Non-Compliant Parents

Dear new therapist,
 

I just finished a phone call with our MH advocate who has been fielding concerns from you that we, C's parents, are continuing to be uninvolved and noncompliant with her current RC treatment plan.  MH has asked me to reach out to you to make sure we have the same information as related to C, her current connection with family and where we go from here.

As her current Clinician I first want to share with you my insights into why I think she is showing as much success as she is at her present placement right now.

1) she is wrapped very tightly there, from what I know,  with a lot of supervision and a lot of monitoring

2) she does not have a lot of contact with family to trigger her emotional reactivity

3) she is not engaging in extensive trauma therapy which also really triggers her emotional reactivity and

 

4) she is not taking a Prozac product (which I am convinced triggers rage episodes and SI thinking in her.)

I wonder if you can imagine how difficult it is to admit that for my child - connecting to family and processing family memories triggers in her episodes of reactivity so severe that she can then not manage except to self-harm? It is a tough pill to swallow. But we have been at this for a long time now and I can tell you that I know all four of the above to be true for her.

So, when I say to you that I am not interested in engaging in family therapy right now it is not because I am uninvolved, don't care enough about my child, or just can't carve out enough time for her. It is because I desperately want to avoid triggering her in a way that makes her seek for a method to hurt herself. She has come close to doing serious damage way too many times already, and I simply do not know you well enough, or honestly have enough of a therapeutic trust in your skill level with her yet, to be able to take that risk again. 

I really need for you to understand that C is our daughter. And though she did not come to us by birth, and did come to us with a great deal of traumatic baggage,  we love her and care deeply about her future. I need you to understand that because I need you to help her understand that. When she says to you that she believes we never should have adopted her if we were just going to throw her away, I wish you could help her shift that perspective. When she says to you that she isn't worth anyone's time, I wish you could help her to remember the many positive connections she has with home and family. When she says she has no family because what kind of family leaves their child in residential for three years, I wish you could help her to understand how much we want her to heal and how hard this has been on everyone.  I know your primary job as her therapist is to empathize with her, take her perspective and be her advocate, but I am asking you to really try to take a leap here and help her to understand that she is and always will be a beloved member of our family, and that although she will not be returning to the family home to live, because this just isn't the best place for her right now, the family home will always be her family home. This is not new news for C. We began this conversation when she was in her last placement and made it very clear when she was hospitalized over the summer getting ready to head to you that the most likely path for her would be to transition from you to a group- home setting closer to home and then on to transitional living towards adulthood. She was not able to hear that plan last summer. As is her pattern, she was too triggered and became reactive before she could grasp any of the big picture. In my opinion, this is the healthiest, most logical next treatment plan goal for her - to help her remember, believe in and maintain her grasp of herself as a member of a family even as she takes the next critical step towards transitional living and adulthood. If you can help her to do that, and she can stay regulated in the process, we stand a chance at helping her to continue to heal. I am hopeful that we can pull together to do just that.

 I apologize if my words came out in any way accusatory or judgmental. My goal in sharing is to attempt to find some common ground. Let me know what you think after taking some time to digest it all.                 

From a Friend

The challenges with stealing continue.. and continue...and continue. After the situation with the stolen Iphone and then the stolen IPod (and pants), next up, over Christmas,  was a stolen Fitbit.  When questioned, Lynn's response to all three, "I got them from a friend." Well, seeing as how all three pieces of electronics have now been returned to their rightful owners, her friend pool is dwindling. Sadly, as much as we understand where the stealing behaviors stem from, those friends do not, and will not. Friends can flex so much.

