2 other special needs kids and 2 year old triplets like you do! We cannot always provide the structure and concrete expectations that our kids need/ crave, especially over the long-term. RTCs have much better staff to child ratios and back up than we ever could!

5. Staff can avoid telling the kids what they don’t want to hear (like “no”), because RTC is ultimately short-term and our child’s best interest is not their problem. So our kids behave better because they like people who rarely tell them no. They can get away without telling your child no because;
  • This is a locked campus that goes way beyond child proofing, so staff don’t have to deal with watching him and correcting him when he gets into things that could hurt him. There are no small 2 year olds or pets running around that he could sexually abuse, torture, torment, or just be cruel to. They don’t have to protect a whole family, just a bunch of kids who are not exactly perceived as defenseless.
  • Your child KNOWS he has little to no flexibility or “wiggle room” on most subjects so they don’t bother to argue with staff about bedtime, computer time, respectful words…
  • It’s not personal at an RTC. It’s just a job. Staff can walk away, they can quit, they can let someone else take over for awhile… we have to protect ourselves and the rest of the family and that influences how we handle our child. Staff don’t have to do anything that isn’t in their job description. If someone vomits that’s the job of the cleaning staff. If they have the flu they can take a sick day. We have to deal with everything our children throw at us, no matter what, and it often hits home and gets personal.

6. Unlike an RTC, when a child is rude, horrible, scary, threatening, tries or succeeds in hurting a family member - we have to continue living with this child. If our significant other treated us the way our child does, then most likely the spouse would go to jail, or everyone would be encouraging us to leave him, but when it’s our child, we’re just supposed to handle the emotions and stress, not show it in any way to our child, and be warm and loving all the time.

7. RTCs are easier for the kids!
  • School is easier, with lowered expectations and lots of one on one instruction.
  • Concrete expectations (there are very few gray areas to figure out).
  • Fewer decisions to make (bedtime, where to sit, what to do next, during what little spare time they have there are very few choices).
  • No social skills needed or required. No one expects the child to care about anyone else’s feelings.
8. Blank Slate - 
  • If you (the child) mess up… you get to start all over again with a blank slate the next day.
  • NO long term expectations at all. No one cares about long-term consequences (except you!).
  • No history either – no one cares what you did last Summer (no grudges, no expectations, no hurt feelings, no holding the child to a higher standard…)
  • If someone doesn’t like you, or you don’t like them… just wait, they’ll leave and/or go home soon.
  • No one knows your family. They mostly only know what you tell them. If you say your parents beat you every day or won't let you have a cell phone because they are unreasonably strict ... well, it's entirely possible. The staff and other kids will validate your every entitled feeling.
9. RTCs can be fun. Tiny successes are celebrated and rewarded. Even with almost no positive behavior they get to go on field trips, go to the playground, have dessert… get to go out to eat with parents, and can eat all the fried foods they want. Things they get to resent you for for not doing all the time when their home.

10. My adopted kids grew up in an environment of chaos, and that feels normal to them. RTC’s feel normal. Nice, quiet homes feel abnormal and “boring.”

11. Tranquilizers, lock down, big scary kids who fight back… RTC’s are scary places. It’s not safe to fight.

12. Honeymooning: I totally agree with STS on this one. RTCs are scary places. My daughter will lie, shut down/ dissociate, “talk the talk” (which she knows from years of therapy and being in hospitals)… anything to get out. With the right meds and enough motivation, they can hold it in for months – up to a year depending on whether or not they see that it’s working.

13. Trust: The kids trust you enough to “let their hair down.” They really do believe that you love them enough to put up with the behaviors. Which is true, but sometimes I wish mine didn’t trust me that much! My daughter “holds it together” all day by cramming everything inside and ignoring it – then she gets home and lets it all out on us. Those feelings have to go somewhere, but they can also hold it for a long time when they know it’s life or death (which it usually feels like it is).

