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 explain it to him and help him. We tried to explain labels are diagnoses. They are not judgments 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 affect 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 wheelchair for the rest of his life...

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 airline 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.



Labeling Has a Bad Rep.

I recently saw this article about labeling and others like it and thought I'd respond:

Why Psychiatric “Labels” are the Problem

Increasing numbers of people realize that just because a child fidgets, or loses pencils or toys—criteria for an “ADHD” diagnoses, this doesn’t mean a child is mentally ill. In fact many now claim that children diagnosed “ADHD” are really suffering from lead toxicity, or allergies, or poor diet, or lack of reading skills, and not a mental “illness.” The problem is that they continue to use the psychiatric label, such as “ADHD”, which stigmatizes a child as “mentally ill.” If in fact a child suffers from lead toxicity, then why not call it lead toxicity? If he hasn’t been taught to read, why don’t we just say he hasn’t been taught to read?

The same is true of all psychiatric diagnoses—every single psychiatric label stigmatizes the person being labeled and as long as we continue to use psychiatric labels (contained within the DSM) to describe behaviors—psychiatry will continue to profit while the public suffers.

Psychiatric diagnoses are simply lists of behaviors that psychiatrists have compiled into little lists, given a name, added “disorder” on the end—then voted them into their billing bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM) as “legitimate.” This is big, big business, but it isn’t even close to legitimate diagnoses. Not in any medical or scientific context. But in a profit making context? Yes—coming up with new lists of behaviors and new “disorders” is the bedrock of the multi-billion dollar psychiatric/pharmaceutical industry. Its how they get paid. Remember, no psychiatric label, no billing insurance. No psychiatric label, no drug prescribed. So until we stop using these psychiatric labels, which mean nothing other than what some psychiatrists decided was a mental “illness,” we will never stop the “stigma.” The psychiatric labels are backed by corporate interests—not medicine, and not science.

Is Free Thinking a Mental Illness?

********
My response (to an article that is no longer available, so forgive me if parts of it sound out of place):

Yea, nice. Unless your kid needs those labels to get services, proper medication, support, and therapeutic help. My kids have most of those “labels” and they NEED them.

Not labeling Bipolar Disorder does not make my son an artist, it makes him a tortured psychotic.

Not labeling or medicating my daughter’s ADHD does not make her a “normal kid,” it makes her unable to participate in school, learn, or make friends.

Not labeling someone with Oppositional Defiant Disorder means that that child does not get any help, which means yes, he might become a revolutionary, but more likely he’ll be unemployed (you can’t hold a job if you constantly talk back to your boss), homeless (no money, no one who can tolerate being around you willing to support you), dead (mouth off to the wrong person), or in jail (mouth off to an authority figure or do something stupid just to spite someone).

Wanna know where to find those unlabeled teens in 5 years? They’re homeless, dead or in jail. And their parents are being told that it’s all their fault.

Some articles state that all mental illnesses are subjective and therefore don't exist. I have QEEG reports that show my kids' brains are hardwired differently than the average person.  

So Why Label?

Lots of reasons!

To get them access to services and medications so they can:

• heal if they're able to heal 

• get the right treatment - therapeutic parenting, attachment therapy, physical therapy, trauma therapy... instead of wasting time on treatments that aren't effective for their type of issues.

• have a break from their symptoms so they can mature and gain coping skills without having to feel like they're in a war zone 24/7

• help them remain calm, stable, and generally happy, so they can focus on living their life and attaching and developing relationships

• help them sleep, focus, and learn

• access needed programs at school and other organizations 

• keep them from being constantly suicidal, homicidal, and/or psychotic

• keep others from believing they're just bad kids, manipulative, deliberately defiant, need punishment, deserve/ want to be in juvie or worse... 

• keep them from internalizing the negative effects of their diagnoses as their fault, personality or identity shortcomings/ flaws, or blaming others

• ... 

Medications

I have 2 kids with major trauma and mental illnesses. They take meds for their bipolar disorder, and the one with severe ADHD takes meds for that too.  Hubby doesn't have a lot of problems with these (although he hates the sheer number of meds they take and the thought that they will have to take many of them for the rest of their lives), but most of their major issues cannot be "fixed" by medication (C-PTSD, RAD...), and are trauma-based, not biologically-based.

