Falcon Ridge Ranch Month 2: BPD d13 in residential treatment center

[Parents! Get help here!]

Just a quick update.

We now have social calls w/BPDd-13 once a week. In our last conversation on thurs. she told me she misses her old therapist.

Our 2nd family therapist session went very well.  BPDd-13 missed going on a trail ride because of our scheduled session.  Aaid it was "ok, I'd rather talk to my mom and dad anyway".  She sounded very sincere.  We thanked her for her attitude and loving response and wished her happy trails very soon.

Therapist says BPDd-13 is working really hard and being open and more cooperative this last week. She had an incident where she became upset and bit herself.  BPDd-13 read us a list of 10 coping skills she came up with to use in times of distress; hasn't used them yet though.  

BPDd-13 told us she was glad she is there at the residential treatment center - was mad at us at first but realizes she needs to be there and needs some help!  This is the 3rd time she has said this.   Dare I believe she is being honest?  

After the therapist told us a story about what happened when she got between a mare and her foal one day I commented that moms have a very strong protective instinct when it comes to their children. We had a great many problems when we wouldn't allow BPDd-13 to do/go where it was unsafe whether it be due to her not making good choices or the situation being unsupervised.  BPDd-13 said "yeah, I understand that now".

BPDd-13 asked if we were going to come for the next family visit in September.  She said she was afraid we might not come.  I assured her we were coming and told her we already have our flight, hotel and rental car arranged.  she wants stepdaughter (21) and brother to come as well.  i assured her that stepdaughter (21) wants to and we will see what the recommendations from therapist are and if the residential treatment center rules will allow.  She replied "ok".  This would have been a major melt down situation at home!

At the end of the session therapist told us that she is preparing BPDd-13 for "cleaning the slate".  A confession of all sins past and present.  i told BPDd-13 that we love her no matter what and that what has happened in the past is not nearly as important as what she is doing right now and what she will do in the future.  t confirmed that BPDd-13 understands that our love is unconditional.  Now I must prepare myself for the affirmation of my suspicions from the past years.  I don't want to react in a way that does not promote further work on her part and at the same time I know she will need a reaction (emotional) from us to know that we care.

BPDd-13 ended the session with a request for pictures from home - the ranch, all the animals, even pictures of her holding a snake 8, dogs we have had in the past. Oh yeah, and a few of mom and dad too.

"I love you"s and" I miss you"s exchanged again with looking forward to talk to her on Monday.

lbjnltx

BPD d13 in residential treatment center «

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[lbjnltx]

Just a quick update.

We now have social calls w/BPDd-13 once a week. In our last conversation on thurs. she told me she misses her old therapist.

Our 2nd family therapist session went very well.  BPDd-13 missed going on a trail ride because of our scheduled session.  Aaid it was "ok, I'd rather talk to my mom and dad anyway".  She sounded very sincere.  We thanked her for her attitude and loving response and wished her happy trails very soon.

Therapist says BPDd-13 is working really hard and being open and more cooperative this last week. She had an incident where she became upset and bit herself.  BPDd-13 read us a list of 10 coping skills she came up with to use in times of distress; hasn't used them yet though.  

BPDd-13 told us she was glad she is there at the residential treatment center - was mad at us at first but realizes she needs to be there and needs some help!  This is the 3rd time she has said this.   Dare I believe she is being honest?  

After the therapist told us a story about what happened when she got between a mare and her foal one day I commented that moms have a very strong protective instinct when it comes to their children. We had a great many problems when we wouldn't allow BPDd-13 to do/go where it was unsafe whether it be due to her not making good choices or the situation being unsupervised.  BPDd-13 said "yeah, I understand that now".

BPDd-13 asked if we were going to come for the next family visit in September.  She said she was afraid we might not come.  I assured her we were coming and told her we already have our flight, hotel and rental car arranged.  she wants stepdaughter (21) and brother to come as well.  i assured her that stepdaughter (21) wants to and we will see what the recommendations from therapist are and if the residential treatment center rules will allow.  She replied "ok".  This would have been a major melt down situation at home!

At the end of the session therapist told us that she is preparing BPDd-13 for "cleaning the slate".  A confession of all sins past and present.  i told BPDd-13 that we love her no matter what and that what has happened in the past is not nearly as important as what she is doing right now and what she will do in the future.  t confirmed that BPDd-13 understands that our love is unconditional.  Now I must prepare myself for the affirmation of my suspicions from the past years.  I don't want to react in a way that does not promote further work on her part and at the same time I know she will need a reaction (emotional) from us to know that we care.

