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Category Archives: Mental illness

Residential Swings

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Photo credit: Derek Bruff

I have a love-hate relationship with playground swings.

More hate than love these days, since the unreasonable swing manufacturers refuse to make swings properly. Back when I was ten, they made the swings so much larger; a perfect fit with no pinched thighs…

The part of the arc that sails me up to the sky makes my heart soar. I defy gravity. I fly like a bird. I touch the clouds. I…

drop like a rock back to earth.

As everything below rushes up to meet me, as my stomach drops away, I grit my teeth and brace for impact.

Every time.

Because once, on a cheap plastic yellow swing with a rusted chain, it happened.

Just as I realized my pinky had caught in a chain link, I fell. I don’t remember whether the seat cracked or the chain snapped, but I ended up on the ground with no nail on my pinky.

It never stopped me from swinging, but I can never fully enjoy the high of grinning madly while the wind tousles my hair.

I’m always waiting for the drop.

Having a child in residential care is a bit like taking a ride on a playground swing.

Highs, lows, devastation and recovery.

We get back on the swing, each ride a little more careful than the last.

Progress warrants rejoicing, but experience requires caution. One weak link breaks the chain.

Today, we celebrated. Our son had overall success this week, which meant he earned a 6-hour on-grounds pass.

For those of you not familiar: in most residential facilities, family may visit or come to the center to participate in family counseling as much as they like, but the child may not leave the grounds or have special privileges. In our case, the child earns passes by 2-hour increments on-grounds. Passes gradually step up to off-grounds (staying in the general area) and build up to a pass to go home. Once a child meets qualifications for 48- and 72-hour passes home, discharge from the therapy center is on the horizon. 

Before Christmas, our son earned his way to an 8-hour off-grounds pass and we expected him to have a 24- or 48-hour pass by Christmas. He regressed, once again becoming violent and suicidal. The passes were revoked for his own safety (and that of individuals around him).

His recovery from this phase has been slow; once he managed to curb the violent outbursts, he channeled his energy into testing limits. Because of his specific attachment issues, we worked with his therapist closely and kept visits to a minimum if he didn’t participate fully in his therapy plan.

In practical terms, this meant that if he didn’t do his part, we had to reschedule. (This may seem extreme, but it’s necessary for him to learn that relationships require effort on his part.)

As soon as he (finally) completed his requirements, we immediately scheduled a visit. We want him to see that he can trust us and that we’ll show up when he does. Today, we celebrated the ability to visit a second weekend IN A ROW. Swing up. 

This afternoon, just before we arrived, another child put his hands on our son’s neck. It was apparently horseplay (albeit inappropriate) on the other child’s part, with no ill intent. In months past, an incident like this would have ended with our son punching the kid in the face. Today, he simply left. He got up, went to his room and slammed the door to let everyone know he was angry.

In the grand scheme, that’s fabulous coping. Swing up. 

We had a family therapy session, discussed the situation and commended our boy for his great reaction.

The rest of the afternoon, we played Clue, Scrabble and Don’t Take My Words. (Full disclosure: we utilized several Hypervigilant Game Guidelines.)

He made the first Accusation in Clue, and I was proud because he didn’t get it rightand didn’t freak out. He helped set up and clean up each game. He offered us water. He was polite. He was kind to his sister. He hugged and kissed us each goodbye.

As we walked to the car, Hubby and I agreed he seemed better.

Swing up, up, up.

But what goes up…

A few hours after we left, he called, upset. He started crying. He said he was homesick. (I absolutely believe he is homesick, but my SuperMamaSenses started to tingle.) I asked whether he just felt homesick or was upset because something bad happened.

He said, “yes, something bad happened.” Swing down.

Then he told me about walking into a darkened room with a movie playing. Another specific child yelled at him, telling him to leave. This upset our son, so he began hitting and kicking the walls. He said he might have cracked the plaster, but the evening staff  told him he wouldn’t have to pay for it.

That last statement zinged my antennae further, because the admission contract is clear: if your kid breaks something, you pay. Big time. For the staff to say he wouldn’t have to pay…that was just weird.

I asked to speak with the staff member who’d been present.

Turns out, he made most of it up. By the time I found out, he was already in bed, so I’m sitting here trying to wrap my mind around why he might have thought it would be better to change the story. The end result in both stories was pretty much the same.

Actually, our son’s false story described a situation worse than what truly happened, because the staff member said he’s not aware our son cracked any of the walls.

