Month 9: BPD d13 in residential treatment center

[Think About It...]

Great to read your posts lbjnltx, this journey is so informative and helpful.  Wonderful that your dd is making so much progress

[oglobaith]

Great to read your posts lbjnltx, this journey is so informative and helpful.  Wonderful that your dd is making so much progress

[lbjnltx]

Positive Peer Culture Chapter 6   Family T session 2-15-11

#1 Positive Peer Culture is started at the student level T or F
nale:  what did you answer mom?
me: I answered true.
nale:  what did you answer BPDd-13?
BPDd-13: I answered false.
nale: why?
BPDd-13:  well, I figured the book was written by adults and the leadership for a group is adult so it must begin with the adults.
nale:  both answers are correct because it depends on the group.  if it is a new group then it is started by adults.  if it is an established group then to each new member added to the group it is started by the group members or students as the book calls them.
#2 Positive Peer Culture is started at the authority level and is filtered down. T or F
BPDd-13: I answered true
nale:  mom what did you put?
me:  I answered false.
nale:  once more it depends on the group.
#3. what are the first stage of development of individuals/new groups ?
BPDd-13: 1.casing
           2. limit testing
           3. polarization
           4. positive peer culture
nale:correct.
#4. Explain the casing stage.
me: this is an information seeking stage where members try to find out about each other and see who they can manipulate and use as a scapegoat.  members will be very defensive and avoid showing self.
nale: right.  they are feeling out the other members and seeing who can be used as a puppet, who is weak and can be blamed instead of taking accountability.  this is the stage where students try to convince their parents that they get it, they understand, they are ready to come home. they say that this place stinks and it won't help them. did you ever hear that from BPDd-13?
me:  no.
nale: 90% of them do.
me:  the first 3 weeks with no contact may have helped her with that.
dh:  I think that an emotionally strong person would be able to head off alot of this type of behavior if they are prepared for it and we were.
#5. Explain the limit testing stage.
BPDd-13:  members start to be vulnerable and gravitate towards cliques.
nale:  they are seeing what they can get away with, who they can push around. mom what did  you write for this one?
me: cliques form as members begin to reveal their personalities and negative behaviors, unauthentic positive participation occurs, negativism about each other and the Positive Peer Culture process are voiced and fronting goes on.  some individuals in the group will realize their own problems.  still not functioning as a positive group.
#6. Explain the polarization stage.
BPDd-13:  the stage where a decision is made to change and create new sets of values for yourself.
me:  the discovery of new ways of thinking and resulting in new ways of behaving.  cliques fall apart causing anxiety for those not ready to change resulting in some hostility.  others who are moving forward bond together with the common purpose of care and concern for self and others.
dh: this is the yes or no stage...being open minded and seeing other ways or avenues of coping with problems.
nale:  every Positive Peer Culture teen and parent goes through this stage...the polarization of values.  until  you practice Positive Peer Culture you won't know if it works.  most think it is too easy to be affective so they will sit on the fence and watch.  when they begin to see it's effectiveness then they must make a decision...do I want to change and let go of the old stuff and use new tools or stay where I am?
me:  this sounds like it could take a long time for some people.
nale:  yes it can.  Positive Peer Culture can help them express themselves effectively and honestly.  it teaches to serve and allow yourself to be served.  also, its' members are vigilant about solutions and owning those solutions.  BPDd-13, are you polarizing more now or practicing Positive Peer Culture more?
BPDd-13:  Positive Peer Culture
nale:  I agree
#7  Explain the Positive Peer Culture Stage.
BPDd-13: a large clique with common positive goal of care and concern and problem solving skills shared among its' members.
nale: awesome.  this needs to happen at home.  how do you feel about your skills and care and concern for yourself and your family?
BPDd-13: my therapist said that I will be coming back for a while every summer so I can brush up on my skills.  I feel like they are good now and I am willing to use them at home.
me:  while we have discussed the availability of BPDd-13 coming back for a bit each year it is something we will have to evaluate the need for.  I understand that sometimes she has intense emotions and during those times it is difficult to remember skills.  I believe that she will return to care and concern for herself and others though.
dh:  I think she has a much better quality of life now and sees how much better her life will be and she will want to share that with others.  I think it will come naturally to her.
nale:  when she does that I have concerns about boundaries and the need to save and rescue others.  BPDd-13, you have to learn to take care of you and set good boundaries.
dh: mom has tried to teach all of us that we have to take care of ourselves if we want to be able to help others.
nale: yes, parents often want to do the work for the teens but they have to do it for themselves.
dh: if  you are practicing Positive Peer Culture is it possible that others can bring  you down?
nale:  absolutely.  that is why boundaries are important.  we tell the girls this "if someone is drowning and instead of extending a stick to help them out you jump in and then  you realize you don't know how to swim".  when she comes home, in her desire to help others she might forget to take care of herself.  in order for help to be valid they must be willing to help themselves.
me:  how would we know if she is over focused on someone else and not herself?
nale:  you may have to pry...ask questions, read body language.  if she is overly concerned or preoccupied you will need to pull her back.
me:  I can see how what we worked on in individual therapy works with the Positive Peer Culture process.  BPDd-13 made a list of priorities.  what is the first one on your list?
BPDd-13:  self
me: so if  you are over focused on another person then you are not making self  a priority.  I know it is your desire to help others and I also know that there are limits on what we can actually do.  to help another person is not the same thing as solving their problems or controlling them...we don't have the power to do that nor should we.
you could listen, validate, ask validating questions and offer solutions and that is all the power you really have.
nale:  open communication between all of  you and her understanding  your boundaries is important.  she may case, test, and polarize when she gets home.  I believe she will use her Positive Peer Culture skills too.
me:  I think she has a good understanding of our boundaries and our values.  I believe she will do well.
nale:  ok. lets do chapters 7 and 8 next time.