BPDd-13 ended the session with a request for pictures from home - the ranch, all the animals, even pictures of her holding a snake 8, dogs we have had in the past. Oh yeah, and a few of mom and dad too.

"I love you"s and" I miss you"s exchanged again with looking forward to talk to her on Monday.

lbjnltx

BPD d13 in residential treatment center «

Month 1 Month 2 Month 3 Month 4

Month 5 Month 6 Month 7 Month 8

Month 9 Month 10

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[qcarolr]

lbjnltx - I have you on my mind and in my prayers every day. An so glad things are going so well so far. Sounds like the 'clean the slate' step will be a hard one, but so needed. Good luck with this for all of you.

qcr

[ingridp]

lbjnltx, this sounds so positive. It's great!  I know what you mean about being a bit scared to believe - I wonder what my S has done, or what he wants, when he starts 'being nice'. Unfortunately I'm right on this one more times than not. When he sets up goals for himself, he's very sincere at the time, but completely looses interest three hours later, so I'm also sceptical when great plans are announced.

I think about you often - and all my other friends here - and wish you all the very best on your journey. Please remember to take time for you.

With love

 

Ingrid

[Jemima]

lbjnltx, Thinking of you throughout this time.

[lbjnltx]

on thursday morning we had our 3rd family therapist session... .cleaning the slate.

it took BPDd-13 a few minutes to pull herself together... .she said she was scared and nervous to confess things she had done that we weren't aware of.   I heard her tell her therapist that she "wanted to get it over with so she could get through the program faster".   we were asked not to comment until she was finished.  here is the list: 

talking to older men on fb about sex

smoked marijuana in the alley behind the school 2x

had inappropriate touching w/boyfriends (no oral sex, no intercourse)

stole from walmart 2x (gum and candy)

engaged in satanic worship a few times... .tried to put a curse on mom.

the only thing that surprised me was that she had tried to put a curse on me.  I just told her that it could not affect me because I belong to Jesus Christ... .she said "i know, and i'm glad it didn't work".  I asked her if she was ready to put that behind her now?  she replied "demonic is part of me.  i'm a scary person who writes scary things".  i'm sure the therapist will address this issue w/her.  I asked her if she is still seeing things and hearing things. she replied "yes.  shadows in front of me and out of the corner of my eye "  I asked if she is hearing voices still?  she replied "just whispers calling my name.  sometimes I hear really low, sad music".

BPDd-13 tearfully said she was sorry for doing these things and I told her "you are forgiven".  she replied "thank you".  therapist asked her at the end of the session how she was feeling now?  BPDd-13 replied "happy". 

later that day I spoke w/her case manager. she said BPDd-13 told her "i kind of like it here.  i'm learning a lot of things I need to know. i'm learning to love my mom again and God, I kind of like myself more."

next week we will talk about family values.

lbjnltx

[qcarolr]

lbjnltx 

This is such a great report. so much progress in a steady path so far. Seems all your hard work and research is being validated. Will keep praying that it continues.

qcr

[Jemima]

    Glad to hear positive news!

[lbjnltx]

BPDd-13's individual therapist called me on Tuesday.  Said she just had a meeting w/BPDd-13's psychiatrist (pdoc).  He wants to increase her Prozac®, Abilify®.  I was left w/the impression that it was to see if it addresses her psychotic features.

I called the case manager at the residential treatment center and said "no, please wait until I have a chance to talk to the pdoc".

I spent 25 min. on the phone w/him and didn't get much info.  A lot of "i'm not sure", "i don't know yet" and "let's wait and see".  his explanation for the increase in meds was more along the lines of depression.  told him the feedback I get from individual therapist and case manager, weekend staff is that she is doing well, lots of smiles, joking around, making more friends.  doesn't sound like a depressed person.  he says she seems "flat" when he talks to her... .uh duh... .she doesn't even know him/trust him.

i suggested that we not increase meds... .Abilify® has never worked as a mood stabilizer for her... .she doesn't have a mood disorder... .explained to him that she is fine as long as she doesn't have limits put on her by anyone she is emotionally attached to... .he replies "in that case she may have Intermittent Explosive Disorder".     then he says "i would be surprised if she has real psychotic features" and "i think when this all plays out we may find she has an axis II disorder"      this guy  has a complete psych evaluation from one year ago w/ the emerging BPD dx, he has a complete history in writing from me... .I JUST WANT TO SCREAM "GET WITH THE PROGRAM BUDDY".  I am feeling like they are discarding her dx of BPD until she can "prove" it.    then he starts suggesting we take her off meds completely and will get some feedback from the staff on her behaviors and how they think she is doing... .at this point I don't have much confidence in this pdoc... .trying to withhold making a judgement at this time... .?

