Category: parenting

Is your child’s psychiatrist listening to you?

Is your child’s psychiatrist 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.”  With the mother’s authority undermined, 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 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.  This kind of dismissal of parents should never happen.  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 my daughter saying terrible things about me and the doctor believing her.  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 as anything less than a full partner.

 

Insist that the whole family get time with the psychiatrist, without the troubled child or teen, to check-in and see how everyone is doing.  Make the appointment and tell the doctor 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 doctor needs a full picture of the child’s life at home, 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 psychiatrist 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 psychiatrist working together, in partnership, to identify all the symptoms that lead to a working diagnosis.  You and the psychiatrist are a team that works together to do what’s best for your child.  And don’t forget, since you have all the responsibilities, your needs must always be considered when a doctor is developing a treatment plan.

 

–Margaret

What have your experiences been?  Your comments inform others who read this article.

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, the more power they lose, and the more you recover your authority.  It is normal to fight back harder and harder against rules and boundaries, then have an over-the-top tantrum.  It’s a psychological response that psychologists call an “extinction burst.”  It means the original behavior goes extinct and behavior changes thereafter. We have all done this at some point. 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
When parents disagree on discipline

When parents disagree on discipline

Your primary relationship comes first

Stress can affect the most solid relationships. Families like yours, with a troubled child, have a higher divorce rate than the general population, 50% higher. Coping with your child will bring out any and all relationship issues that may have been manageable under normal circumstances. If your relationship is falling apart, and it was mostly healthy before this period of stress, then it must be a priority over the child for now. Get counseling, if not together than singly. Or ask for help from supportive friends–prayers, cheerleading, or the opportunity to vent. Partners must stand by each other and present a solid front as the family leaders. This is just as important for your child as it is for you. Let this draw you closer together rather than pull you apart.

The most common situation I’ve seen is men emphasizing discipline and women emphasizing protection–neither is wrong.

This must be worked out and balanced.  Your mission must be identical and your goals must be balanced.  Sometimes the child needs discipline, and sometimes they need protection and nurturing.  Discipline need not be uncaring or harmful, and protectiveness need not be enabling.  While your grapple with this ongoing polarity, here’s a good way to manage in the mean time.

  • Stand strong, shoulder-to-shoulder
    If you strongly disagree, then together make a list of the things you agree on and worry about the disagreements later. This list should include:
  • List each parent’s strong points, so you can remember what attracted you in the first place, and strengthen your bond and respect.
  • Never ever argue in front of children, and make a rule for how and where to argue.  Observing parents arguing creates problems that worsen your child’s behavior.  Stress is an obvious result.  But what about kids who manipulate their parents in order to get their way with something?  Parents can be played against each other!  This happened to me and it damaged my relationship with my children’s father for years (yes, we divorced too).  Don’t let this happen to you.
  • An agreed-upon role for each parent, which is something that they’re good at.  If one parent is competent at handling a specific challenge, the other steps back, and vice versa.
  • Take turns managing the household for a period while the other takes a break.
  • Set aside personal feelings temporarily to co-manage one specific little problem at a time, a problem you both agree on.

Have each other’s back

A true story with names changed:

Susan and her daughter Pam were constantly fighting over who hurt who the most by what each said. Jason, husband and father, was frustrated and angry by these conflicts, but avoided interfering because he knew he’d upset both his wife and daughter. Yet Jason was always able to calm Pam down quickly because their relationship was different. One day, Jason took his wife aside and suggested they try something. He suggested that Susan step back from certain daily interactions with Pam, those which always ended in fights, and let him do the communicating. Susan did not like the idea that Pam had “won” by getting all of her dad’s attention, nor did she like the implication she couldn’t handle their daughter! But Jason came up with the idea that if he saw Susan and Pam slipping into a fight, he would use a code phrase, like “Hey dear, can you help me find the _____?”, and Susan would catch herself, save face by stepping out to look for the ____, and let Dad take over. This worked wonders rather quickly. Nothing was ever discussed openly, but after a few weeks, both mother and daughter started to catch themselves starting a fight, and one or both would find some reason to step away from the situation.

