Thursday, January 19, 2012

Need to Control = Fear


The Princess and I had family therapy yesterday morning.  It wasn’t fun.  This is the second session in a row she has refused to participate.  She just sits there, with her arms folded, and won’t say anything other than, “I don’t know,” or “I don’t want to talk about it.”  There’s a lot going on, but for her, if she doesn’t think about it, then it’s not really happening.  For her, if she doesn’t deal with it, she doesn’t have to feel it.  For her, those big feelings are still there whether she wants to feel them or not.  So, because she will not deal with “it,” she is easily triggered and then explodes, (like she did at the zoo), or she’s constantly talking, bouncing off the walls, and using her baby voice.  You see, she MUST be in control.  If she lets go, if her control goes, then there’s no telling what feelings will come to the service!  She’s crazy scared of what those things REALLY feel like.  The fear is HUGE!

There is nothing we can do to MAKE her participate in therapy or in other community based services.  Nothing.  We can be there.  We can offer her support and help, but if she doesn’t want to participate, we’re (therapist, social worker, SRS case manager, parents) just spinning our wheels.  She’s just not ready for talk therapy right now.  She’s 13 and has the shape of a young woman, but she is still about as emotionally capable as a preschooler.  So, backwards we go.  In therapy, we’ll deal with the preschooler.

After the $140 waste of time yesterday morning, the Princess’ therapist called to talk with me privately.  We had two choices:  quit for now (not an option to me) or revert back to play therapy with puppets, sand trays, play dough, and other toys (like you’d use with a much younger child).  I asked the therapist to try taking her backwards and working with her as though she were in preschool.  When she started therapy two years ago, these are the kinds of tools we used in our attachment therapy.  She responded well then.  She revealed her thoughts and feelings through play and responded well to receiving ideas for helping her to deal with situations.  So now, in going back there, I am hoping she responds well again.  Things have been so hard with her the last several months.  I cannot imagine her (nor I) not having our therapist and HCBS (home & community-based services).  I don’t want to imagine it.  (I know some of you, dear readers, do not have a mental health facility near you like we do.  Please forgive my whining.  I know a lot of you do this on your own.  I am a wuss, and God knew that when He plunked us down here.  Believe it or not, I just “lucked into” finding our therapist.  I didn’t even know we had a MH facility in our community when we moved here.) 

When I picked The Princess up after school yesterday, I told her the therapist called me, and that we talked about adding a community-based service (someone who’d work with The Princess in the community and talk with her about family and social skills).  We also talked about the need to cooperate and work in therapy.  I explained we’d be going back to doing play therapy more so than talk therapy, but that she needed to do the work of dealing with the big feelings that have been bubbling up inside of her.  I did not tell her about the possibility of being “fired” from therapy for not cooperating.  She would seize CONTROL of THAT like a drowning man grabbing a life ring!  I did tell her if she did not cooperate, we would be facing a lot more years of therapy and interventions than we could begin to imagine.  (I did not elaborate.)

The Princess is not afraid of me, nor of her therapist.  That’s not where her need for control rests.  She trusts us.  The person she doesn’t trust is herself.  She doesn’t trust she’s strong enough to handle those big feelings that are festering under the surface.  She’s afraid of peeling off the emotional scab and letting whatever poison out that is there, so the healing can begin.  Alas, we plod on.  We try to help her feel safe enough to “go there,” assuring her that developing coping tools now, while she’s young, will help her out much more effectively than waiting till she’s older to deal with things and does not have us “right there” to catch her, and help her back up.

That’s what therapeutic parenting is, you know.  Plodding on.

Trauma sucks.  Big time.

Wednesday, January 18, 2012

Scholarly Education on Complex Trauma

When I was a teenager, I spent as little time as possible studying.  I did what I had to do to get by in school.  I was a lazy scholar.  Deep down, I still am.  My thirst for learning is only fueled by my desperation.  When I feel I NEED to know something and do not, it is then I am most ready to study and to learn.  There is much I have needed to know these last several years.  If you also need to know, below are some scholarly papers and websites with resources for higher learning about complex trauma:

     *Neuroscience & Behavior - a free undergraduate level course on MIT's open learning website.  There are over 700 courses on this site - both undergraduate and graduate level courses - in a wide range for fields of study.

     *Articles by Dr. Bruce Perry (one of my favorites):
          Anxiety Disorders
          Bonding & Attachment in Maltreated Children
          The Neurosequential Model of Therapeutics
          and FOR TEACHERS
          Children and Loss (on Scholastic's website)
          What Childhood Neglect Tells Us About Nature and Nurture

     *Treatment of Complex Trauma in Young Children:  Developmental and Cultural Consideration in Application of the ARC Intervention Model.  Arvidson, Kinniburgh, Howard, Spinazzola, Strothers, Evans, Andres, Cohen, Blaustein, 2011.  Journal of Child and Adolescent Trauma, 4:34-51

     *The Amygdala, Fear, and Memory.  Fanselow & Gale discuss the role of the frontotemporal amygdala in classical fear conditioning, 2003.

 More links are available at:  Tip Sheets for Psychology Majors.  Additionally, even more links -- more than you will ever read or need, but may want to browse for some gems -- are available at www.trauma-pages.com


Tuesday, January 17, 2012

UPDATED! - Fact Sheets for the Classroom

Educating teachers about PTSD, RAD, ADHD/ADD, FASD/FAE, PDD, anxiety, depression, and even Aspergers is a chore each year for me.  It is a necessary chore, however.  Unfortunately, our teachers are overworked and underpaid and frankly, clueless about what it REALLY means to deal with all these things, or how to best educate a child with complex trauma.  (Let's face it, we were all clueless, too until we had to deal with it face-to-face ourselves.)

I wish I'd found these Fact Sheets back in 2007.  They are posted on the Kansas State Department of Education website and are designed to give teachers an overview of the challenges our kids face every single day.  They are not comprehensive, but they provide the basics.  (Besides, I've learned most teachers don't bother reading much of the information given to them even by their own administrators.  Even if they WANTED to, there just aren't enough hours in the day to read everything they're told is "essential.")  

I've developed a lot of presentations and materials of my own through the years and I promise to share more of those over time on the blog.  But my best piece of advice for communicating your child's needs to his or her teachers is to develop a relationship with them.  Be prepared to advocate (a.k.a. "fight") when you need to, but work with your child's teacher to show them you appreciate their professionalism.  Hopefully, they in turn will respect your expertise as a therapeutic parent, raising a hurt child.  

Do not expect a teacher to work like a therapist.  Their job is to educate your child.  Give them tools that support them in their job, even as you ask them to support your job as a therapeutic parent.  Hopefully, they'll appreciate your efforts to make their job easier, and thus make your job easier by avoiding those triggers which set your kids off on behaviors most teachers never get to see.




     *Anxiety

     *Depression



     *Asperger Syndrome

Additional resources for the classroom here:  Child Mental Health Resources