14. Different expectations. I always forget that staff’s definition of “normal” and “sweet” needs to be taken with a truckload of salt. Remember what they are comparing him too – NOT neurotypical children his age! My son is the best behaved kid in the school for emotionally disturbed youth that he attends. They’re always trying to promote him back into regular public school, but that’s because they don’t even notice his “minor” behaviors, like crying, cussing, punching lockers, being rude and oppositional to staff but complying in the end… because they have kids that are listening to the voices in their head that tell them to kill, spitting in people’s faces, constantly screaming and cussing in the middle of class at other students (because he broke up with her to date her twin – yes this was my son *sigh*), destroying property…

15. The staff is used to being treated like scum, so any child that is nice to them… They don’t necessarily recognize or care that it is manipulative. My kids are what I call “Charming” RAD – they hug and are warm and sweet to everyone (as long as they aren’t family). This helps them feel safer. They don’t actually trust or care about these people, but they are pretty believable so the staff, case managers, teachers… have no clue. They want to protect this sweet, loving child from obviously crazy, overly strict parents with Munchausen syndrome. Which feeds right into what the child wants.

16. They don’t know your child’s history or what is normal for him or her. They don’t recognize his anxious behaviors. We were told our daughter was “a little homesick,” but other than that was doing great. On the same day they gave her an anti-anxiety med PRN because she told a staff that she wanted to hit a girl for telling her to “shut up.” They don’t know this is totally out of character for our daughter.

17. They tend to believe the child if he tells them that you beat him daily, or “hug him too much” (yes, my son told the staff that was one of the main reasons he was there – we’d known him less than 6 months at that point and he was in an RTC for violent behavior… let’s just say that was NOT why he was there). They’re not used to working with kids with loving, involved parents. They’re not used to working with kids with attachment issues. The staff and other kids will validate your child's every entitled feeling and pressure the family to give the child the same privileges a normal teen "deserves." Example of how we handled this once.

18. ALL the kids in RTC have poor social skills, so no one will notice that your child is not “good friend” material. So he can have lots of friends if he wants. Plus my kids are naturally attracted to other kids with issues (probably because kids with issues are more tolerant of the poor social skills or maybe because they crave chaos since that’s what they grew up with) so they have a large pool of choices… who can’t escape! It's all short term too so they can even appear to be popular.

19. The kids in RTC will reinforce your child’s beliefs, and make them feel better about themselves (usually at your expense), based on whatever the child chooses to tell them. Ask my daughter how many of her “friends” think we are evil, strict parents, and have offered to kidnap my daughter and let her live with them – most of them call us names (which she loves to share with us) and some of them have offered to hurt us for her.

20. There’s always something to do and people to entertain you. For example, if we try to stick to a schedule that says we have dinner at 6pm then we have to leave the child(ren) to their own devices for ½ an hour or so while we make the dinner. In an RTC there is staff with them entertaining them all the time, and then they get up and walk to the cafeteria where dinner is magically ready. The child rarely has to self-entertain in an RTC.

20. My daughter feels “safer” when someone who knows her issues is monitoring her 24/7. The child is so well supervised that they don’t have to stress about making bad choices. They can’t suicide, self-harm, use drugs or tobacco (supposedly anyway – my son found a way to sneak chewing tobacco).

21. RTCs can make dramatic med changes, whereas we have to work with small increments and don’t have access to 24/7 nursing/ psychiatric care if our child has a reaction.

There’s more I’m sure…

Monday, May 9, 2011

Weighty Thoughts


This has been a long week (yes, I realize it's only Monday), but I did finish quite a few things on my "to do" list. Now all I have to do is survive the rest of the week. The kids are nervous about me leaving Wednesday for the ACT seminar. I never did find anyone willing to drive with me, but I'm a big girl and can make the drive by myself. Just more fun to have company.


Making it Right: Trauma and Attachment Disorders, What Really Works?


Presented by;Lark Eshleman Patterson, Ph.D.