end of session

thanks for reading

lbjnltx

[lbjnltx]

Family T session #32  2-17-11

Chapter 6.  Learn the Effective Validating Phrases and Questions

we started the session w/BPDd-13 reading aloud from the first and second pages of the chapter.

t:  so being kind and gentle is the same as care and concern...the terminology is different and they mean the same. if we are not open to the care and concern and reply with "sounds like one of those validating phrases" what will happen?
BPDd-13:  it will shut down communication
t:  honesty in communication is important.  when we are in a bad mood we can sometimes reply sarcastically or dig in our heels.  what skills do you use, BPDd-13, when  you recognize that you are digging in your heels?
BPDd-13:  humor, take a walk down to the coral.
t: this happened yesterday.  you were not being difficult but I recognized your non verbal communication.  I saw that look you get when  your brain gets stuck and doesn't want to change gears.  I validated you and you were not accepting it so we walked down and you introduced me to nugget.  when you get home you can do the same w/mom and dad.  they can ask you to take a walk with them or lighten up the mood with humor.  mom what did you get out of this chapter?
me:  I learned about asking validating questions in order to keep communication flowing, aid the speaker in exploring their emotions and options for problem solving.  I also recognize that this must take place only after validation occurs.  I think that sometimes the speaker may not be open to answering or considering validating questions right after being validated...sometimes it may be best to wait a while. perhaps some self time is needed between the validation and the validating questions.
t:  when BPDd-13 first gets home the transferring of skills may be rocky.  we are only a phone call away if you need us.  do you think that the skills you learned and use here will work at home?
BPDd-13:  yeah
t:  we would not teach you skills that only work in a controlled environment.  that would not be very helpful in the long run.  ok, each of you read some of the list of validating phrases from the book.  BPDd-13, you go first.
(BPDd-13 read about 14 phrases out loud).
t: ok dad, now your turn.
t: mom, go ahead.
t: BPDd-13, I noticed you smiling while they were reading these phrases. how did it feel to hear those validating statements?
BPDd-13:  it felt good.
t: sometimes we can relate the phrases to past experiences and feel the comfort of the words.  ok, dad, choose 2 validating questions to read.
dh:  well before I would say "BPDd-13, why did you do that".  now I would ask "how can I help you make a better choice for yourself?", "what did you mean?"
t:  did you notice the voice inflection.  you can hear the care and concern in the question.  it sounds very sincere doesn't it?
BPDd-13:  yea it really does.
t:  ok  your turn mom.
me:  "did that hurt your feelings?", "what do you think caused the problem?"
t:  how did it feel when mom and dad asked these questions? what were you thinking?
BPDd-13:  well, I was thinking of solutions. I felt like I could express my feelings.
t:  mom might need to ask another question if "yes" is the only answer you give to her question "did that hurt your feelings?" 
BPDd-13:  oh yeah, because I can explore my feelings more then. 
t:  can you think of an incident where your feelings were hurt here?
BPDd-13:  no. 
t:  it has been a long time since your feelings have been hurt then?
BPDd-13:  yeah. 
t:  any more thoughts on this?
me:  I was going over chapter 5, it is about when to teach.  I kept coming back to an idea expressed in the book about needing to establish a safe environment for honest and open expression of feelings and open mindedness for problem solving.  I hope that BPDd-13 knows that home is a safe environment where she is loved and cared for.  I hope she feels understood and not judged here.  I don't think she felt that way at home before going to falcon ridge and that is why we weren't able to resolve any issues or problems no matter how long we waited after the storms passed.
t:  BPDd-13, do you think that your parents would ever hurt you intentionally?
BPDd-13:  no, I know they wouldn't.
t:  you can see now how hard they have worked to improve themselves and get you the help  you needed.  it took a lot of love to do all this.  if you are not in  your Wise Mind  your feelings may tell you that your home is not a safe environment.  it is very important to get into your Wise Mind asap before the fight/flight response kicks in.  if you are in the outside world from your home, and you don't feel safe, you may not be. 
dh: I think she honestly and truthfully knows she is safe with us.
t:  I have given BPDd-13 a packet of worksheets to do on mindfulness.  we won't have family therapist next week as I will be at home recovering and resting after surgery.  mindfulness is gaining a lot of ground in the world of therapy.  mom, I have a new book for you to get.
me:  oh great.
t:     dbt skills to help your child with intense emotions or something like that.
me: oh, I already have that book.  I found it helpful but I think it is geared more towards younger children.
t:    I should have known  you would have that one.
everyone:   
me:  did you get my email yesterday?
t:  yes, but I haven't read it yet.
me: I sent you a link to a new dbt skills work book for teens.  it is coming out march the first.
t:  great. well, we are finished with this book.  keep it handy and read it over occassionally to sharpen and refresh your validation skills.  BPDd-13 that includes you when  you get home.  while I am home I will do some reading too.  my students will be receiving extra counsel from nale and extra equine therapy in place of our time together in the schedule.  the equine specialists are very impressed with BPDd-13.  they say she has the ability to feel what the horses feel.  that is a gift.
me: yes it is.  it is not something that you can learn.  around here we say that "horses need help with their people".
t and BPDd-13:   
t:  well, it is time for  us to go.
me:  we will lift you up to the Lord in prayer for a successful procedure and ask for extra comfort for you and your family during this time.
t:  thank you so much.  the surgery is an answer to our prayers.
goodbyes to BPDd-13 and I love yous