In reality, our son was setting up a movie in the DVD player. There was no darkened room. The child who “yelled at” him wasn’t even present. A completely different child made a suggestion for getting the machine to work, at which time our son flipped out and started hitting and kicking the walls.

Why he would make those changes confuses me. If lies, why? If he somehow perceived reality to have happened that way, well…we’ve got a whole other can of worms to deal with.

The link breaks again.

The real issue is this: he has to learn to deal with peers’ interactions. Whether they’re giving him a suggestion, yelling at him or putting their hands on him, he’s got to be able to react in ways appropriate to the community.

I TOTALLY get that his emotions are raw and that didn’t help. I know he’s homesick. But I have to consider the future.

What if he’s at school feeling homesick?

Last year, he frequently wished to return home from school; he tried to find ways to be dismissed from school. He even caused minor harm to another child. Luckily, the child’s parents accepted his apology; at the time, there was a possibility the incident was accidental. Afterward, we confirmed his intent: he’d hoped the more extreme measure would end in suspension.

What if he does it again? What if he goes further than before?

What if a peer informs him she thinks his science project is crap? What if someone runs past and knocks him down? What if he’s having a bad day and someone suggests he should try a different method for figuring out a math problem? What if one of these things sets him off?

On one hand, I could make myself crazy trying to mitigate what-ifs.

On the other hand, the past predicts the present unless a catalyst induces change. 

The what-ifs above are likely to happen unless he corrects his course.

And if he gets upset, throws a chair and hits someone in the head—even if it’s a true accident—he’ll likely go to jail.

He has a great week. Swing up. 

He has a bad week. Swing down. 

He reacts appropriately to a bad situation. Swing up. 

He flips out. Swing down.

He lies. I’m sitting on the ground. Dust off, get back on the swing. 

We want him to come home.  Swing up. 

We want to protect him from himself.  Swing down. 

Sometimes, I want to hop off the swing and leave the playground altogether.

But he needs me.

So, I won’t.

And your kid needs you.

Let’s just keep swinging.

 

 

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MRI

We met with a neurologist a few weeks ago. She ordered an MRI for our boy, to rule out any physical brain issues. The appointment is tomorrow.

I assume we won’t have any answers for several weeks, but at least we are finally getting some traction.

Guilty

Continued from Desolate

When the kids first came to live with us, I clocked three to four hours of sleep a night. The girl wailed until after midnight; the boy woke screaming around in the wee hours.

Every. Single. Day.

The initial sleep deprivation lasted about six months; four months for social services (still the legal guardian) to approve meds and two more months for the doctor to find the correct dose.

I still remember the relief I felt the first morning after we found the right combination, waking around 6 instead of 4 am.

I’d forgotten how it felt. September brought it all rushing back.

This time, I think, was worse.

Digressing a bit: I’ve had a recent epiphany that I experienced almost no change in stamina from the time I was seventeen. Until now.

Sometime this year, I looked in the mirror and realized I am no longer twenty-seven. Or thirty-seven, for that matter. Am I too old for a ponytail? 

Apparently, up to this point my brain has been convinced I’m a decade younger, and the shock of realizing I am OH NO middle-aged was a bit too much.

This time, sleep deprivation almost killed me.

Ok, that’s hyperbole.

But I was beyond exhausted. By the end of September, I started telling Hubby I might like a weekend in the acute center, if they actually had white padded rooms available. 48 hours sleeping in a soundproof room…sounds like heaven.

Unfortunately, checking myself in at one of those places wasn’t an actual option. Hubby took over on weekends and let me nap as much as possible while he was home.

Finally, after weeks of phone calls and meetings and waiting, we got the approval call from the treatment center.

Because we were concerned about what our son might do if we informed him ahead of time, I packed him a suitcase during the night. I crept into his room and slipped his stuffed dog from under his arm. The next day, as we drove to the treatment facility, we explained.

  1. We are not counselors or psychiatrists; we have researched and prepared as much as possible, but we are not trained to provide the care you need.

  2. We care very much about you and want to give you the best chance to succeed in life. The people at this facility have the qualifications to help you.

  3. We are NOT giving you up, letting you go, abandoning you or sending you away.

Our son responded with little emotion.

Like I said before, you’ve tried everything. We might as well try this.

His absolute lack of reaction still stymies me.

The experience at this treatment center was a complete change from the acute center. We met the director, head nurse and several staff. While the nurse completed the intake with our son, we toured the facility.

The staff explained to our son that the initial stay would be thirty days; he perked up and I watched determination firm his jaw.