on thursday we had our 4th family therapist session.  we talked about family values.  each of us added to the list and said how we define each "value".  BPDd-13 did really well until we got specific.  she became upset when we talked about her xbox online.  in the past she used it as a telephone... .not playing games w/these boys... .just talking through the headset.  I told her that was not what the xbox was for... .that it is ok to play games and talk about the gaming experience but not to use it in a way in which it was not intended.  BPDd-13 was not listening to me and began saying "you just want to keep me from my friends".  when I tried to tell her it was ok to use the xbox for gaming she replied "you won't let me use it", "i know how you are".  therapist jumped in and tried to get her to talk about this in an intelligent way but BPDd-13 was not able to comply. therapist said "BPDd-13 is not ready to discuss this at this time so I think it is best to end the session.  

it will be interesting to see how BPDd-13 is on monday... .whether or not she will take our social calls... .

thanks for reading... .the saga continues

lbjnltx

[qcarolr]

lbjnltx,

Sorry the pdoc sounds like he wants to do it his own way - it is so hard when professionals won't trust what is in the history. With my DD mood stabilizers made her feel really dull, sleepy, tired - she always stopped taking them. Abilify and seroquel made her really anxious and depressed immediately. She has just started prozac for her anxiety attacks and takes trazadone for her depression and insomina and these seem to be working for her.  She finally got the meds. doc to hear her. And maybe she (the doc) finally read the copy of the neuropsych eval. I faxed for D's record at the mental health center when they reopened her case file last month. (They claim they lost her file to DD and this is why her case was suddenly closed in May, but the lawyer for her SSI appeal has received copies of all those records? ? Wonder whose covering their ___ here.

Has your D been showing an psychotic symptoms at the residential treatment center or is this just in the history? Would they try to push her into these to test the waters - so to speak? Would this be OK or professional? Will they listen to you when you want them to hold on changing her meds.?

You are a smart, well informed parent - you know your D better than anyone. Hopefully the pdoc will take the whole team's input into account in making his decisions - not just his personal exposure (which is much more limited than the other t's).

Keeping you all in my thoughts and prayers.

qcr  

[lbjnltx]

dear qcarol,

Has your D been showing an psychotic symptoms at the residential treatment center or is this just in the history?

  yes, she complains about it to her individual therapist at almost every session and says she "wants it to stop. why isn't anybody doing anything about it ?"

Would they try to push her into these to test the waters - so to speak? Would this be OK or professional?

  they don't know any more than I do about these psychotic features she claims to be having.  I suggested before they resort to any anti psychotic meds that they consider a placebo... .pdoc said no to a placebo because it would violate trust... .

Will they listen to you when you want them to hold on changing her meds.?

they cannot make med changes without my permission.  for now her meds and dosage are remaining unchanged until pdoc speaks w/other staff and gets feedback from them.  then either pdoc or nurse or case manager will contact me for the ok to make any changes.

thanks for the continued prayers... .we need them, especially BPDd-13  :'(

lbjnltx

[lbjnltx]

just got an email from individual therapist at the residential treatment center:

I sure seen some of the behavior you were describing during our last session. ***** really shut down when we started talking about the strangers on the Internet. In staff meeting today it was reported her peers even have tried to talk to her about talking to strangers on the Internet after she stated she didn't see anything wrong with it. She is now mad at them. She stated she doesn't want to talk to you or me anymore. We will take her down to talk to her horse and help her work through her emotions. I'm giving her the week-end to calm down although I talked to her briefly today and she stated she was doing fine. I'll call next week and let you know where she is at.

Hang in there,

this is kind of funny... .in a sad way... .that they think "shutting down" is a troubling behavior... .wait till they see her rage... .

i emailed her back and told her the reaction at home would have been to fly into a rage and her behaviors would escalate to threats of suicide, running away, self injury, violence against me, etc... .

getting into the hard stuff, week 7 at residential treatment center... .

lbjnltx

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[ingridp]

Hi lbjnltx

Thank you so much for keeping us all up to date, and thank you for being such an excellent example for the rest of us. You are doing such a sterling job. 

