Category: oppositional defiant disorder

Is your child’s therapist listening to you?

Is your child’s therapist listening to you?

 True story:

After a lengthy 2-hour session and a series of questions asked of both mother and teenaged son, the psychiatrist wrote:  “the mother is over exaggerating her son’s behavior.  He can’t possibly have all the symptoms she describes.”  Later, the mother said, “I was completely ignored; this doctor affirmed [my son’s] disrespect for me, in front of me, and [my son] got the idea I was full of it and didn’t need to take his meds.”  She felt her authority had been undermined, and that she lost an opportunity to get treatment for her son sooner.  He was eventually diagnosed with schizophrenia, and hospitalized several times.

 

What makes this situation tragic, to me, is that early medication, prior to the first psychotic break, prevents the loss of gray matter that occurs in schizophrenia.  This doctor’s unprofessional and judgmental behavior hurt the recovery prospects for this family.  And sadly, this kind of dismissal of parents is common.  I’ve heard many complain that doctors, therapists, or teachers don’t listen to them, or that they subtly or overtly blame parents for their child’s problems.  Researchers found this to be widely true.  In an article titled “Uncharted Waters – The Experience of Parents of Young People with Mental Health Problems,” the author writes:

 

“Parents’ distress is exacerbated by their need for expertise, but from those who don’t take their concerns seriously.”

Harden, J, 2005. Qualitative Health Research, 15(2), 207-223.

 

I always appeared to be overly upset and stressed whenever I brought my child to see her psychiatrist because, leading up to any appointment, were a series of challenges and acts of resistance that were stressful and frustrating.  It appeared to the psychiatrist, time and time again, that I was the problem… just like she suspected.  All I could do was sit in the waiting room while my daughter was in session, and imagine she was saying terrible things about me.  All I could do was wonder if the psychiatrist could see through it all and know that I, the mom, was doing everything possible to help my daughter, that I was a good parent. Could the doctor see this and give me some hope?

 

Don’t accept being treated this way.

 

Insist that the whole family get time with the therapist, without the troubled child or teen, to check-in and see how everyone is doing.  Make the appointment and tell the therapist why.  Your family needs to say things they wouldn’t ordinarily say when the child is around.  They need to open up secrets and let out difficult feelings without the fear of setting off an explosion later.  The therapist should be astute enough to get the full story, and use this as an opportunity to help the family work through challenges in ways that support everyone’s well being.

 

Insist on being told what to expect.  Another common experience is that parents are not told what to expect from treatment or why.  You need to know everything they know, even if the professionals are still unclear about a diagnosis or treatment approach.  Your child may have many physiological or psychological tests, expensive medications, or visits to many different kinds of ‘ologists’, and you may still not be clear on where the inquiry is going, why, and what the doctors or therapists are looking for.

 

Insist that they consider your daily experiences.  Since a therapist observes your child only during an appointment, they aren’t fully aware of the types of situations that aggravate your child’s behavior.  You are the expert on your child and their behavior patterns; you are the expert on what drives them, and on what drives them crazy.  You know that, behind-the-scenes, much of what your child does is easily missed by a psychologist, psychiatrist, or therapist.  An experienced professional will listen to you and ask more questions.  You should expect them to seek clarity on your child instead of assuming they already know everything about them and your family.

 

Team up.  It takes both you and the professional working together to comprehend your child’ nature and arrive at a working diagnosis and treatment that works.  Develop a partnership and a shared vision with the therapist so you can, together, do what’s best for your child.  And don’t forget, since you have all the responsibilities, your needs must always be considered in spite of what a therapist thinks is best.  If your family is not included, then it’s not the best.

What to do when you’re blamed for your child’s behavior

What to do when you’re blamed for your child’s behavior

  

Our sick kids deserve compassion too
Our sick kids deserve compassion too

I have yet to meet one family with a troubled child that has not felt blamed or judged by close people in their lives:  best friends, family members, a religious community, co-workers, even medical and mental health providers.  Nothing could be more wrong or more hurtful to the family’s well being.  Blame adds emotional burdens on top of what they already face, and can undermine an already shaky hope and faith. 

 

Parents like us are aware that many people are not comfortable around a child with bizarre or extreme behaviors, like our child.  We understand this.  After all, who else knows more about the stress they create?  But it is unacceptable to be blamed or judged by others on our parenting, our character, our child, and/or presumed to be abusing our child.  This is simply not true for the overwhelming majority of families with troubled children.

 

These are some things that have helped caregivers cope with, and overcome, the debilitating effect of judgment and blame.

 

First, resist defending yourself; it will only attract more unwanted attention and disagreement.  You don’t have the time or emotional energy to teach someone who resists and challenges everything you say with countless questions and misinformation.  Avoid people like this (even friends and family!).

 

Second, actively seek out supportive people who take the time to listen, just listen.  You need as large as possible a network of compassionate people around you.  Stop and think about this, you have many around you already.  They may be waiting in the wings, at a polite distance so as not to interfere or add to your stress.  If you think you can trust someone, ask them to be your friend.  You will be surprised at how many people are out there who have a loved one with a mental or emotional disorder, and how many are willing to help because they completely understand what you’re going through.

 

Third, politely and assertively say thanks but no thanks.  If judgmental people ask why you haven’t contacted them or returned calls, tell the truth, also without blame or judgment.  “Our situation is not good, but we are getting the best professional help, and we have been pulling back to take care of ourselves.  Thanks for showing interest, and thanks for your understanding and for giving us space.”  No apologies.