Experts say some symptoms (like insomnia, anxiety, restlessness, irritability...) can be alleviated with medication, even though it doesn't cure or affect the actual diagnoses (like trauma-based issues).  I'm all for medicating those symptoms, because, in my opinion, you can't work on healing trauma if you can't sleep, focus, sit still, stop crying or raging, react normally to external stimuli (like someone saying, "you dropped jelly on the counter," which, in my opinion, should not trigger a screaming rage but has)...

So in the past Hubby's opinion was that I have allowed the kids to be over-medicated. I disagree. They are on lots of meds, but it took time to find the right meds and good combinations that worked for their individual body chemistry. They are already taking fewer meds than they did 2 years ago. I think a lot of this is due to the fact that they could focus on internal healing when their outside world didn't feel totally chaotic. (I hope it goes without saying that we are not addressing anyone's needs and issues with ONLY medications - we also do therapy, therapeutic parenting, and many other tools).

I think it's like surgically inserting a pin in the leg of someone with a shattered bone and giving them a crutch, a cast, and major pain meds. The cast keeps things stable while the body works on mending and healing. The crutch helps them be able to do the things they would normally be able to do if they hadn't broken the leg (like walk and go to school). The pin is necessary to give the remaining bone pieces something to heal around. There is scientific evidence that the body heals better when it is not in pain so you need the pain meds.


Some drugs are like casts and crutches and will not be needed down the road. Other drugs are like the pin and the body wouldn't work without them. I would never allow my children to be drugged into zombies, and when the child is stable I will start looking at lessening or removing their meds (or amping up therapy treatment) - for as long as they continue to make progress healing.



Do Kids Need to "Buy Into" These Labels?

Bear thinks he's normal.

When kids are little, they call it Magical Thinking. Could be positive thinking I guess.  All I know is that whenever we discuss a diagnosis, medication or issue, Bear gets mad - at us.

We've talked to him about this repeatedly. We are not labeling him to be mean and put him down. We are not doing this to him. We are trying to identify triggers, symptoms, and issues so we can help him deal with them.

Did you know, that there is even a mental illness called Anosognosia that prevents people from being able to recognize their own bipolar disorder?

Someone asked me if it was really necessary for Bear to "buy into" his labels and understand them. I think his reaction highlights that yes, he must understand. If Bear thinks he's "normal," then he has no motivation to do anything to deal with his issues. In fact, all of his energy is devoted to getting away from the mean people who think he's not normal and that he should be doing stuff he doesn't want to do. {By the way, the "mean people" is mostly me in case you hadn't guessed.}

Also, when he has behaviors that we know to be symptoms of his mental health disorders (depression, anxiety, night terrors, rages...), and he doesn't believe in his "labels," then he is very likely to attribute the behaviors to something else and/ or blame himself and his faults. Just more proof that he is unlovable and unworthy of love, or that people are out to get him, or that if he's feeling depressed then there must be something causing it. He starts looking around him for what is causing these feeling and of course, he finds "it" 

Unfortunately, "it" is rarely the actual problem. Because of his RAD, "it" is usually me. I want him to be in special ed (it's not because his brain injuries and ADD severely affect his academics). I just want to control him by not letting him go somewhere or do whatever because I enjoy being his warden and torturing him. Because I'm "holding a grudge." This is all worsened by the fact that he really doesn't remember the past very well. He has magical thinking, distorted reality, poor memory, and dissociates.

PTSD/ Not Feeling Safe
Bear needs his world to be within his control. This is a life or death feeling. It's always someone else's fault because that's safer {Why Doesn't My Child Feel Safe?}- he's terrified we will discover that he's not perfect and leave him. {If You Find Out I'm Not Perfect, You'll Leave} 

Therefore, someone else did or said something to make him mad - his raging now has a reason that makes sense to him and is not caused by his Bipolar Disorder. Instead of being caused by his PTSD, his night terrors must be because the devil is mad at him or he has special powers (because he is Native American) - and they must be predicting that someone close to him will die.