Advocates for Children of Trauma


Location: Mercado Event Center

1500 N Main St. Suite 300

Fort Worth, Texas 76164

Date: Thursday, May 12, 2011

Time: 9:00 am – 4:00 pm

Registration Fee $50.00

Lunch on your own

Nursing and Social Work CEU’s Available


Given the complexity of developmental disorders associated with early attachment traumas, clinicians, parents and treatment team members all need a wide range yet cohesive approach to diagnostic and treatment options.




Still to do:



  • Pack for seminar in Fort Worth

  • Finish reading The Explosive Child. So far it describes the kids exactly. Now if I can just find the time to get to the part of the book on how to treat it!

  • Attend Kitty's pdoc appointment, therapy appt, and skills trainer appointment on Tuesday and Wednesday

  • Pay traffic ticket - had taken care of it, but forgot to include copy of driver's license and they sent it back - too late to take Defensive driving. *sigh*

  • Make weighted blanket for Kitty - 16 lbs. 128 squares - 1lb per 8 squares – 1 bag per 4 squares - after figure out what went wrong with Bear's blanket

  • Write school letter for Bob saying absent because ill on afternoon of Wednesday, April 27th

  • Change out for spring bouquet - still have the Christmas one on the front hall table!

  • Paint front door - Ok, not really high on my list

  • Job hunt - also not high on my list because Kitty is still only attending school for 1 1/2 hours a day. I've been enjoying the 1 1/2 hour volunteer work I've been doing at the school.

  • Talk to NE DHS worker about NE Medicaid about covering partial day psychiatric hospitalization and the paperwork needed to extend TX Medicaid to 19

  • Find ear cleaning stuff for Kitty's ears (doc says they have to be cleaned EVERY day from now on. It's so messy we haven't even started.

  • Make GI appointment for Kitty?

  • Make eye appointments for all

  • Check out BETTERWORLDBOOKS.COM

  • Clean under kitchen sink - we had a garbage disposal unit that sprayed dirty water everywhere - for years. So nasty and moldy.

  • Sew buttons on seat belts - those little plastic buttons that keep the metal part from sliding down the belt to the floor.

  • Write FAIR Club book - in my spare time


Completed items!:



  • Pay overdue MUDD bill

  • Get Cashier’s check for traffic ticket

  • Bake cookies for the Advocates for Children of Trauma Seminar:

  • 5 2/3 doz carrot oatmeal

  • 6 doz Sugar Cookies

  • 14 ½ dozen Chocolate Chip

  • 2 dozen Oatmeal Raisin Choc Chip - Crispy

  • 2 ½ dozen Oatmeal Raisin Choc chip

  • 6 ½ dozen Oatmeal Raisin

  • Pick up Bear’s new med. Add Trazod*ne and remove Clonid*ne

  • Move kitty litter to below stairs - now that Hubby uses his study more often our scaredy cat won't "do his business" when the room is occupied. He's started peeing on the pool table cover and any other plastic he can find - at least he's a cat, not a kid!

  • Car inspected

  • Bear weighted blanket - 21lbs. 128 squares – 1lb per 6 squares – 1 bag per 3 squares.

  • Clean out Kitty's room - finish before she's released from psych hospital

  • Wash river rock - actually pea gravel - used for the weighted blankets.

  • Sort river rock - measure correct amounts into baggies to make even distribution on weighted blankets easier.

  • Grocery shopping/pharmacy/ pick up money order

  • Mail traffic ticket paperwork and check

  • Lunch with STS

  • Clean carpet in master bath - try to get rid of the smell of poo

  • Take care of Service engine soon light so can get car inspected

  • Send everyone e-mail about Bear's twitching and Kitty not being stable

Sunday, May 8, 2011

Mother's Day



Posted for to all the moms who are struggling with less than perfect children:












"Mother’s Day isn’t for the mothers who are proud parents of perfect children. They don’t need a day to celebrate their perfection. They get that every day when their loved ones and strangers tell them their children are perfect. They get that when their children bring home perfect papers from school with perfect pictures of perfect families all holding hands in front of perfect houses with perfect lawns and flowers and happy dogs and cats lounging nearby.

