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!

Wednesday, May 11, 2011

Why does my child act differently away from home?

Lovely, Naughty, Smile, Girl, Child

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 {psychiatric residential treatment} 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:

RTC Is Not The Real World
How we parent is based on life in the real world... not life as it is in RTC  with 24/7 staff, quiet rooms, and PRN (as needed) tranquilizers. Staff are looking at short-term solutions that will keep the child compliant while they are in RTC. Our kids can often honeymoon for a long time. Things like Level Systems appear to work because the child can "work the system" short-term. 
{Level/ Point Systems and Sticker Charts - Why They Don't Work With Our Kids}

Parenting is Long-Term
Parenting styles HAVE to be different than what works for an RTC. Kids are going to react differently with RTC staff, teachers, other parents... people who are not trying to get them to emotionally engage and are not looking at long-term solutions or how your child's behaviors affect the rest of the family. 
{Prioritizing Yourself, Your Family, and Your Child }

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!
{Structure and Caring Support}

Be very aware that this is a tough life and having people telling you that you're doing it wrong is incredibly draining on your limited emotional reserves. Please take care of yourself!! I know it can feel impossible, but look at this time as respite and focus on healing yourself. You can't parent effectively if your emotional reserves are empty.
{Self-Care! Caring for the Caregiver}


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 {See the Frozen Lake Story at the end of this post}.


2. Reduced Stress. In an RTC, our children don’t have to deal with the stress of family and emotions, school is usually easier, and staff and teachers have lower expectations. This may reduce their stress to a point where they can handle it better.

3. 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.

4. Structure. 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 to feel safe. {Structure and Caring Support, Why Doesn't My Child Feel Safe?}

5. It is not possible to live real life like an institution (although it sometimes feels like 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 better staff-to-child ratios and back up than we ever could!

6. 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 childproofing, so staff doesn’t have to deal with watching him and correcting him when he gets into things that could hurt him or others or worry about him hiding or running away. 
  • No vulnerable people or animals. 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 kids who are not exactly perceived as defenseless.
  • Kids KNOW they have little to no flexibility or “wiggle room” on most subjects because it's "policy" so they don’t bother to argue with staff about bedtime, computer time, respectful words…
  • It’s not personal for staff. It’s just a job. Staff can walk away, they can quit, they can let someone else take over for a while… We have to protect ourselves and the rest of the family and that influences how we handle our child. Staff doesn’t have to do anything that isn’t in their job description. If someone vomits that’s the job of the cleaning staff. If a staff person has the flu, she 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 especially when we're under continuous stress. {Continuous Traumatic Stress}

7. Living with your abuser. 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.

8. 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 - or manipulate).
  • 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/ emotional skills needed or required. No one expects the child to care about anyone else’s feelings.
9. Blank Slate - 
  • If the child messes up… he/she gets 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 – no one cares what the child did last Summer (no grudges, no expectations, no hurt feelings, no holding the child to a higher standard because you know what he/she has accomplished in the past…)
  • The child knows that if someone doesn’t like him, or he doesn’t like them… just wait, they’ll leave and/or go home soon.
  • No one knows your family. They mostly only know what the child tells them. If he says his parents beat him every day or won't let him have a cell phone because they are unreasonably strict ... well, as far as the staff and other kids know, it's entirely possible. The staff and other kids will validate the child's every entitled feeling.
  • The child has "rights." Rights to refuse meds. Rights to refuse to see parents. Rights to refuse treatment.
10. 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 because you don't allow them to do it all the time at home.

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

12. RTCs are scary. Tranquilizers, lockdown, big scary kids who fight back… RTCs are scary places. It’s not safe to fight.

13. Honeymooning:  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 their honeymoon behaviors are successful.

14. Trust: The kids trust you enough to “let their hair down.” They finally 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). {If You Find Out I'm Not Perfect, You'll Leave}

15. Different expectations. I always forget that staff’s definition of “normal” and “sweet” needs to be taken with a truckload of salt. Remember who they are comparing your child to – NOT neurotypical children his age! Children who are in a program for kids with issues.

