Kitty would "rather die" than let anyone see her as less than perfect. When you remove some of the stress (family especially), then she can really hide her issues. Plus she really does have major issues with impulse control and processing - so she can't access coping skills when she's "in the moment."
I did a staffing with the treatment team (psychiatrist and nurse) at the residential treatment facility via conference call. I'd asked them to speak to them before Kitty came into the room. I got pretty passionate about it, because I was freaking out about her coming home so soon. Maybe I was too passionate. I think the pdoc started discounting what I was saying.
Good news. I got them to put her on a second mood stabilizer (Lamictal - which takes forever to get in her system) so hopefully that will help when she gets home. The pdoc started to put me off until we saw how she did on a pass, but I informed him that she was HORRID at the last family visit (most of them really), and we were afraid to take her on a pass.
I told the staffing team she also had been complaining about not having an ADHD med to help with focus. The pdoc said, "well, the school and staff say she's fine. She's making As and Bs and doing well." I tried to tell him she was probably doing everything in her power to maintain her "perfect" image. I also argued that this might be why she's having issues with impulsivity and inability to do her DBT skills when in the moment. He still said, "no."
Have to admit I LOLed (quietly) when he asked her about ADHD issues after she came in the room... and she said EXACTLY what I said. They're still going to add the Lamictal first and then focus later on the ADHD meds. She also apologized to me about her behavior at the last family visit. A little validation for me.