People Tell Children They're Fine/Normal
People either don't understand mental illness, or just can't believe how severe the issues and behaviors are and how they affect the child, or how these illnesses and trauma interact. Often, they think the child's issues should be kept from the child to help keep from "damaging his/ her self-esteem." They don't seem to understand that without this understanding of the child's issues, then the child often assumes his/ her behavior is his or her fault; that there is something wrong with him/her. Which do you think damages a child's self-esteem more?

Everyone around him (school, friends, girlfriends...), is telling him he's fine. They think telling him the truth will damage his self-esteem and cause him to feel bad about himself, or they really don't understand it. The special program he’s in for emotionally disturbed kids sees that he is no longer physically aggressive, and do not consider him severe enough to need to be there anymore. They don't see that the structure they provide is the reason he's doing well.

It doesn't help that my kids have what I call "Charming RAD" (Disinhibited RAD). Kitty's caseworker denied that she had RAD, because "she gives me big hugs every time she sees me." (That's actually a huge red flag. It means she indiscriminately tries to please others so they will take care of her). It is easy for Bear to "fool" people who are not around him much. Truthfully, he fools some people who are around him all the time too. It is a survival instinct leftover from when he had to make people like him or they'd hurt or abandon him.

How does that saying go?

You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time.
Abraham Lincoln, (attributed)16th president of US (1809 - 1865)

When it comes to people outside the family, I'm not so sure about this. None of these people have a relationship with him, he's not actually capable of them, but they don't see that. There is no give and take, and they really know nothing about him. He can and does function in public, and that is a huge step forward. However, he will eventually have to have relationships with people that lasts longer than 6 months.

Even those who know him well enough to understand that he has serious issues, cannot agree on how best to help him. Unfortunately, Hubby and I often fall into this last category, and it is not helping our relationship at all.

PTSD/ C-PTSD/ DTD in older child adoption

You may have heard of Post Traumatic Stress Disorder (PTSD). It's usually talked about in association with soldiers, victims of rape or other violent crimes, or natural disasters.

DSM-5 Criteria for PTSD

All of the criteria are required for the diagnosis of PTSD. The following text summarizes the diagnostic criteria:



Criterion A: stressor (one required)
The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

• Direct exposure
• Witnessing the trauma
• Learning that a relative or close friend was exposed to a trauma
• Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B: intrusion symptoms (one required)
The traumatic event is persistently re-experienced in the following way(s):

• Unwanted upsetting memories
• Nightmares
• Flashbacks
• Emotional distress after exposure to traumatic reminders
• Physical reactivity after exposure to traumatic reminders

Criterion C: avoidance (one required)
Avoidance of trauma-related stimuli after the trauma, in the following way(s):

• Trauma-related thoughts or feelings
• Trauma-related external reminders

Criterion D: negative alterations in cognitions and mood (two required)
Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

• Inability to recall key features of the trauma
• Overly negative thoughts and assumptions about oneself or the world
• Exaggerated blame of self or others for causing the trauma
• Negative affect
• Decreased interest in activities
• Feeling isolated
• Difficulty experiencing positive affect

Criterion E: alterations in arousal and reactivity
Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

• Irritability or aggression
• Risky or destructive behavior
• Hypervigilance
• Heightened startle reaction
• Difficulty concentrating
• Difficulty sleeping

Criterion F: duration (required)
Symptoms last for more than 1 month.

Criterion G: functional significance (required)
Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H: exclusion (required)
Symptoms are not due to medication, substance use, or other illness.

Two specifications:

• Dissociative Specification In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:
• Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).
• Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").

• Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.

Complex PTSD (C-PTSD)  
When the Trauma Doesn't End 
First proposed by  Judith Herman in her 1992 book, Trauma and Recovery,  she suggested people dealing with child physical abuse,  intimate partner violence,  women trapped in sexual slavery, and other people experiencing long-term stress often showed symptoms very different from people experiencing single-event traumas.   As a result, they can often become passive and withdrawn (due to learned helplessness), or develop highly unstable personalities.   This could lead to dangerous repetitive behaviours such as becoming involved with violent partners,  repeated self-harm attempts, or chronic substance abuse.