–Margaret

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Support Your Child or Teen’s Recovery From a Disorder or Addiction

Support Your Child or Teen’s Recovery From a Disorder or Addiction

What recovery looks like – A person with a mental or emotional disorder who is in “recovery” lives a normal life and aren’t affected by their disorder.  They look and act normal.  At the very least, they have stable relationships, a steady job, a place to live, a regular diet, cleanliness, and regular mental health check-ins.  Recovery is maintained when the person pays attention to themselves and notices if their symptoms are starting, and then takes action to stop the symptoms.

Recovery is like the alcoholic who stops drinking–they still have an addiction, but they stop using.

What your child will need to sustain recovery as an adult:

INSIGHT  +  STABILITY  +  RESILIENCE

Insight – self awareness

Insight allows a child to recognize they have a problem, and choose to act to avoid the problem.  If insight is not possible, they need a toolbox of options that help them to respond appropriately, instead of reacting to chaotic messages in their brain. Knowing and admitting they have a problem, or knowing techniques for avoiding problems, are very powerful skills they need as adults.

Stability– fewer falls or softer falls

Your child is like a boat that’s easier to tip over than most other boats; any little wave will capsize them, and everyday life is full of waves, big and small.  Your job is to notice when the troubled child is starting to capsize and show them how to right the boat, or if that doesn’t work, how to use the lifesaver.  Eventually, your child will learn how to sense when trouble is coming on, avoid the thing that causes problems, and ask others for help.  Sense it.  Avoid it.  Ask for Help.

Resilience– bounce back when they fall

Troubled children have a much harder time bouncing back from problems.  They have extreme responses to simple disappointments like breaking a toy, or poor grades, or something as serious as the parents’ divorce.  Some even fall apart in joyous times because the emotional energy is too much!  You must be acutely aware of this–they will not get back on track by themselves.  Don’t worry that helping them will spoil them or “enable” them.  Eventually they will learn from you how you do it.

“…We are all born with an innate capacity for resilience, by which we are able to develop social competence, problem-solving skills, a critical consciousness, autonomy, and a sense of purpose.”

“Several research studies followed individuals over the course of a lifespan and consistently documented that between half and two-thirds of children growing up in families with mentally ill, alcoholic, abusive, or criminally involved parents, or in poverty-stricken or war-torn communities, do overcome the odds and turn a life trajectory of risk into one that manifests “resilience,” the term used to describe a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity…”   http://www.athealth.com

Your troubled child’s recovery and how you help them achieve it

Your troubled child’s recovery and how you help them achieve it

What recovery looks like – A person with a mental or emotional disorder who is in “recovery” can look and act like anyone else.  They have:

  • stable relationships
  • a steady job or in school
  • a place to live
  • a proper diet
  • cleanliness
  • regular mental health check-ins.
Their mind is unstable. It’s like they stand on a beach ball that can topple them at any moment.

Recovery is maintained when your child can pay attention to themselves and notice if their symptoms are starting up, and then take action to stop the symptoms.  You teach them what to look for, and how to do a personal check-in.  It’s just as if they are monitoring any other problem in order to stay healthy such as: blood sugar, body temperature weight gain or loss, digestive system function (gut microbes).  In mental disorders, their signs and symptoms are not steady.  Anything can lead them from “OK” to “out of control” in an instant, and problems can last minutes to weeks to months.

What your child will need to sustain recovery as an adult:

INSIGHT  +  STABILITY  +  RESILIENCE

INSIGHT– self awareness

Insight allows a child to recognize they have a problem, and choose to act to avoid the problem.  If insight is not possible, they need a toolbox of options that help them to respond appropriately, instead of reacting to chaotic messages in their brain. Knowing and admitting they have a problem, or knowing techniques for avoiding problems, are very powerful skills they need as adults.