here is the link to the new book coming out:
http://www.amazon.com/gp/product/1572248831/ref=pe_5050_18786600_snp_dp#reader_1572248831


thanks for reading
lbjnltx
 

[j's friend]

Thankyou lbjnltx for the link to the new book out in March for teenagers.
I have just pre ordered my copy.

I have followed your d's progress at the residential treatment center,and she is making excellent progress.I looked at back at  some of your much earlier posts when

your d was first dx and see just how far your d and your family have come, and it gives me hope that things can improve with the right kind of input.

[lbjnltx]

dear edenblu,

thank you for reading about our experiences with our BPDd-13 and the residential treatment center.

I looked at back at  some of your much earlier posts when

your d was first dx and see just how far your d and your family have come,

wow!  that was like 3,000 posts ago!  I can still feel the pain, fear, and frustration I had during those days...i don't think I will ever forget it.  it makes me appreciate and respect the journey and hard work it took to get to where we are today.  I would probably be amazed at my ignorance of this confusing and complex disorder called BPD if I were to go back and read about those days.

how is  your d doing now?  you don't post much anymore.

lbjnltx

[qcarolr]

Positive Peer Culture Chapter 6   Family T session 2-15-11

dh:  I think she has a much better quality of life now and sees how much better her life will be and she will want to share that with others.  I think it will come naturally to her.
nale:  when she does that I have concerns about boundaries and the need to save and rescue others.  BPDd-13, you have to learn to take care of you and set good boundaries.
dh: mom has tried to teach all of us that we have to take care of ourselves if we want to be able to help others.
nale: yes, parents often want to do the work for the teens but they have to do it for themselves.
dh: if  you are practicing Positive Peer Culture is it possible that others can bring  you down?
nale:  absolutely.  that is why boundaries are important.  we tell the girls this "if someone is drowning and instead of extending a stick to help them out you jump in and then  you realize you don't know how to swim".  when she comes home, in her desire to help others she might forget to take care of herself.  in order for help to be valid they must be willing to help themselves.
me:  how would we know if she is over focused on someone else and not herself?
nale:  you may have to pry...ask questions, read body language.  if she is overly concerned or preoccupied you will need to pull her back.
me:  I can see how what we worked on in individual therapy works with the Positive Peer Culture process.  BPDd-13 made a list of priorities.  what is the first one on your list?
BPDd-13:  self
me: so if  you are over focused on another person then you are not making self  a priority.  I know it is your desire to help others and I also know that there are limits on what we can actually do.  to help another person is not the same thing as solving their problems or controlling them...we don't have the power to do that nor should we.
you could listen, validate, ask validating questions and offer solutions and that is all the power you really have.