Mother’s Day is really for those of us who are in the trenches. It is our “Memorial Day”. It is a day for us to mourn the loss of our perfect families and to celebrate our little victories. It is a day for us to take a moment and be thankful that we were able to keep our children alive for another year. It is a day for us to pat ourselves on the back – because we aren’t going to find anyone else who gives us pats on the back while telling us they are proud of us.




So let us take this day – this Mother’s Day, and give ourselves a little celebration. We have kept these children alive for another year. We do (sometimes) get papers home from school – so what if the pictures are messy and upside down? Our children do smile at us sometimes – so what if it is while they are trying to bite or kick or scratch or strangle us? Our children still have beds to sleep on and pillows for their head – so what if it is just a mattress on the floor because they broke the good bed?




I raise my (virtual) glass to all of you wonderful Moms. You wake up every day knowing the battleground you are entering, but you don’t shrink from the war. You enter with all the weapons at hand, knowing the only shield you have is the love in your hearts. You walk through the day – and, indeed, all the days, with your head up and a glint in your eye that says to the world: “This is my child. For better or for worse, I will love this child until the day I die. I may not like this child right now. I may not want to look at this child right now, but I do love him/her, and if you mess with my child – you mess with me.”




I support all you wonderful Moms who are walking through storms darker and more frightening than any storm known to the perfect moms with their perfect children. You walk through chaos and tornado and fire and wind and rain and rage and mania with an aplomb that is not even found in our Special Forces. You face heartbreak and loss with strength and calm. You have PTSD that is untreated and undiagnosed, and yet you still enter the daily battle. You smile when others would cry. You carry on when others would give up.




Maybe you do retreat to your room sometimes, and maybe you do want to give up, and maybe you do cry and rage at the heavens. Maybe you do yell and tear your hair out. But you are allowed.




So give yourself this day to mourn the children you dreamed about and to laugh at the heavens because you are winning. Every day you are winning. Every day you come closer to the picture of perfection. Every day you are able to laugh in the face of total annihilation.




Good for you! Give yourself this day to know that each of us thinks of you as a hero. Each of us gives you pats on the back and says “You are wonderful. You are doing a good job. You are appreciated and you are not judged. You are special.
You are loved. You have sister-warriors and brother-warriors who are in the trenches you are in. You are worth having a day named after your amazing feats.
You are loved. You are loved”




Kerry

Thursday, May 5, 2011

*sigh* It's NOT over



Kitty apparently didn't sleep well. She took a long time to get moving this morning. Tuesday she and I had sat down and created a schedule, because I didn't want her sitting around all day:


  • 7:15-7:30
    Wake Up

  • 7:30-7:45
    Get Dressed. Put on Deoderant.
    Pick Up Clothes. Laundry as Needed.
    Pick Up Room.

  • 7:45-8:30
    Check in with Mom. Eat Breakfast.
    Take Meds. Brush Teeth and Hair.
    Feed Dogs.

  • 8:30-8:40
    Brain Gym

  • 8:40-9:00
    Exercise - Walk with Neighbor?

  • 9:00-10:00
    School Work - Independent
    with Assistance from Mom
    or Chores - If Have Homebound later(we didn't get Homebound because the psychiatrist didn't call the school in time).

  • 10:00-10:15
    Snack

  • 10:15-11:15
    Chores (if chores take longer she has less time on the computer - if they take less time she gets a little more)

  • 11:15-12:00
    Computer Time

  • 12:00-1:00
    Lunch Prep and Eat Lunch

  • 1:00-2:10
    Reading/ Quiet Time

  • 2:10-2:15
    Brain Gym

  • 2:15-2:30
    Go to School

  • 2:30-4:00
    School

  • 4:00-4:20
    Go Home with Mom

  • 4:20-4:45
    Shower

  • 4:45-5:00
    Snack

  • 5:00-5:20
    Walk in Backyard

  • 5:20-8:30
    Family Time/ TV/ Dinner

  • 8:30-9:00
    Take Meds and Get Ready for Bed


Kitty couldn't get started this morning. By the time we got back from taking Bear his glasses and some other stuff he'd forgotten (if it hadn't been his glasses I wouldn't have bothered), she was already ranting at me about the same old stuff (I won't let her be friends with the boy she fell in love with at the hospital, I won't let her talk to her friends ever again - that's the black and white / all or nothing thinking again.).