Though not part of the new DSM-5, suggested C-PTSD symptoms in adults include:

• Difficulties regulating emotions, including symptoms such as persistent sadness, suicidal thoughts, explosive anger, or covert anger
• Variations in consciousness, such as forgetting traumatic events (i.e., psychogenic amnesia), reliving traumatic events, or having episodes of dissociation (during which one feels detached from one's mental processes or body).
• Changes in self-perception, such as a chronic and pervasive sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
• Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge.
• Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer.
• Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair.

Symptoms for children are similar but also include:

• behavioural problems,
• poor impulse control,
• pathological self-soothing (through dysfunctional coping mechanism such as self-cutting), and
• sleep problems.

Developmental Trauma Disorder (DTD)
Since C-PTSD does not adequately reflect the kind of developmental impact seen in children,  clinicians have suggested an alternative diagnosis, Developmental Trauma Disorder (DTD). 

DTD, also paralleled with complex PTSD (CPTSD), is caused by chronic and multifaceted traumatic events that occur during childhood that permanently influence a developing brain, affecting emotional and cognitive function and behavior. 

Traumatized children meet the DSM diagnostic criteria for many disorders, such as PTSD, but the various symptoms of DTD or CPTSD are not completely listed in the PTSD criteria and are often labeled as comorbidities. 

Click to enlarge 

Most recently, DSM modifications for PTSD included a subtype group for children aged younger than 6 years. Research has shown when diagnostic criteria that are sensitive to child developmental stages were used, together with an appropriate behavioral assessment, more children qualified for a diagnosis of the child PTSD subtype than any other PTSD groups. 

Child PTSD evaluation include a lack of verbal skills in reporting abuse and the manner in which trauma-related symptoms and memory are expressed. For example, decreased interest in routine activities and play or “restricted play” are considered, and severe temper tantrums are noted to represent increased arousal behavior. 

Other childhood signs of PTSD include “loss of interests, restricted range of affect, detachment from loved ones, and avoidance of thoughts or feelings related to the trauma.” These symptoms are typical for children but are less distinct in adults with PTSD. 

In short, victims of childhood trauma exhibit many symptoms of PTSD, including dissociation, guilt, and hopelessness, but the diagnostic criteria for PTSD does not accurately include all the important indicators of DTD. Developmental Trauma Disorder: the effects of child abuse and neglect by Maureen V. Kilrain, MS, PA-C

Edited to add: Something we often forget is that we, the parents, can experience PTSD or Secondary PTSD. Working with children with trauma and/or attachment issues can be a very traumatizing experience. It can also trigger issues from our own past that we may have thought we had dealt with long ago. Please get help for yourself and take care of you! Parents get overwhelmed too. If we ignore ourselves and give until there is nothing left then we can no longer function as parents or even just as people.

Some resources:  http://www.psychologytools.org/ptsd.html


What Worked for Us

My children have many overlapping diagnoses, and what works for one doesn't always work for the other, but here are some of the things we've found to help when adopting an older child with known Complex PTSD (C-PTSD):

Therapists
Get a good therapist who understands and has experience working with adopted/foster kids with trauma. We love our EMDR therapist for our daughter but still use a good attachment therapist too.
NOTE: Don't be afraid to "fire" the therapist if it's not a good personality match.

EMDR Therapy
EMDR is the most recommended therapy for people with PTSD. It is most often used by soldiers and victims of trauma (like rape or being in a natural disaster), and usually only requires 2-3 sessions.

Obviously, people who have suffered from long-term trauma (Complex PTSD), such as child abuse, would most likely require more sessions.

Medications
There are no meds specifically for treating PTSD, but with good therapy and meds that help with the symptoms, the child can recognize the effects of the trauma, learn to cope, and move on to dealing with the cause of the trauma.

Overlapping Diagnoses
Don't be surprised if PTSD is not your child's only diagnosis, adopting older children usually means they have more going on then just one issue - attachment disorders, physical and sexual abuse, bipolar disorder, ADHD, FAS/FAE...

Caseworkers will not or cannot tell you all of what caused the PTSD, and often symptoms overlap and appear to be other things. I don't think I've ever heard of a child with RAD that didn't also have PTSD. Here's a good chart for Overlapping Behavior Characteristics.