I'll keep you all in my prayers as you get deeper into some of your D's issues. It can't be easy for any of you.

With love

 

Ingrid

[qcarolr]

lbjnltx 

Everyday you are all in my prayers - esp. d13. She is entering such a scary place to have to face these fears and emotions. I am so thankful that she is is a safe place with lots of good support to do this work. And it is such hard work.

Hang in there - this is has to be hard for you, to have to place your trust in others that can better see your d13 through this time safely than you. She is so lucky to have you for a mom.

I know you do take good care of yourself - keep on with what works for you. You are a strong, wise woman, with a solid faith.

qcr 

[Ruby807]

Dear lbj,

I just wanted to let you know that I have been fallowing every single one of your post and updates about your baby girl13 in residential treatment center, since my baby girl is on her way to an residential treatment center. I want to let you know that all the information you post here it is very important to me. Thank you!.

I also wanted to share a little bit about my experience. Baby girl15 was a complete nightmare when she didn't take any medications. After her second suicide attempt in October she was put in 5mg Abilify and 5 Lexapro, which was nothing... .then was slowly increased to 20mg Abilify and 20mg Lexapro. At the beginning she was always very sleepy and tired until her system got used to it, then she was fine with it. Unfortunately, every trip she too to Dominion Psychiatric Hospital (4 times in the past 9 months) they always tried to change her medications to Zolof (did nothing for her) Lamictil (gave her a horrible rash all over her face, very dangerous syndrome) and prozac (which made her extremely aggressive and out of control). Unfortunately like you mention before, sometimes out children do things to cause the medication not to work for example mine d15. She used to throw up several times a day, she smoked weed, she drank alcoholic beverages, and sometimes even snorted her pills when I didn't make sure to put them in her tongue and watched her swallow the pills. I don't think it is very good to change the medication that often. I think it is important to give the body enough time to get used to them. I don't think it would be a very good idea to take her off the meds completely. I think your d13 will turn into a nightmare that no one is going to be able to control. Take the time to consider that. My baby girl15 is a nightmare with no meds.

Having said that. I always keep you both in my thoughts... .

Ruby807

PS: Good luck in your meeting on monday! 

[Ruby807]

Dear lbj,

I just wanted to let you know that I have been fallowing every single one of your post and updates about your baby girl13 in residential treatment center, since my baby girl is on her way to an residential treatment center. I want to let you know that all the information you post here it is very important to me. Thank you!.

I also wanted to share a little bit about my experience. Baby girl15 was a complete nightmare when she didn't take any medications. After her second suicide attempt in October she was put in 5mg Abilify and 5 Lexapro, which was nothing... .then was slowly increased to 20mg Abilify and 20mg Lexapro. At the beginning she was always very sleepy and tired until her system got used to it, then she was fine with it. Unfortunately, every trip she too to Dominion Psychiatric Hospital (4 times in the past 9 months) they always tried to change her medications to Zolof (did nothing for her) Lamictil (gave her a horrible rash all over her face, very dangerous syndrome) and prozac (which made her extremely aggressive and out of control). Unfortunately like you mention before, sometimes out children do things to cause the medication not to work for example mine d15. She used to throw up several times a day, she smoked weed, she drank alcoholic beverages, and sometimes even snorted her pills when I didn't make sure to put them in her tongue and watched her swallow the pills. I don't think it is very good to change the medication that often. I think it is important to give the body enough time to get used to them. I don't think it would be a very good idea to take her off the meds completely. I think your d13 will turn into a nightmare that no one is going to be able to control. Take the time to consider that. My baby girl15 is a nightmare with no meds.

Having said that. I always keep you both in my thoughts... .

Ruby807

PS: Good luck in your meeting on monday. I also asked about the scan and neurofeed back to the Dr. and he said that some people are trying to get money from people by telling them this things work... .but there is no study to back that up. :-(

[qcarolr]

Ruby 807, I so hope that at the residential treatment center there will be a long term consistent staff to monitor you DD so she is allowed to adjust to her meds. This is such an individual thing, there are so many to choose from, and each person reacts in their own way. And it is so hard to control everything else going into a teenagers mouth (or nose!) that eliminates a true reading on how meds are doing. The contolled environment of the residential treatment center should help with this process.

How are things going for your Dd there?

qcr

[lbjnltx]

dear ruby,

thank you for your kind words and concern for my BPDd-13.