At the time, we didn’t realize this would become a problem.

He thought if he could “act good” for thirty days, they’d release him. And he decided to make it happen. 

He hugged us goodbye without a tear, then walked through the metal door with a staff member. It closed behind him with a heavy thud.

We walked to the car.

I expected to feel guilt at leaving him with strangers.

I expected to feel great sadness at leaving him behind. For almost seven years, we’d been four. Now, at least temporarily, we were three.

I expected to feel lonely, to feel his absence, to experience a boy-shaped hole in my existence.

I expected to feel that I was a failure as a mother, having not been enough to help him.

But here I must admit: I felt nothing but relief.

I truly believed the people in that building would be able to help him in a way Hubby and I could not. I knew we weren’t leaving him permanently; we would, soon enough, once again be four. I understood that I’d exhausted every possibility available, turned over every proverbial stone.

As for missing him—maybe this sounds awful, but…I didn’t.

My only source of guilt: the relief at being able to relax.

No checking every thirty seconds. No worrying whether he’d wake before I did. No concern about destruction or harm to property or living creature (including his sister) if my visit to the loo lasted an extra minute.

The first three days after drop off, I slept like the dead.

A week later, Hubby looked ten years younger.

And the nurse called to tell me our son was the best behaved child in the center.

He is so polite. He is kind to everyone. I wish they were all just like your son.

I was gobsmacked. Flabbergasted. Shocked.

How could this be the same child?

Until now, I’d never realized how determined he could be.

Guess how long that dogged kid kept it up.

Desolate

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Photo credit: Dustin Spengler

Continued from Excruciating Ride, Part 2

If you asked for a one-word description of my internal landscape during early fall, I would use the word desolate.

Desolate, synonyms: miserable, despondent, depressed, disconsolate, devastated, despairing, inconsolable, broken-hearted, grief-stricken, crushed, bereft

Dark storms on the horizon and a long, lonely road ahead.

His six-day stint in acute psychiatric care only seemed to magnify his behaviors. He literally came home worse than when he left. Although he fed us lies about some aspects, we observed serious lack of supervision in the acute facility. He came home with a softball-sized bruise on his arm from playing a “punching game.” Roll the dice, the other kids punch you. Granted, there’s a good chance he willingly participated, but there’s no reasonable explanation for kids getting away with that kind of assault under true supervision.

He hid his shoes in the gym and blamed another child (we found out after); they still hadn’t found the shoes when we came to pick him up, so they led him outside in stocking feet. The nurse couldn’t fathom why we were upset. It never occurred to anyone that perhaps a pair of flip-flops (or a call home so we could bring shoes) might be necessary.

Peripheral concerns like these made us more concerned about the true level of care and supervision at the center. We began to hear stories from other families whose children had bad experiences and became determined to keep him safe at home until we could find a better solution.

I slept about 4 hours a night, making sure he was sound asleep before I went to bed and waking before he stirred. Thankfully, Hubby made it possible for me to stay home starting mid-summer (as we were planning to homeschool). I don’t know how I’d have survived trying to work as well as fully supervise the boy.

We instructed the girl to stay out of his way as much as possible. It was now early September, so each day included school work; he generally complied with the intent of “beating” his sister. Normally I discourage competition, but in this case it kept him focused so I didn’t fight it. Surviving the day was my only goal.

After schoolwork completion and some time in the yard to run around (and outside the fifteen hours of time per week with the in-home counselor, psychiatrist and office-visit counselor), I allowed him to play with Legos or let the two kids watch movies (a complete anomaly; our normal TV schedule included almost no screen time other than a Friday night movie). The only time I could guarantee no violence were the minutes his eyes were glued to the “bug light.”

Meanwhile, I spent hours on the phone with our insurance company, the social workers, a county government team and his in-home counselor. I called and researched longer-term psychiatric facilities within 6 hours of our home. Most wouldn’t take him as they were not considered locked facilities. They couldn’t protect other children from him, and they couldn’t prevent him from running away or hurting himself.

I prayed we could find a place for him; Hubby and I were completely exhausted. He took over much of the supervision in the evening so I could get a shower and make dinner, which meant he was basically working two jobs.

Finally, I found a facility within reasonable driving distance. As I researched further, I found that the original trauma counselor who saw our family in the beginning of our journey wrote the program for the facility and continued to consult with them. They utilized Trauma-Focused Cognitive Behavioral Therapy, something we’d been advised to pursue.

Every conversation gave us more certainty this would be our best option.