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…

16. Superficial Charm. The staff is used to being treated like scum, so any child that is nice to them… The staff doesn’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 by proxy syndrome. Which feeds right into what the child wants.

17. 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 our daughter told staff that she wanted to hit a girl for telling her to “shut up.” They don’t know violent behavior is totally out of character for our daughter.

18. They tend to believe the child if he tells them that you beat him daily, or “hug him too much” (yes, my 14 y.o. son told the staff that was one of the main reasons he was there – even though 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.

19. ALL the kids in RTC have poor social skills so no one will notice that your child is not “good friend” material. Now 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. {Like Attracts Like}

20. Validate the child's beliefs. 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.

21. 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, of course, 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.

22. 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). {Why Doesn't My Child Feel Safe?}

23. Safe med changes. 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…


What we did: 

I constantly reassured my kids that I would help them deal with these feelings (and find others to help) and that I wouldn't allow them to push me away. I also reassured them that I knew these behaviors and feelings were caused by their "issues," and that as they healed the behaviors and feelings of fear and wanting to hurt us would get better.

At the same time, I set up boundaries/ rules/ structure that let them know they were safe (this is a perceived sense of safety - nothing to do with real life physical safety). I let them know that while they were healing, I would be there to keep them and the rest of the family safe. That hurting me and the family was not OK, and that I would not allow it.

I took away most of their control (even about little stuff like when they would be eating and where they sat in the car), and by doing so they knew that I was strong enough to handle them and love them despite their issues. It took me a long time to understand that they didn't just need someone to love them unconditionally - they didn't believe in that, they needed someone to make them feel safe. Their favorite teacher was the strictest teacher, one of the staff in the behavior unit at school. She tolerated no nonsense, but they knew she really cared about them.

They were afraid (deep down) of the teachers/ people that they could manipulate, that they could fool into not realizing that the child was not perfect and was "unlovable and unworthy of love." People that gave them a blank slate every day, that forgave them every time, that didn't hold them accountable for their actions... those people weren't strong enough to keep them "safe."

I think me staying, no matter what they did, was a big part of what helped them heal, but I think a bigger part of that was providing the structure and support needed to make them feel safe and know that someone else was in control. That was, I think, one of the hardest things I have ever done. It was not the way I had parented my other children, most of the people involved in the kids' life thought I was overbearing and controlling, and it was NOT my personality (I'm a pretty laid back unstructured person), but they NEEDED that structure and loving support to heal.


The Frozen Lake Story
"In order to understand what an unattached child feels like, one must understand his perspective. Imagine that you are the young child who must cross a frozen lake in the autumn to reach your home. As you are walking across the lake alone, you fall suddenly and unexpectedly through the ice. Shocked and cold in the dark, you can't even cry for help. You struggle for your very life, you struggle to the surface. Locating the jagged opening, you drag yourself through the air and crawl back into the woods from where you started. You decide to live there and never, never to return onto the ice. As weeks go by you see others on the ice skating and crossing the ice. If you go onto it, you will die."
"Your family across the pond hears the sad news that the temperature will drop to sub-zero this night. So a brave and caring family member (that is you, the parent!) searches and finds you to bring you home to love and warmth. The family member attempts to help you cross the ice by supporting and encouraging, pulling and prodding. You, believing you will die, fight for your life by kicking, screaming, punching and yelling (even obscenities) to get the other person away from you. Every effort is spent in attempting to disengage from this family member. The family member fights for your life, knowing you must have the love and warmth of home for your very survival. They take the blows you dish out and continue to pull you across the ice to home, knowing it's your only chance."
"The ice represents the strength of the bond and your ability to trust. It was damaged by the break in your connection to someone you trusted. Some children have numerous bonding breaks throughout their young lives. This is like crashing them into the ice water each time they are moved, scarring and chilling their hearts against ever loving and bonding again." By Nancy L. Thomas


Other posts:
Why Do They Act Like That? - If You Find Out I'm Not Perfect, You'll Leave
Prioritizing Yourself, Your Family, and Your Child 
Structure and Caring Support
Chores, Responsibilities, and Other Things My Kids Can't Handle
Document, Document, Document!!!

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.