Yesterday she lied about finishing her chores (kitty litter) and got on the computer (privilege for completing choresa) without permission, so today her consequence was that she wouldn't be allowed to play on the computer. Hubby was going to disable it before she got up in the morning and direct the brunt of her anger at him, but he forgot. I called him and asked his advice on how to deal with her (after being yelled at for an hour). He decided to come home and work from home.



Before he got home she'd stormed to her room because I told her she'd lost the computer privilege for today. With her black and white thinking she feels that "Not today" and "As soon as you're stable" (once I explained what "stable" meant - I can't believe we've been using that term for years and she didn't know what it meant)... means "Never." I let her go, despite the fact that she might try to hurt herself, because I couldn't take much more.



Hubby went up to talk to her, and she escalated to screaming, being verbally abusive and cussing, threatening us and herself - overdose, and trying to claw herself. Eventually she was begging to go back to the psych hospital to get away from us (although every time I got on the phone today she has freaked out because she's convinced I'm calling the police). Finally I decided to give her a Klon*pin (not that I've seen that they help much) and went upstairs to "rescue" her from Hubby. Basically she was mad at him because he was standing next to her and she wanted me (it's the opposite when I'm with her and Hubby isn't there).



Hubby was holding her hands so she couldn't gouge her skin, and I told her to get him to stop, she was going to have to do some yoga breathing to help her calm down. Breathe in for four counts, hold it for 7 counts, breath out for 8 counts. Because I wasn't the parent she was actively mad at, she complied. In less than a minute I got her calm enough to take the Klon*pin and Hubby was able to completely release her. I told her to come downstairs with me, and put her down for a nap on the couch. I wrapped her in a blanket (compression) and gave her the option of me sitting next to her or just nearby. She chose next to her and was asleep within minutes.



All you single parents out there - I think you are totally amazing!!!!



Now I don't know what to do. It feels like the psych hospital made things worse. She's on a wait list for residential treatment, but that could take months, and I'm not sure it's going to help because so many of her issues are family and school related so they don't see it. First choice is partial day hospitalization (she'd be on the hospital campus from 9am to 4pm - getting school, therapy and psychiatric services and then home in the evenings and overnight), but the only one nearby doesn't take Texas Medic*id. In fact almost no one takes TX Medica*d - this state is one of the worst mental health service providers in the country (if not the worst).



We didn't get the homebound services we wanted because they psychiatrist's liaison didn't call the school back - even though she said she was sure they psychiatrist would give permission. The school's psychologist was against the idea. She was the only one, but without that psychiatrist's permission, she could veto it easily.

Wednesday, May 4, 2011

Is it over?



Good news! Kitty’s psychiatrist has reinstated her Abil*fy. Hopefully that, on top of the additional med, will finally get her stable. She did make it through school today, with no issues as far as I know. She was extremely agitated on the way home, but managed to keep from threatening me, so I allowed her to isolate. So far no major meltdowns. I just gave her the Abil*fy. Please pray, cross your fingers… whatever you do - that Kitty responds well.