 

Continued…

Excruciating Ride, Part 2

Continued from Excruciating Ride
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Photo Credit: Benjamin Wong

I often search Flickr for just the right photo, but I don’t always find what I want. In this case, the picture is worth about a million words.  

The roller coaster we’re riding with our son right now isn’t any fun.

As I walked into the hall, my son whipped the pencil away from his chest.

“What are you doing?” Reaching for the pencil, I leaned over to see whether he’d progressed through his school work. I used the pencil to point, summoning as much nonchalance as I could.

“You need to fill in these blanks in pencil, please.” I handed the pencil back, adding, “Pencils are for paper; pencils are not for poking people.”

He nodded and took it.

After he finished his school work, I gave him a journal assignment. He wrote about suicide by a pencil stab.

An hour later, he growled in frustration when I wouldn’t believe an obvious lie. He left the house and headed down the driveway. The timing worked well, because we needed to head to an appointment, so I pretended to think he was going to get in the car.

Unlocking the vehicle, I called, “Hey, thanks for getting out of the house so quickly so we can be on time! Do you want me to meet you at the end of the driveway?”

He froze, then turned slowly and shuffled back to the car, muttering, “wearing the wrong shoes, anyway.”

His sister gave him a sharp look. “Were you trying to run away?”

“Yeah, but I need my other shoes.”

She shook her head. “Running away is stupid. What are you going to eat?”

In a cool, flat tone that gave me chills, he said, “Dead squirrels, probably.”

By late August, I was spending an average of seven hours per day closely monitoring our son. Completing tasks became almost impossible; he didn’t want to move, so he began a sabotage campaign. When we put the house on the market, we asked the kids to try to keep things neat for the showings. He thought buyers would refuse to purchase the house if he worked against us. He trashed his room, wrote on the walls in permanent marker, decimated a large planter…every time he wasn’t by my side, I looked for the next bit of destruction.

He did the opposite of whatever we asked and began doing things he’d never done in the past, like climbing out of his window to leave the house. Hubby and I did our best, but…have you ever tried to keep an 11 year-old in sight at all times? It’s even harder than it sounds.

Cameras and a newly-installed alarm system helped, but we still couldn’t supervise 100% of his day. Showers became especially problematic, because he’s really too old for one of us to stand there. He plugged the drain with toys and toilet paper, defecated in the tub and filled the curtain with water, letting it go when it became too heavy (all over the bathroom floor).

Because he is diagnosed as “on the edge” of the Autism spectrum, the in-home counselor suggested we apply for ABA therapy for help with behavior modification. Good ABA therapists have successfully helped non-verbal, low-functioning children learn to communicate and to perform self-care tasks. If his apparent inability to follow directions stemmed from the autism, the therapists would be able to help. And maybe, once he had a habit of doing the right things, he would feel better about himself.

While I sat outside with the supervisor, outlining the challenges of the last several months, another staff member sat with our son to evaluate him. I explained to the supervisor that he’s great one-on-one with an adult, so I expected the other therapist to find nothing. Sure enough, when she joined us, I saw The Look.

The Look, n., facial expression indicating the parent must be out of her mind, as this child is brimming with intelligence and compliance. 

Thankful for backup from the in-home counselor, the supervisor and I explained there is more to this kid than becomes obvious in one meeting. We were approved for services, but staffing shortages meant ABA wouldn’t start for several weeks.

A week later, the threats of suicide came almost daily, sometimes several times a day. His moods swung between anger and depression. I couldn’t leave him alone with his sister for even a minute because he started lashing out at her.

ABA wasn’t going to be enough.

We began looking for residential treatment, this time for a program that lasted more than a few days.

Continued

 

 

 

 

 

Excruciating Ride

Continued from Roller Coaster, Part 2

Angela Duckworth, author of Grit, believes we reach “expert” level by practicing our craft for at least 10,000 hours; K. Anders Ericksson specifies those hours are spent in “deliberate practice.”

Therefore, I would like to announce that

I am an expert.

For at least thirty years, I have deliberately practiced…procrastination.

Don’t even have to try anymore; Hubby agrees my practical level of procrastination is unbelievable—even mind blowing.

Blog procrastination happens when I know it’s time to write but I’d rather pretend nothing is happening.

Writing about the last six months is painful, terrifying, discouraging.

I’ve been procrastinating.

As I mentioned earlier, the roller coaster with our girl has morphed into a super-fun ride most days. (And yes, I know that super-fun is technically not a word.)