STABILITY – fewer falls or softer falls

Your child is like a boat that’s easier to tip over than most other boats; any little wave will capsize them, and everyday life is full of waves, big and small.  Your job is to notice when the troubled child is starting to capsize and show them how to right the boat, or if that doesn’t work, how to use the lifesaver.  Eventually, your child will learn how to sense when trouble is coming on, avoid the thing that causes problems, and ask others for help.

  • Sense it.
  • Avoid it.
  • Ask for Help.
Life throws punches. Vulnerable brains need to be more wary and resilient than the average person.

RESILIENCE – bounce back when they fall

Troubled children have a much harder time bouncing back from problems.  They have extreme responses to simple disappointments like breaking a toy, or poor grades, or something as serious as the parents’ divorce.  Some even fall apart in joyous times because the emotional energy is too much!  You must be acutely aware of this–they will not get back on track by themselves.  Don’t worry that helping them will spoil them or “enable” them.  Eventually they will learn from you how you do it.

“…We are all born with an innate capacity for resilience, by which we are able to develop social competence, problem-solving skills, a critical consciousness, autonomy, and a sense of purpose.”

     “Several research studies followed individuals over the course of a lifespan and consistently documented that between half and two-thirds of children growing up in families with mentally ill, alcoholic, abusive, or criminally involved parents, or in poverty-stricken or war-torn communities, do overcome the odds and turn a life trajectory of risk into one that manifests “resilience,” the term used to describe a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity…”   http://www.athealth.com

–Margaret

 

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Are you trying to reason with an irrational child?

Are you trying to reason with an irrational child?

I regularly speak with parents with children with a brain disorder and a history of serious behavior problems.  Many are truly at the end of their rope.  The parent is so exasperated by their child’s relentless acting out, they start nagging, repeating themselves to exhaustion.

They plead for answers: “Why does he keep doing this?, or, ” Why doesn’t she stop after I’ve explained things over and over.”  Then they answer their own questions:  “It’s because he always wants his way,” or, “She’s doing this to get back at me.”

The parent then lists all the ways they’ve tried reasoning with their child or disciplining with consequences.  As they tell their story, they continue to ask questions and provide answers, going around and around and around:  “He does this just to make me mad;”  “She manipulates the situation because she wants more (something) and I won’t give it to her.”  What’s interesting to me is that these children can be quite young (4 or 5), too young to expect reasoning in the first place, or they can be young adults (early 20′s) who have a long track record of doing things that don’t make sense.

Saying something a 1000 times doesn’t work. It just becomes nagging that’s tuned out.

You don’t need to be this frustrated

Parents’ stress and frustration vanish if they accept that their child is not ready to reason or control their behaviors.  It’s not their fault, and not the parents’ fault. Irrationality is the hallmark of brain-based problems, and chronically challenging behaviors are the evidence.

If you feel you have run into brick walls over and over again, and your child is not learning what you’re teaching, do both of yourselves a favor and stop trying the same things that still don’t work.  Stop assuming that if you say something a thousand times they’ll finally get it, and stop any paranoid assumption that your child or teen has an evil plan to get back at you.

When you find yourself trying to reason with a troubled child or teen (or young adult), step back and calm yourself this way, and ask what your child needs in the moment.  Then change your whole approach.

  • Try different ways of communicating, such as softening your tone of voice.
  • Pay attention to whether they respond best to words or images, and use what works most naturally for them.  Try using touch to communicate, or withdrawing touch if that’s threatening to them.
  • Post (polite) signs and simple house rules in the house as reminders for things they need to do every day.
  • Show instead of tell. Your child or teen may not be able to learn through their ears.  Or they tune you out.  Demonstrate how instead of telling them how.
  • Avoid explaining how their behavior will hurt them in the future.  Children and teens often cannot track how pushing one domino leads to all the dominoes falling.

If you’re nagging and harping and chiding your child, forgive yourself.

It’s so common one might call it normal.  You are still a good parent who wants the best for your son or daughter.  Over the many years I’ve facilitated parent support groups, I’ve heard so many regret how they’ve treated their child once they begin to understand that it won’t work.  You are not alone.  Raising a child like yours is tough, but you’ll move on and figure things out.  Don’t give up.

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

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