Thank You for the Candy Cane

Every year I re-experience the void of emotions that is Lynn as she opens gifts. Actually, it is more than once a year, because the same thing happens on her birthday, or any time she receives something from someone who gives it in love. I don't really know if it is because she just can't feel excitement or gratitude, or doesn't realize she can't show it, but the reality is that her deadpan expression as she quickly unwraps and puts aside her gifts without a single trace of a smile or word of thank you is not only unsettling, after 10 years of trying to help teach her a better way, it can also be enraging. And so another year goes by and I forget again until the next one. But this year was particularly poignant because of the addition of my grandson Enoch to the picture. As Christmas morning dawned and it was time for gift opening, Melissa and I opted to share the experience with one another via texting pictures so we could be together that way. Her first text: "He is taking Christmas morning slowly and sweetly. He focused on his candy for 10 minutes and now he is focused on 2 Leggo men (he still has 6 more to unwrap) and he has yet to open anything else."  By contrast, Lynn flew threw her gifts in less than 5 minutes and I honestly don't even remember most of what she opened because she had moved them aside before I could even catch up with what she was doing, and as usual she didn't remark on anything. I think I would have been able to stay at resigned, though, if not for the message from Melissa that came through minutes later with a picture of sweet Enoch on the phone. He was trying to call Jesus to thank him for his candy cane. Such a stark contrast.

Peanut Butter and Jelly

Sometimes you just have to find the humor before the difficulties just completely overwhelm you.!

Lynn is currently really struggling with stealing. Last week she was caught with an Ipod and a pair of pants she took from a peer. As part of her consequences she was asked to write a letter of apology to the peer she stole from. In the letter she attempted to explain why she had chosen to steal the items and stated that she was “jelly”, (which if you don't know is teen-speak right now for jealous.)  I was feeling particularly sensitive and vulnerable this time around, probably because this situation was the third or fourth serious breach of the week, and involved colleagues of mine, so I was not feeling terribly open to hearing her ‘excuses’,  and could actually feel myself getting pulled into a depression instead. My husband, maybe reading my mood, or maybe just being his sarcastic self, after being given the interpretation of the word jelly just looked at me stone-faced and said – “maybe she’d like some peanut butter to go with that jelly. It might even help her fingers to be stickier…”. The belly laugh that it evoked it me was much needed and helped me regain perspective. I'm sure there are those who will say that it is insensitive of me to laugh when she is trying to express her feelings, and maybe it is, but the laughter was so needed.

Cowabunga

I've never actually been surfing, but I imagine the experience must have some real similarities to raising attachment-challenged children. To begin with there is the whole balance thing. It is always a battle trying to balance the needs of everyone in a family to begin with. When you factor in the executive function and social skill deficits of the attachment-challenged teens the board becomes that much smaller. And then there is the difficulty level. Surfing is not an easy sport. There are multiple skills needed to be successful as well as overall fitness and endurance. Also true for parenting these teens. But perhaps the similarity most striking to me is the wave factor. You just never really know what kind of wave you are going to get - how high it is going to be or how strong, and you have to be constantly on guard because you just can not predict when they will appear, how long they will last, or how strong they will be. So, you balance, utilize all your skills, and ride that wave. And then, you can rest for a time; always wary but at some level of peace, until the next one. And pray that there is enough time between them for you to prepare.. and catch your breath.

Chilling

“it was the same dynamic that had vexed his family and  'service providers for years'. It was the challenge of a ‘person’ who does not want to be seen as having challenges, who manipulates for advantage, who suffers severe discomforts yet seeks to create discomfort in others, who deals with distress  and disintegration by reaching for ever more forceful means of control, and who harbors, beneath all these attempts at coping and containment, a chilling rage that erupts when they fail.

 This is a quote from a book I am currently reading that is a biography of a young man who ended up killing a young woman because of his mental illness. It is a chillingly close representation of Cheyann's profile. Chilling...

Georgia

And so the decision was made and Cheyann is now in a new facility in Georgia. It was a grueling few weeks as the team continued to meet and search for the logical next step. There was no right answer. In the process, Cheyann's birth father popped back onto the scene attempting to play knight-in-shining armor coming to the rescue, accusing us of not having her best interests at heart. I mostly ignored him but it hurt a little.  We went back and forth as to whether or not we would transport Cheyann down south or have at least familiar people do so, but in the end, her behavior was sliding so much that it was deemed a severe safety risk to even attempt it and a secure transport was hired. Cheyann refused to talk to me after our one uncomfortable visit at the Retreat, and then the day she was told what the decision was she finally called me so she throw some F bombs at me and let me know that when she finally was successful at killing herself it would be my fault. As hard as it was to hear that, in some ways the anger was easier to deal with than the sadness and despair. And now that the transport has successfully delivered her, we wait to hear from this new team, and start yet another leg of this journey.