Mary Themom
cell (###) ###-####
Founder: http://groups.yahoo.com/group/PCT_ParentsofChildrenofTrauma/

There are no seven wonders of the world in the eyes of a child. There are seven million.
~Walt Streightiff

Kitty's evening:

Kitty's meds HAVE to be changed. Ms. Pdoc Liaison, please call me and let me know what we can do. She is not safe right now. The whole family is struggling with being around her, and I’m barely able to keep her regulated.
Mary

****************

Kitty had a tough morning yesterday. We argued about what to eat (she preferred nothing, I insisted on more – she claims I “shoved down her throat” the slice of lunch meant, ½ a slice of cinnamon toast, and cup of zucchini – that she chose to eat when I told her she had to eat more than nothing, more than a slice of meat, more than… She finally ate and I got her calmed down. After all the arguments that I was “trying to make her fat” by forcing her to eat when she wasn’t hungry (her meds decrease her appetite), she insisted I take her to the grocery store for some ice cream (I didn’t). Food is a major trigger for her. When she’s stressed (like therapy) then she gorges. Last night when she got mad, she said she was going on a hunger strike, but I knew she wasn’t capable of doing so. We keep reinforcing with her that she HAS to eat to be healthy, and have been working on helping her understand portion sizes and the difference between junk food and healthy food… but she doesn’t want to hear it.

She continued to get agitated several times, but I managed to get her regulated again. She even got her room picked up (chores) and some computer time (privilege). Then we went to school. On the way there she told me that she was in love with a boy that she had met at the psych hospital, and needed a Faceb*ok page to maintain contact with him. I explained to her that the hospital had a reason for having a no contact rule. That relationships started this way, highly emotional, crisis, sharing really personal info with someone – without getting a chance to get to know them… can really skew her feelings. Plus, right now she, and the boy, need to be focused on healing, not someone else. I also pointed out that she KNOWS this boy has issues (drugs, depression, cutting…). This is not the best person to have a relationship with… someday, if this really is her soulmate then they will run into each other again, when they’re in a good place. I tried giving her relevant examples from my own life, but she focused on the fact that I wasn’t allowing her to “make her own mistakes” and of course she didn’t want to hear what I had to say.

We got there early and she talked to some of her friends during passing period. She chose to tell her friends that I was mean and too strict, didn’t trust her… Later, she took great pleasure in telling me that her ex-boyfriend thought I was a “bitch” and threatened to hurt me. She got a lot of reinforcement from her friends and got more and more agitated. By the time we arrived at therapy she was raging, but still managing to keep it to verbal threats. She chose to stay in the lobby instead of coming to therapy. Her attachment therapist and I talked without her. Finally after half an hour she’d calmed down enough to come into the session.

During the session, Sue let her vent, and I held my tongue and let her rail at me and threaten me. Anytime Kitty paused to see if she could get her AT to agree with her, she pretty much answered before the AT could – saying AT agreed with me because she was an adult and all adults took my side against her. She wasn’t really rational.

Kitty continued to rage all the way home. I couldn’t help but “rationalize at her” (explain myself), knowing it wouldn’t help but needing to respond in some way.

I tried to tell her that I still love her despite her current behavior, but at the same time I feel her threatening behavior wasn’t giving me a choice but to seek help (trying not to threaten her with phosp, but at the same time letting her know that I thought this was based on a chemical imbalance, not true emotions although I know it feels that way.) I tried to keep our conversation as supportive and non-threatening as I could, but it was difficult to do when facing the reality that she is not able to control this… and then we got home.

When we got home, she stormed into the house. I called her back outside and told her that I needed her to stay near me until she was calm, or that she could walk in the backyard. She argued with me, but then it was like she flipped a switch and was a little agitated, but pretty much acted as though nothing had happened. It was freaky, but she maintained it for the rest of the evening. Even came up and hugged me with an apology. Not sure if I scared her or if she dissociated or what. I had gotten her to take a Klon*pin while we were on the front porch, but it could not have worked that fast.

Tomorrow is her IEP meeting. She did fine in school. I still think she needs homebound, but it scares me a little that she’ll go off on me again. I guess it could have been the stress of school.

The case manager is looking at RTC for us. I hope we can get her stable with medication and that won’t be needed.