I also asked about the scan and neurofeed back to the Dr. and he said that some people are trying to get money from people by telling them this things work... .but there is no study to back that up. :-(

the Brain Spect Scan is only valuable if the results are read by a qualified doctor, the recommendations of the doctor for specialized therapy are followed by the patient, and the patient takes the recommended medications/supplements that target the specific areas of the brain that are over active or under reactive.

as with anything else... .knowledge is power and as with a BPD patient... .it is mostly up to them whether they comply and make the effort to help themselves.  ;p

lbjnltx

[lbjnltx]

thank you qcarol.  as always your kind support gives me a boost!

after getting the email from her individual therapist stating

she doesn't want to talk to you or me anymore.

i felt like writing her back "congratulations, my BPDd-13 has an emotional attachment to you and now you have been painted black.  how does it feel?" 

but alas I did not write that back to her. 

lbjnltx

[GameGirl]

thank you qcarol.  as always your kind support gives me a boost!

after getting the email from her individual therapist stating

she doesn't want to talk to you or me anymore.

i felt like writing her back "congratulations, my BPDd-13 has an emotional attachment to you and now you have been painted black.  how does it feel?"  

but alas I did not write that back to her.  

lbjnltx

I think that she knows that.  I work at an RTC for adolescents with drug problems and many have BPD tendencies.  We get painted black and white every day by our clients.  It is just part of the illnes, and it does show that they have actually attached to us, which is a good thing.  As for how she feels, I cannot speak for her, but I do not take it personally.  If you do, you can't help the client.  Personally, I think that you should let your child's therapist know how you are feeling, even if you feel like you are not being nice.  I always appreciate it and I get lots of negative feedback from parents, not because I or my facility are doing anything wrong, but because all of our kids come in during extreme crisis and it is a very stressful situation.  The more I know about what everyone is thinking and feeling, the more I can help the kid.  The more the parents know about where we are coming from, the more they can learn about what is going on in treatment.

Just an opinion from someone on the other side.  

[lbjnltx]

thanks gamegirl for your reply.

BPDd-13's individual therapist has not accepted that my d has BPD... .this is the first time they have seen any acting out behaviors from her... .perhaps now the individual therapist will begin to get a better understanding of my BPDd-13 and the driving force behind her past actions... .perhaps she will start to see how the pieces of the puzzle fit together.

lbjnltx

[GameGirl]

thanks gamegirl for your reply.

BPDd-13's individual therapist has not accepted that my d has BPD... .this is the first time they have seen any acting out behaviors from her... .perhaps now the individual therapist will begin to get a better understanding of my BPDd-13 and the driving force behind her past actions... .perhaps she will start to see how the pieces of the puzzle fit together.

lbjnltx

I do understand, but I can also see the therapists point of view.  I personally would be very hesitant to diagnose anything on Axis 2 in a child so young until I had definitively ruled out everything else because the personality is not yet fully formed at that age, so the whole notion that a child can have a personality disorder is really kind of iffy.  She could have all kinds of other things going on with her that are causing her to display the behaviors you are describing.  There could have been a head injury to the frontal lobes, it could be really bad ADHD or bipolar disorder.  Or it could be ODD.  That can later merge into a personality disorder but not neccesarily.    Kids can also have BPD traits and not have BPD.  There are just so many things at play, especially when you remove the child from the home environment.  Just like the therapist needs to be open about your opinion that your DD is definately BPD, you might want to be open about the treatment teams opinions too. 

Have you ever thought about the fact that you DD's acting out behaviors stopped when she left home? Maybe that could provide a clue to the puzzle.  Generally, my really BPD clients do not stop acting out when they enter treatment, they get worse within a week or so.  Their patterns of behavior  and relating to people are consistent across settings.  That is one of the hallmarks of a personality disorder.  That is not to say that you DD has a bad home by any means, please don't get the wrong impression, but 7 weeks is a long time to observe a kid and way too long for a 13 year old to be able to con people.

Anyway, my two cents is probably way overspent at this point.  Good luck with your situation.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[lbjnltx]

dear gamegirl,

yes, d13 has been dx w/odd, mdd, and emerging BPD.  complete psych evaluation done inpatient last year.  does she HAVE BPD ... .?  she has BPDtraits. 

BPDd-13 rarely shows her BPDtraits to anyone she has no emotional attachment to... .she doesn't rage at school, she doesn't rage at church, she only rages at me and dad. 

if you would, please go back and read my thread Life at my house, BPDd-13 going to residential treatment center.  you will get a more complete picture of the situation... .then give me more feedback after you have read... .does anything give you some clues about what is happening w/my BPDd-13... .especially the psychotic features?  your input would be greatly appreciated.