lbj - this part really struck me as so very important for all of us to practice. And it helps me to continue to overcome the guilt that still pops up about "taking care of myself = being selfish". It is really the most caring thing I can do for others - to be doing my self-care stuff so I am calm, grounded and available.

Are you anxious about d14 coming home? It is coming soon, and I will be keeping you all in my thoughts and prayers. There is much hope, yet tempered with the reality of the transistion that will take place.

Thanks for sharing,
qcr         

[INFORMATION ABOUT THE 'SUPPORTING A CHILD' BOARD]

INFORMATION ABOUT THE 'SUPPORTING A CHILD' BOARD Our objective is to learn how to support our loved ones and to find peace and understanding in our own lives. There is real help and real hope available for families. For information and guidelines please click here :

[lbjnltx]

Are you anxious about d14 coming home?

all in all no.  there are certain aspects that I have concerns about.  schooling is one.  it is still up in the air.  the educational director and BPDd-13's individual therapist both recommend home school for the rest of the year.  I have found an online public school that we are considering...there are many factors affecting this decision.  I am waiting for a reply from the ed. director ... asked her what she thought of this program...will it be good for my d?  husband (to some degree) wants her to go to her new public school...and d is under the impression that she will do just that when she gets back...so for now I am waiting (hard for me) ... I have already put in place a math tutor for my d.  her individual therapist will be out for a few weeks so I don't know if I will get any  input from her...it has been a week since I left the message for the ed. director and emailed her the link to the site...haven't heard back.. ;p

another concern...getting the Positive Peer Culture group underway...
and last but not least...finalizing the decision (still waiting for a definitive "yes" from dh) to make plans for neurofeedback therapy.

lbjnltx

[qcarolr]

What kind of commitment is needed for the neurofeedback - ie. number of sessions - to decide if it is helping? How do they evalutate progress? How is this different from 'biofeedback'? Are there any easy to read resources online I could check out - in case by some remote miracle DD ever gets her SSI and medicaid (and there is any funding left with our state - the record holder for 50th out of 50 for mental health support!)

Thanks,
qcr

[lbjnltx]

What kind of commitment is needed for the neurofeedback - ie. number of sessions

from my research, a minimum of 20 sessions to see improvement.  the minimum requirement varies from therapist to therapist. for example: at the university mental health lab, one of the leading sites for neurofeedback training of therapists, there is a minimum of 30 sessions.

How do they evaluate progress?

they take 2 base readings at the evaluation...one with the mind at rest, 1 with the  mind in a state of concentration and do comparatives at intervals.

How is this different from 'biofeedback'?

neurofeedback is a type of biofeedback.  electrodes are placed at strategic points on the head and the ears to measure brain wave activity in all areas of the brain...depending on the results from the evaluation and any diagnoses the patient may have in place, a computer program is designed to increase or in some overactive areas, decrease brain wave activity.  the patient controls the feedback solely through the electrodes placed on their scalps.  the computer screen will react with some type of reward...like pack man eating up the dots...the more affective the desired  brain wave activity the faster the dots get eaten up...or something similar.  this is a very simplified explanation.

areas where neurofeedback has been successful:  add/adhd, depression, addiction, and an across the board double digit increase in iq.

google neurofeedback therapy and you will get more info than you need.
i read a few books as well.

lbjnltx

[qcarolr]

Thanks for the info. sounds really very different than biofeedback I did years ago. much more focused. I will check it out.

qcr

[lbjnltx]

dear qcarol,

i  was just going through my list  of favorites...cleaning house a little and found this there.  copied it to come here and paste for you...what a
coincidence!...or is it...