TRIGGERS

• Puberty
  Puberty will exacerbate the problem. Be sure you do everything you can to facilitate attachment before it hits and be ready for some regression. {The Teen Years}
• Bedtime
  Bedtime can be a huge PTSD trigger, often causing Night Terrors and nightmares. Our son frequently has trouble going to sleep, sleeping through the night, and during a particularly bad period, would wake up with his heart pounding and his body shaking all over (his central nervous system releasing stored memories). His "nightmares" of the devil were so real he thought they were visions. Hubby and I took turns sleeping near him for a week. {Sleep Issues}
• Projecting on Others (especially parents)Be prepared for your child to blame you for their past. My daughter recently admitted to seeing one of her past abuser's face everywhere - on walls, and particularly - over my husband's face. She hates "him," rages at him, tells him he is mean and evil, accuses him of yelling at her (even though Hubby isn't even raising his voice) and dissociates.
• Stimulating/ Overwhelming Situations
  We avoid big groups, noisy places, and in particular, any situation that we know could trigger a flashback. I strongly recommend this, particularly for the first 6 months the child is in your home. Especially avoid the temptation to travel, have a party, introduce your child to everyone, shower him with gifts - he's already dealing with an overwhelming number of changes just by moving into a new home with a new family.
• Stimulating Environments
  Avoid stimulating events, situations, etc. We have our daughter and son's rooms stripped down to the bare essentials, not just because they've done lots of damage, but because anything more is overwhelming.

Fight/ Flight/ Freeze
When in a meltdown Kitty mentally shuts down - we call it fight, flight, or freeze. She is acting instinctually to protect herself. The thinking part of her brain is not "online."

It's difficult not to hold her accountable when she rages during these times, but we've learned to wait until she's calm and then process what led up to the event so we can help her prevent re-occurrences. There are times when she doesn't remember the meltdown/ rage happening at all. {Handling Rages}

School 
Some suggestions for dealing with schools.  PTSD is rarely recognized in schools. My children have behavior issues as well as diagnoses that require an IEP (including OHIs -other health impairment- like ADHD). Once you get an IEP though, you can access behavior accommodations that can really help.

Look for knowledgeable parent liaisons who will help you find the resources and accommodations your child needs. Be aware that no matter how wonderful and helpful the school seems, they usually will not volunteer information, and they may actually discourage you from getting help.

Request an assessment of your child in writing - they have 30 days to respond. Make sure they know you are willing to get or have gotten, in touch with an advocate/ lawyer.

ADVOCATE for your child. NO ONE else is as qualified as you are about your child's needs.

My Top 10ish Things I Couldn't Do This Without
I've written a lot of posts on things like Why Won't My Child Just Behave? and Why Doesn't My Child Feel Safe? maybe one of them will have some ideas for you.

Read Beyond Consequences, Logic and Control. It really helped us understand why our kids act the way they do sometimes (they are SCARED!). I also liked Parenting with Love and Logic - it's for "neurotypical" kids so a lot of it doesn't apply to kids of trauma, but it helped me stay calm!

Prioritizing Yourself, Your Family, and Your Child - In That Order! 
Get lots of support and take good care of yourself, your husband and your marriage.

Self-Care
Try to surround yourself with people who "get it." In person is best, but the internet has lots of great parent support groups, including BeTA http://www.momsfindhealing.com/ and Facebook groups like the one I admin - Parenting Attachment-Challenged Children and others like Parenting with Connection.

We as parents often get our own PTSD, CTS (Continuous Traumatic Stress), and Caregiver Fatigue. Please take care of yourself!!

__________________
Kitty - came into our home at 11, now 13 - originally diagnosed with ADHD, ODD, learning disabilities, attachment "issues" and victim of abuse. Now diagnosed with bipolar, attachment disorder, ODD, Complex PTSD, learning disabilities, and victim of abuse.

Bear - Kitty's 1/2 sibling, came into our home at 13, now 15 - originally diagnosed with PTSD, conduct disorder, victim of abuse and mood disorder. Now diagnosed with bipolar, RAD, ADD, PTSD, cerebral dysrhythmia, and victim of abuse.
__________________

Kitty Meltdown

Kitty reminds me of a Chow I used to own (Chows only have 2 people in their life one person who is master that they obey and one playmate - everyone else does not exist - and they do not play with master or obey the playmate).