Anyway, my two cents is probably way overspent at this point.

i can use all the help I can get... .residential treatment center is very expensive and is coming out of my pocket... .two cents is a welcome donation 

lbjnltx

[GameGirl]

dear gamegirl,

yes, d13 has been dx w/odd, mdd, and emerging BPD.  complete psych evaluation done inpatient last year.  does she HAVE BPD ... .?  she has BPDtraits. 

BPDd-13 rarely shows her BPDtraits to anyone she has no emotional attachment to... .she doesn't rage at school, she doesn't rage at church, she only rages at me and dad. 

if you would, please go back and read my thread Life at my house, BPDd-13 going to residential treatment center.  you will get a more complete picture of the situation... .then give me more feedback after you have read... .does anything give you some clues about what is happening w/my BPDd-13... .especially the psychotic features?  your input would be greatly appreciated.

Anyway, my two cents is probably way overspent at this point.

i can use all the help I can get... .residential treatment center is very expensive and is coming out of my pocket... .two cents is a welcome donation 

lbjnltx

I did read them, and the things she is describing hearing could be from anxiety.  Like when a person feels as if they are hearing a radio on low volume etc.  That is not psychosis.  Gneraly people hearing vpices are hearing real voices telling them to hurt themselves or other very scary things.  This does not seem to be what you DD is describing.  But, I don't think she is neccesarily making it up.  As for the RTC not reading the other evaluation - I am sure they did read it.  I have kids who come in with 3 or 4 evalautions.  But we need to evaluate them independently because we have no idea who the other person or facility was.  Not to do so would be not giving the client the best treatment.  We take into account what has already been said, but we go based on what we see.  If she has rage issues, Abilify is not a bad choice.  The thing that I find most striking is that this behavior is only occuring with family.  Generally, a kd with problems will act out across the settngs. 

Was there a specific point in time when all this started?  Could there have been some type of trauma that you might not know about?  Has she ever taken a blow to the front of the head?  If so, have you ever had an MRI done?  Sometimes hearing voices can be a part of a brain injury.

I know that you are religious, but how does she feel about it?  Could it be that she might not view spirituality the way that you do and this is causing her conflict?  Would this be a problem for you if she told you that she did?  I am just throwing this out there, but could she be realizing that she is gay and afraid to tell you?  We recently had this issue with a 14 year old girl from a strict Mormon family.  She was starving herself and picking her skin because she was so afraid of her parents reaction.  I am sure this is not the case with your daughter, just throwing it out there.  Also, what if she stayed emo but did not act out?  Would you be ok with that?  How much room are you willing to give her to be herself?

Off the top of my head, it sounds like intermittent explosive disorder to me, and like she really has something she is ashamed of that is on her heart.  Also, do you know for a fact that her therapist knows nothing about BPD or are you assuming this based on your interactions with her?  There is no way a therapist can work at an RTC for girls and not have BPD clients or clients with BPD traits.  You have one.  We have up to 40 at a time.  It gives a person a sloghtly different perspective.  It sounds like the T has done all the right things, involving the clinical director, seeking adivice from another therapist etc.

Also understand that the T was not upset or more cool to you because of your conversation with the clinical director.  This is what we do.  It is our life every day.  It is not personal for us.  We deal with sick kids and their parents.  Parents can get very insistent about what they think is up with their kids.   We try to listen and understand even if we are seeing something different.  Clinical directors do not go after therapists because their is a disagreement with a parent.  Mine justs talks it over and comes up with a new game plan.  No big deal.

Please take this in the spirit it is intended.  Falcon Ridge Ranch is a great facility.  Maybe you need to take a step back and let them do their job.  The primary mode of treatment at any RTC is the group therapy and the peer culture.  That is what your child will derive the most benefit from.  I would not worry so much about what the individual T thinks she has, buit rather what the treatment plan is.   And from what you have described, it sounds pretty good to me.  However, this is a purely personal, not professional opinion. 

[lbjnltx]

dear gamegirl,

did read them, and the things she is describing hearing could be from anxiety

   BPDd-13 has not shown any signs of anxiety... .according to any therapist she has had in the past or present.  what are some signs of anxiety that would indicate anxiety.

Generally people hearing voices are hearing real voices telling them to hurt themselves or other very scary things.

she did tell one mhmr worker that the voices were telling her to "just do it"... .when I asked "do what"  the mhmr worker replied "what ever!" 