Neurofeedback is a holistic, non-invasive, comprehensive training system that creates changes in the brain at a cellular level. Neurofeedback training is brainwave biofeedback. It corrects both the symptoms and the cause of the problem, as well as improving one's sense of well being. Also known as neurotherapy, neurofeedback can be used to improve both mental and physical performance.

here is the link to the site:
http://www.thebraininstitute.net/what_is_neurofeedback.html



During neurofeedback training, electrodes placed on the scalp and earlobes measure the electrical patterns coming from the brain. Some brains are under-active and others are over-active. Neurofeedback retrains the brain to naturally heal by teaching it to repattern abnormal brain-wave patterns and produce normal ones. It is based on the classical operant conditioning system using rewards and feedback.

[lbjnltx]

greetings friends,

just an update on the recent goings on:

during our social call wednesday BPDd-13 told me she is having trouble regulating her emotions.

possible factors:  individual therapist is out for a few weeks for surgery, BPDd-13 is in the transitional phase of treatment and still has the goal of graduating in mid march, the expectation that she will consistently meet the requirements for being in the trans unit are causing stress for her.

we did not get an email from her wed. nite...when I finally got to speak with the educational director last nite she told me she ran into my BPDd-13 this am and told her she would be calling me tonight and BPDd-13 told her "tell my mom I am on probation so I can't email her".
i got an email late last nite from the trans director stating that BPDd-13 had more than 5 issues last week and is now on probation.  ;p

i got the go ahead on the online public school with the recommendation that a 504 be set up so I will begin the process of enrollment, scheduling phone conferences, etc...
the educational director is going to give my BPDd-13 a practice taks test next week to see what areas she needs to work on so that they/we can be more efficient in our focus of study w/BPDd-13.

lbjnltx

[whiletheseasonspass]

Dearest lbj,

If you don't mind my two cents...I think you are right- with your possible reasons for this stuff going on...

That because our BPD's do not do well with changes...and there is a big one coming up for your dd...and her T is out for surgery- I agree i.e. I think it is throwing her off a bit. 

My faith in you and your gained knowledge ( you are really brilliant and could write a book IMHO) and because of your faith in God- I think that whatever challenges come about- you will be led in the right direction to keep your dd headed in the right direction.   

And maybe there will be bumps - yes...but so much progress has been made.  Your daughter seems to have so much pride in her new self...and your love means a great deal to her- that is so so so huge with a BPD - you have gained her trust- very wonderful and so much to be hopeful for.  There have been so many changes in the past months for the GOOD.   

So anyway I just wanted to give you the reassurance that bumps do not mean way bigger un-doable bumps... and I believe you already know this...but just wanted to say it anyway and I wanted to offer my support and reassurance to you.


wtsp
 

[j's friend]

during our social call wednesday BPDd-13 told me she is having trouble regulating her emotions.

So great that your d is able to share these feelings with you!

[qcarolr]

lbj - I'm with edenblu. This is such a great thing for your D to have this awareness that she is struggling, and to let you know about it. Even tho her T being out with surgery may aggravate things, it is also providing a great opportunity for your D and the staff there to be working with her under this stress before she comes home. Kind of like practice.

The school option with the 504 plan sounds like a good choice for you. Great that they can start getting things ready - getting a connection with your D - while she is still at the residential treatment center.

Hang in there - keep breathing and thinking and feeling and moving back to the Wise Mind you have in place.

qcr    

[peaceplease]

It must be difficult for your dd to be scared and her T is not there to validate her.  Her trouble with regulation emotions is so understandable.  She really has made tremendous progress.

 
peaceplease

[lbjnltx]

And maybe there will be bumps - yes...but so much progress has been made.  Your daughter seems to have so much pride in her new self...and your love means a great deal to her- that is so so so huge with a BPD - you have gained her trust- very wonderful and so much to be hopeful for.  There have been so many changes in the past months for the GOOD.   

yes! yes! yes!  my greatest fear was that my d would never know my love for her...i fear no more.  we are so close emotionally now. it is awesome.

It must be difficult for your dd to be scared and her T is not there to validate her.

yes, I think it is but the transitions director doesn't seem to think so...either way my d will be ok.  instead of being able to offer her some extra support from home, communication was cut off. ;p   no emails wed-sat for her.  rules are broken and consequences happen...this is one of those situations where there are pros and cons to each decision and I must step back and let the powers that be do their job.  just wish I could have sent her some words of encouragement and validation...reminded her to go to her Wise Mind...her individual therapist was to remind the staff to use this phrase with her ... don't know if they have or not...perhaps not... ?

we will have Positive Peer Culture tomorrow and a social call...i think.  her therapist is supposed to be back this week as well.  we will see.

lbjnltx