Kitty has certain people she Obeys (me and Hubby) - she'll whine, complain, tattle, and meltdown, but she'll do what we tell her to, if we insist - this was a long time coming by the way! She does trust us a little, but only allows hugs and affection on her terms. This is why I think of her as a cat!

She has certain people she idolizes - (Mrs M. our neighbor who is also her teacher at the private school; Aunt Christy who she wants as her mom because she "gives her kids thirty dollars a week in allowance for doing nothing Mom!"; Aunt Tammy a family friend who she wants as a mom because she isn't very strict with her son who is Ponito's age) - basically people who rarely tell her what to do and are very sweet about it if they do ask. She'll do almost anything for these people - even clean! She particularly likes to show them affection -especially in front of me - very pointedly letting me know she won't hug me, she'd rather hug them.

She has people she HATES (Grandma who Kitty insists favors Ponito because he's the baby and is always "yelling" at Kitty - FYI, for Kitty, any criticism or lack of praise is yelling; Mrs. P at school who Kitty says is alway yelling at her and telling her she's doing her work wrong; and anyone who is not currently her BFF - kids fall on and off her pedestal faster than Bear goes through Kleenex girls (that's another story!). Kitty's siblings are often members of this group.

There is really no one else in Kitty's life - everyone fits in one of these categories. She is a very passionate child.

It helps for me to remember that because of the past trauma she is emotionally only about 6 years old. If she is worked up about something - even younger. I think in some ways both she and Bear understand that they are different, and accept it. Most 15 year olds would not expect to have as much restriction on thier life as ours do (they are not even allowed to cross the street, they can only watch G rated shows for the most part, they can't have friends over without direct supervision, they can't go anywhere without adult supervision - and adults are Hubby and I and sometimes Grandma, not other people's parents). Our children rarely even complain about it. Truthfully I think they feel safer because of it. It can make parenting two totally healthy, "normal" kids like Bob and Ponito more challenging though. They end up with much more restriction and consequences then they probably should. All in the interest of keeping it "fair." Not that my kids would EVER say the word "FAIR" - thanks to the FAIR Club (I'll tell you about that some other time!).

This morning Kitty was exhausted and mad because we made her get up early even though she's not going to school yet. I knew we were going to have trouble because today was her first day at Grandma's house with Bob, doing their schoolwork.

Before therapy she got into trouble for tattling on Ponito's behavior while Grandma was supervising. Hubby came down on her kind of hard because she was being particularly obnoxious and justifying it by saying she was protecting Bob (who at 5'7" and 167lbs is perfectly capable of taking care of herself, especially from her little brother.) All the way to therapy I heard about how mean Grandma is and how much Grandma hates Kitty. What can you say besides, "No, Grandma doesn't hate you. Why do you think she might have said that? What were you doing at the time?" Of course all I hear is Kitty's side, to be honest though Grandma has gotten pretty tired of dealing with Kitty, and probably is a little hypercritical.

In therapy we watched a video on EMDR, but didn't have time to actually try it yet. I can't wait! The therapist got to see Kitty in all her oppositional defiant disorder glory for the second session in a row (last week Kitty insisted she was starving and ended up eating grass and chewing on her own arm). This is not her attachment therapist, who we love, this is a therapist who specializes in trauma work. I could see the therapist getting a little tired of Kitty's attitude too. At one point she asked Kitty, "Do you realize how many times you've asked for something? I'm going to keep track in my mind of the number of times you ask for Mom to give you something." Kitty was supposed to be talking about things that made her happy in her childhood. During the prior 2 minute conversation she asked -

1. "Can I go to the public highschool?" - she's in 7th grade and knows I think she does better in private school.

2. "Can you please get me the Jonas Brothers CD? Why don't you like them? I'm going to ask Aunt Christie to give it to me."

3. "Can I have a pizza?" This was random and what prompted the therapist to comment on the questioning.

I commented on the fact that all the questions had one thing in common. They were all questions she knew I would answer NO to.

We see the psychiatrist tomorrow and I think we are going to request another med increase for Kitty. The mood swings are getting wilder, and the therapist warned us to expect behavior issues to increase as we start this type of therapy.

Better get some sleep,

Mary