The roller coaster ride with our boy…not so much.

Right now, his roller coaster is excruciating.

When we began our journey, people supported us in the best ways they knew. However, few had the experience to understand, so we stopped trying to share our angst, because conversations went something like this:

Me: “Our foster son won’t stop screaming. Anything sets him off. He won’t let me touch him until he’s out of his mind—then, still screaming, he clings to me like the earth is falling away and I’m the last thing standing. Sometimes it lasts for hours; I don’t know what to do.”  

Friends my age: “Yeah, my kid does that, too. I just turn on the TV and he settles down,” or “Put him in his room, tell him he can come out when he’s done, and shut the door.”

Friend my mom’s age: “Tell him if he doesn’t stop crying, you’ll GIVE him something to cry about.” 

Friend my grandmother’s age: “He probably has gas. Have you taken him to the doctor?”

Social worker: “If he’s too much for you, we’ll find another placement.” 

The above suggestions didn’t help.

But those kinds of conversations prompted me to start this blog, because Hubby and I agreed no one should feel as alone as we did.

Have a troubled kid? You are not alone.

Terrified of the future? Wondering whether your child will have the ability to function in society? “Cautious optimism” is your motto?

You’ve come to the right place.

Everyone’s story line is a little different, but the internal conflict connects across all boundaries: parents want beautiful life to happen for their kids, but we don’t always know how to best assist.

We want them to thrive, be mentally healthy and happy, be successful, have a great future.

Three months ago, the main life plan for our eleven year-old son was

stay alive.

His roller coaster almost went off the tracks in August. The happy boy who lived with us during the summer of 2016 was long gone. He used his intelligence to charm and manipulate adults but could not stand his peers. Aggressive behavior caused his expulsion from two summer camps.

Several life alterations (loss of Hubby’s dad, job changes, selling our home, moving) or hormones may have something to do with the downward spiral that held a tenacious grip on his personality; we don’t really know the cause. Hindsight sometimes holds clues and answers, but in this case, we can’t find any triggers.

I once read that talking about suicide is “just” a cry for attention unless the person has a plan. (We can discuss “just” another time…if a person is reaching out, there’s a reason.)

Our son had a plan.

Several plans, actually.

When he was upset, I often sent him to write in his journal; after he finished, he allowed me to read it and we took time to discuss his thought processes. As he found that I would not give him a consequence for anything he wrote (he tested this with a list of swear words), his writing became darker and included plans to run away or harm himself.

His list of ways to die included throwing himself in front of a vehicle, drowning himself in the pond or stabbing himself in the heart with a pencil.

Because of his extreme behaviors and inability to function appropriately in most settings, he had an in-home counselor ten hours a week. She became an invaluable presence in our family, mostly for me. (I no longer had to wonder whether I might be overreacting.)

We monitored him closely, working with the in-home counselor with the goal of keeping him with us.

We were, in a word, Hypervigilant.

We installed an alarm on the house to alert us if he tried to leave in the middle of the night, and cameras so I could keep an eye on him when I had to be in another room. Most of the time, I slept only when he slept, woke before he did and kept him in my physical sight almost all day. If I needed to use the restroom, I took the monitor, and only took showers when another adult was in the house. Hubby took over when he got home from work so I could get a little rest.

We were exhausted but determined to do everything we could to prevent residential care.

We believed our love could be enough.

Our in-home counselor agreed he needed immediate and urgent help after he acted out a detailed suicide scene in front of a camera in our home. We aren’t sure whether he chose the setting intending a manipulation, since he knew the camera was there. Regardless, the underlying issue remains the same: his thoughts were focused on ending his life.

As I explained that we might need to seek help from a facility outside our home, he shrugged.

“You’ve done all you can. You’ve tried everything else. We might as well try this.” 

We checked him into an acute care psychiatric facility that afternoon. We visited every chance possible and each time he fed us lies (people hurting him, taking his shoes, trying to fight him). After a visit on day 5, Hubby and I resigned ourselves to the knowledge he’d be there a while as his mindset was obviously not changing.

Less than 24 hours later, a nurse called and told me they planned discharge that day. I was shocked.

“He told the doctor he’s not thinking about suicide anymore, so he can come home now,” she chirped.

I asked to speak to the managing director, who told me they could only keep the child if the child continued to want to hurt himself or someone else. Since our boy knew the right words, he had to come home.

The next day, as I painted a closet, I glanced at the monitor to see him trying to shove a pencil through his ribs.

Continued

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