Mary Themom
cell (###) ###-####
Founder: http://groups.yahoo.com/group/PCT_ParentsofChildrenofTrauma/

There are no seven wonders of the world in the eyes of a child. There are seven million.
~Walt Streightiff

Monday, May 2, 2011

Puddle Girl




Letter to Kitty's therapists and psychiatrist case management staff:






Kitty was released today at 6pm. She was agitated and manic, but the nurse at the psych hospital thought she looked “normal” considering she was anxious about release. Kitty has alternated between being a puddle (which you guys have all seen) and irritable - pushing us away and ranting about how we love the biokids more than her and don’t treat her like a teenager. This was the first time I had seen her manic though. I was nervous about bringing her home. She seemed OK, but I was afraid that if there were any stresses/upsets that she would be too emotionally fragile to handle it. She did make it through the evening OK, although she got a little belligerent at bed time.

Kitty had apparently gotten upset a few hours before discharge because another girl had told her to shut up. Kitty told the nurse that she felt like hitting the girl and was given a Klon*pin (her first during hospitalization as far as I know). The discharge nurse couldn’t tell me if Klon*pin was still prescribed for Kitty. It wasn’t included on her med list.

Med list
Tril*ptal –900mg am and pm. Unchanged.
Abil*fy – 40mg. Removed!
Trazod*ne – 100mg. Removed.
Conc*rta - 54mg. Unchanged.
Clonod*ne- .05mg am and .1mg pm. Added.

Will let you know how tomorrow goes. Will probably try her at school if she continues to be up and seems stable. She is meeting with her therapist right after school.

No one at the hospital mentioned residential treatment, but they didn’t see much of her behaviors. Kitty was under a greatly reduced/ changed amount of stress so was able to hold it together (plus of course their expectations are based on the kids they have there, not Kitty). I think this is definitely something we need to discuss. Possibly look into whether or not {Residential Treatment Center over an hour away, but that takes Medic*id} would be a good option. Most of the people I know who’ve had kids there, liked it but said their kids were more severe/ aggressive. Kitty is so emotionally young it worries me to put her in places where she doesn’t feel physically safe and she is surrounded by kids with mega issues and behaviors that Kitty can’t handle.

School: We still have to get it approved in the IEP meeting, WEDNESDAY at 1PM!! but we have tentatively decided:








  1. Kitty will only go to school her last period of the day (4th and 7th) for rest of the school year. This is her double blocked math class. The teacher is also her case manager, and is willing to let Kitty do work on other classes. I will take her to school, probably do volunteer work during the 1 ½ hours and then take her home again – no bus.




  2. If Kitty seems to be OK with the one class then we’ll add a 3rd period study skills class. Obviously we can add more if she’s capable of handling it.




  3. We will be adding 4 hours of homebound schooling.




  4. We are suspending the FIE (school psych evals) for now. Testing her academic levels at this point would not be accurate.




  5. We are looking at getting {Bear's special school} to come out and evaluate her for possibly attending there next year.




  6. I will continue to look into Charter schools to see if we can find something that works with Kitty's emotional needs and learning disabilities/ special ed needs. Would love some help.

Sunday, May 1, 2011

"Applying Therapeutic Heat"

"Angry Teen"
"Puddle"

Two days ago, Kitty seemed to have regressed to "Angry Teen," not letting me touch her, defiant, feeling that she's being mistreated... in a way that's completely illogical and dissociated from reality. I don't want to bring home "Angry Teen," but I have to remind myself that "Puddle" is equally draining. Very few people see Kitty in both modes. School sees mostly the child who internalizes everything and is quiet and helpful, or recently, "Puddle." Hubby and the rest of the family see mostly "Angry Teen." The therapists and I are pretty much it when it comes to seeing the many sides of Kitty.


After leaving the psych hospital that evening, I contacted Kitty's attachment therapist. I wanted to know why during Kitty's last therapy session she had pushed Kitty so hard to get back to school full-time. Kitty had raged at me for almost an hour before the therapy session, and when I finally talked Kitty into going into the session, she had thrown herself face down on the couch and started moaning. Within minutes she had shut down and become "Puddle," laying in my lap with the weighted blanket, refusing to sit up and participate.