 

There is a curious phenomenon where craziness seems to attract “crazy” people.  You must block them from your life.  They might be obsessed with a religious, medical, or philosophical belief and want to make your child’s life their cause.  If this happens to you, don’t hesitate to end contact with anyone that wants to entangle themselves in your lives without your permission.  You are never responsible for meeting another’s needs or fitting their beliefs!

 

I once had a co-worker who had strong feelings about “natural” health care, who offered a steady stream of articles and comments about what could help my child.  I had to firmly insist that if she could find one piece of research proving that her preferred treatments helped even one person with schizophrenia, then I would listen.  This ended the unsolicited advice. 

 

Fourth, be prepared to grieve lost connections.

 

A single mother with a 16-year-old daughter sought help in a support group:  “Can someone help me?  I need someone to call my sister or mother and tell them that I and [my daughter] are not criminals or sickos.  They’ve stopped calling, they refuse to have us over or visit for Thanksgiving and Christmas, and I just want someone else to tell them that she’s fine now because she’s taking meds, and that her behavior is not her fault or my fault.”

 

Let go of those who blame, and move forward with your priorities.  Very often, they eventually turn around and make an effort to understand.  Many really do change and apologize for their insensitivity. I’ve experienced this and observed this, but it is not your job to make this happen.

 

Your criteria for friendship will change.  You will find out who your real friends are, and they may not be family members or current friends.  Real friends let you talk about feelings without judgment or advice, they are always around to listen, they help out with little things:  go out for coffee; call to check in on you; or watch your other kids in a crisis.  They may be people you never felt close to before but who have reached out to you with compassion.  Accept their help.  Don’t be too private or too proud to accept the offer of support.  Someday, after you have turned your family’s life around, find another family who needs your support.  Make a promise to help others in need, and to give back to the universe.

Get your power back and reduce your child’s tantrums

Get your power back and reduce your child’s tantrums

If you have lost control of your troubled child and your household (most of us have), you know how hard it is to get things back on track–especially for following house rules. Each time you try to enforce a rule, it’s ignored, or your child throws a huge tantrum that you give in rather than spend more precious energy.  Who wants to invite another backlash?  Who wouldn’t give up and just try to get by and muddle through?

A powerful tantrum is a good thing; it’s evidence that you are regaining authority.

This seems counterintuitive, but the more your child fights back, and the more power they lose and the more you recover your authority. Fighting back harder and harder against rules and boundaries, then having an over-the-top tantrum, is a normal psychological response that psychologists call an “extinction burst.”  It means the original behavior goes extinct so to speak..  We all do this to some degree. It has been measured through behavioral observations of people of all ages and has nothing to do with troubled behavior.  The term “extinction burst” is even used by dog and horse trainers to describe a behavioral change in training. 

It goes like this: parents set a rule and start firmly enforcing it, and one of two things happen: 1) a huge tantrum, or 2) things are OK for a little while, and then tantrums start up again.  If you can hold the line, psychological studies show that when massive tantrums fade, the extinction burst peaks.  They give up their own power and change their behavior.  Look at this diagram:  The vertical scale indicates level of bad behavior.  When a rule is firmly enforced (intervention), the tantrum peaks then it falls off quickly.

If you can stick it out through that huge tantrum, you will see fewer tantrums over time.  It works, but one must be like a rock and have support when The Big One happens. But be prepared, you might need to face several extinction bursts.  Little by little, simple rules will be followed, or they’ll be followed most of the time (you will always be tested).  But by this point, enforcement becomes easier.

Plan for major tantrums ahead of time and recruit help for holding a firm protective wall.

For explosive and aggressive children, it can be scary or dangerous to be on the receiving end because you know about the potential for violence and harm.  Prepare family members and others, and explain how the tantrum will be handled and how everyone will be kept safe.

Rules for house rules:

  1. Few
  2. Fair
  3. Strictly Enforced

Run a tight ship at home, but only have a few hard-and-fast rules, maybe 2 or 3, to save your energy.  Holding fast on enforcement is draining.  Pick the rules carefully because they need to make sense and feel fair to everyone, and they need to be about safety and family wellbeing, examples: we will eat every dinner together as a family; curfew is 8 pm; if there is any outburst, the person must stay in their room for 15 minutes…

You may be surprised how relieved everyone will be after living through chaos for so long!  They will be thankful someone is finally in charge instead of the troubled child.  When I put on my armor and set about getting my power back, it was exhausting and very stressful, but consistent order brought a sense of security and safety. Use common sense and be flexible, set aside some rules temporarily if your child is in crisis or the family is too stressed at the moment.  Be very strict on only a few critical things, for example:  have zero tolerance for violence against others and alcohol and drug use.

You earn more respect when you are in control and better protect everyone’s peace of mind. 

You are the king or queen of your home, it is not a democracy.  Make reasonable and fair rules, enforce the rules with an iron hand at first, and then relax bit by bit, and live in a peaceable kingdom (with problems you can handle).

 –Margaret
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Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and partners with parents for successfully raising their troubled child, teen, or young adult. She believes parents and families need realistic practical guidance for home and school life, not just information about disorders. Margaret has mentored families for over 20 years. She is an author & speaker, and believes mentally healthy families raise mentally healthy children.

You Can Handle This.

You Can Handle This.

You are not alone. It's no one's fault. Behavior disorders are disabilities! Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
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