The thing that I find most striking is that this behavior is only occurring with family.  Generally, a kid with problems will act out across the settings. 

  at school she has hit 2 different kids in the face but the "rage" only happens w/me and my husband... .since BPD is a disorder that manifests itself mostly in interpersonal relationships I can understand why we are the only ones who get the "rage". 

Was there a specific point in time when all this started?

  4th grade... .dx w/odd.  a really bad school year w/alot of homework that went on far too long before we pulled her out.

Could there have been some type of trauma that you might not know about?

  good question.  it is always possible.  I have talked w/her therapist at the residential treatment center about this possibility.  she says that eventually it will come out if she was sexually abused. 

[quoteHas she ever taken a blow to the front of the head? ][/quote]
yes, twice as a toddler.  both times she was taken to the er and examined.  the pat reply... .she is fine.  she seems ok.  she never lost consciousness, has not vomiting.  her vision is ok... .would an injury from age 1.5 to 2.5 not show up until age 11?

[quote I know that you are religious, but how does she feel about it?  Could it be that she might not view spirituality the way that you do and this is causing her conflict? [/quote]
  we have not forced her to go to church or youth group.  we would ask her to go and encourage her to go but never forced her to go or punished her for not going.  she was asked to work in the nursery with the 3=4 year olds one sunday and has wanted to continue doing that for almost 8 months... .she began going during the sunday school hour as well since easter.  she really enjoys it a great deal... .it is up to her.  she sends mixed messages about her spirituality.  obviously since she is into some demonic stuff and has tried satanic worship she has some different ideas about spirituality.  we have been very careful not to cross the line into spiritual abuse.

Would you be ok with that?  How much room are you willing to give her to be herself?

the whole emo way of thinking and acting is unhealthy... .leads to more unhealthy behaviors.  we have been very careful to not be "controlling" while also limiting behaviors that are self destructive as much as is possible... .it's a no win situation for us!  ;p

Off the top of my head, it sounds like intermittent explosive disorder to me, and like she really has something she is ashamed of that is on her heart.

  pdoc at residential treatment center, from having her rages described to him by me said the same thing.  ied, however through my research into ied it sounds like that is only dx if the criteria for other disorders is not met,  also highly comorbid w/personality disorders... .like BPD.

Also, do you know for a fact that her therapist knows nothing about BPD or are you assuming this based on your interactions with her?

yes, therapist says she has worked w/a few clients w/BPD but not many and is doing some research to learn more.  she often asks me to send her articles that she thinks may help her.  I have made it clear to therapist that the accomplishments made w/my d are nothing short of miraculous and we are very pleased w/her progress.  they are doing a great job w/her regardless of their lack of knowledge or absence of a dx.

[quoteMaybe you need to take a step back and let them do their job.][/quote]
  to the best of my knowledge I have in no way impeded them from doing their job.  I can only answer questions as honestly as I am able to help them put the pieces of the puzzle together to help them.  we were supposed to have a written treatment plan at the 30 day mark.  it has been almost 2 months and they still don't have one because they are still not sure what they are dealing with. 

The primary mode of treatment at any RTC is the group therapy and the peer culture.

  I have high hopes for this as well.  according to the Positive Peer Culture leader she is still not opening up much or being honest w/her peers.  we will just have to wait and see.

Please take this in the spirit it is intended.  Falcon Ridge Ranch is a great facility.

yes, frr is a great facility... .we are pleased with what is happening so far.  I truly believe this is the place that will help my BPDd-13.  and I thank you for taking the time to read and post.  your input is valuable not just as a worker at an residential treatment center but also as a person w/personal experience w/BPD.

thanks so much!  look forward to hearing back from you again.

lbjnltx

[GameGirl]

It sounds like you are doing all the right things.  Concerning the voices - is she hearing them in her head or does it sound like someone in the room is talking to her like you or I would?  That is an important question to ask her.  Two other theorists that I think are really useful are Murray Bowen and Virginia Satir.  They deal more with family dynamics, but they also might help you to put some pieces of the puzzle together.