The AT seemed to be pushing Kitty to "pull herself up by her bootstraps," telling Kitty she needed to get moving and start attending school for longer and longer every day. I wondered if she thought Kitty was faking it, turning into "Puddle" for attention or to get out of doing something. Because I don't think that's the case.

Turns out the therapist was actually trying to "turn up the therapeutic heat" (aka "Poke the Bear") to try to get Kitty to get Kitty out of the stuck place that she'd been in for the last few weeks. The therapist saw the session as a success, because toward the end, Kitty finally got enough energy to say, "No."

Kitty raged the whole way home, but the "therapeutic heat" apparently helped me to finally get her to admit that she had been lying about not being suicidal to keep out of the psych hosp. We talked about how miserable she's been the last few weeks, and that something has to change so she can feel better. When we got home, she slammed into the house and locked herself in the bathroom. I decided to try calling the Crisis Hotline. She freaked because she was afraid I was calling the police, but calmed down a little when she realized I wasn't.

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Yesterday Kitty tried to call me, but I apparently had cell phone difficulties and didn't even know she called. About 15 minutes later I called her to see if she wanted me to come visit, even though it would only be for the last 15-20 minutes of visiting hours (we'd had trouble with traffic). She'd apparently been sobbing her eyes out for the last half hour, feeling unloved and abandoned, and guilty for the way she'd treated Hubby and I the night before. She begged me to come.


Kitty said she had a headache (from the crying) and wanted me to ask the nurse for a pain reliever. In talking to the nurse I found out she'd been "totally fine" all morning. I realized that Kitty was going to do what she always does when in treatment, internalize, shut down and hide all stress so she can get home sooner. I decided I need to apply therapeutic heat.


I had decided to take Bear with me to the psych hosp for several reasons. One, Hubby was working and I didn't want to leave him with Grandma while I went, since he does not do well with her. Two, he wanted to know that Kitty was OK, and this way I could show him. And three, I felt that bringing the family to Kitty would mean she would have to deal, at least a little, with family issues.


When we arrived, Kitty was in "Puddle" mode. She snuggled into my lap and cried and begged to go home. Once or twice she got a little defiant and tried to blame me for her being there or for treating her differently that the biokids, and Bear spoke up in my defense! It was very helpful, because she was hearing it from someone besides Hubby or I.


Honestly, I felt a little encouraged that she hadn't completely regressed to hating me again. It's hard to be hated.


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This morning was "family therapy." Hubby had to teach though so it was just me, Kitty and a social worker. We were supposed to talk about what brought Kitty there, and what we needed to do to keep her from coming back. We'd done it before. Time to apply therapeutic heat.


Kitty came in neutral, but leaning toward "Angry Teen," because she knew I wasn't pushing to get her out of there immediately, but at the same time the social worker was a person she had to show that she was ready to leave.


And so it started.


The social worker brought up a few of Kitty's hot topics, and I decided to start each conversation with... "We've talked about this before..." or something similar. As we talked, I got Kitty to give the answers to her own arguments. It was obvious that she's heard this so many times that she can parrot it back. She's just not logical. This is about feelings, not facts.


The social worker reinforced that ALL teens hate chores. ALL teens would rather have privileges without responsibilities. And she reinforced that ALL teens need chores and parents making sure they have responsibilities. Kitty was surprised for some reason that the therapist felt she was doing what she was supposed to be doing, and I was doing what I was supposed to be doing, and neither of us was wrong.


The best part?


After Kitty had left to go back to the day room, and I was signing out, the social worker told me that she really admired my parenting technique and that I was doing a good job. Then she shook my hand. She was a young social worker. Not an older person for whom hand shaking might be a normal way of saying goodbye.


I felt pretty good. Except for the fact that Kitty will probably be released tomorrow, and nothing has really changed.