[lbjnltx]

thanks gamegirl,

i expect to hear from her therapist sometime today or tomorrow and will ask her to ask my BPDd-13 about where the voices seem to be coming from when the subject comes up again.  I just hope that it doesn't take very long for my BPDd-13 to mend her relationship w/t.

will also google the theorists you posted about and glean what I am able.

you didn't answer my ? about head trauma not manifesting until years later... .is this normal?  therapist had asked us to consider sending BPDd-13 to amen clinic for spect scan... .haven't totally ruled it out (i would probably take her to the clements clinic instead of dr. amen... .same thing w/more emphasis on aftercare) as she has said the same thing about head trauma causing auditory hallucinations. 

it is so hard to know what to do... .financial resources are all committed to keeping BPDd-13 at falcon ridge for at least 9 months.  spect scans run 3,700.   just trying to figure out what to do to best help BPDd-13.  therapist said they have taken other girls to amen clinic in the past.  does the residential treatment center you work for do this as well?  has it  made in difference in helping the client?

lbjnltx

[ingridp]

Hi lbjnltx -

When my S was about 6mo, his cousin (1yo), tipped him out of a box, around 1m off the ground, onto his head, and when he was a toddler, he ran, rather than walked, so had a permanent bruise on his forehead. In the latest talks with his t, she suggested getting an MRI to make sure that there was no frontal lobe damage. He was diagnosed with ADHD + impulsivity very young (5yo), as well as numerous learning difficulties, so she may have something there. He's also done the normal boy things such as falling out of trees, fallling off his bike, etc. ;p

I haven't got around to arranging anything yet because of finances and he's very resistant to the idea - maybe scared of the outcome.  ?

You are doing such a superb job! 

With love

 

Ingrid

[lbjnltx]

dear ingridp,

how does the therapist expect having the information from the mri is going to be helpful to  your son?  what about his treatment or meds might change if the mri comes back showing frontal lobe damage?

in a nut shell... .what difference will this information make?

lbjnltx

[snooky77]

Dear lbjnltx, I have been following your threats on your experiences having your 13 year old daughter in RTC. Our troubles with our daughter (who is now 20) started when she was 13 years and 7 months. After a miserable year (2004) with many psychiatric hospitalizations, cutting, threats of suicide, creating chaos in out home, ODD, an eating disorder etc, etc our daughter was going to be court ordered to RTC. We agreed and so we did not actually have to go to court. She was there for 9 months. Leading up to placement in a RTC, the meds that they put her on in 2004 only made her problems and acting out worse. Prozac made her aggressive and the cutting was out of control. The RTC was a God send and really, really helped!  I would encourage you to hang in there and trust that the RTC knows what they are doing. The thing that was the hardest for me was the fact that we are good parents, we were raising our kids in a loving Christian home and we had done nothing to deserve the utter rage and defiance that we were getting from her. Add that to a lot of slicing on her body and her inability to cope with school and life in a family with 5 children close in age and you get a recipe for disaster. It felt like we were under satanic attack through our daughter. (I believe we were). With her psychiatric hospitalizations they always started with family therapy (the theory being that the child must come from some sort of dysfunction in the family to be acting like this). Family therapy sucked because the goal was always to throw someone under the bus. Mothers are easy targets. When I would point out that my 4 other children were doing well in school and in their lives it was not well received. At least the RTC didn't try to blame the parents as the entire problem. I had some of the same questions as you have. How come this child is hell on wheels at home and at the RTC is the best behaved one of the bunch? What is it about our home that would allow 4 kids to thrive and one to circle the drain? I know that it was difficult for her growing up with 3 older over achiever siblings but what was I supposed to do about it?  My daugher is now 20 and doing well.  I do believe that she has problems with emotional regulation. She does split people black and white and gets dysregulated, but so does my oldest daughter and she is in her 3rd year of med school.  Her main issue these days is anxiety. She actually applied for and got SSI disability. She lives on her own and is doing well. She goes to a local community college and though she is not very motivated she does get mostly A's when she chooses to take a class. There is a recent post about some advice from someones boss about accepting your child on their terms. I find that when I cut her as much slack as I possibly can and try to be as validating as possible, thing go much better between us. You have a long road ahead of you since your daughter is so young. It will get better. It still blows me away that a home environment that I saw as loving and appropriate could have been so invalidating for one of my children. Be extra kind to yourself and your husband. Keep your marriage strong and pray for the best. Snooky

[GameGirl]

dear ingridp,

how does the therapist expect having the information from the mri is going to be helpful to  your son?  what about his treatment or meds might change if the mri comes back showing frontal lobe damage?

in a nut shell... .what difference will this information make?

lbjnltx

Hey LB


This would be my qestion to the therapist.  Why not just send her to a neurolgist first instead of a very exonsive clinic for a very exonsive procedure?  What would the ultimate difference in treatment be?