Tuesday, July 10, 2012

Intensive Day One

We got into Philly late last night- much later than we planned. I immediately gave Hope her meds. I told both girls to get PJs on. Hope told me she was watching TV. I said it was to late- Pjs. Hope was off and attacking. I was caught by surprise and she did quite a bit of damage to the left side of my body before I had her safely restrained. I couldn't stop her from screeching  at the top of her lungs. Not good at 11 o'clock at night in a motel in an unfamiliar city. I was expecting police to knock on my door because it sounded like someone was killing her. When the Dad finally came in the room (5 minutes? 10 minutes? 30 minutes later?) I was in real pain and angry that again I had Hope by myself  when she went off and I hurt. I vented to my Trauma Mamas and had a hard time sleeping. I think both the pain and stress both contributed to my bad night. I ended up getting a little less than three hours of sleep.

We were right on time for our appointment this morning, despite Hope resisting. The first hour plus, Hope drew in the other room while the AT worked with us. I had a lot to say. I told her I was tired of being hurt and it could not happen anymore. She agreed with me. I told her if the Dad worked after the mornings session Hope would not comply and again she agreed with me. The Dad agreed to work after Hope was in bed for the night. Hope is now asleep and The Dad is working.

The AT explained what was going to happen the rest of the session. It was purely behavioral. The AT said she would teach Hope to do jumping jacks and toe touches "her" way. After she was sure Hope had mastered them, she would explain the new rules to Hope. The new rules were really only one rule- Hope has to ask The Dad or I for everything. Ask to sit down, ask to get up, ask for a drink, ask to put on shoes. If she forgets to ask, we tell her how many jumping jacks or toes touches we want. The rules are
  1. Stand at attention
  2. Ask for permission to start in a respectful voice
  3. Use proper form
  4. Count each one
  5. Maintain eye contact
Afterwards, we are to ask her why she had to do them. If she doesn't know, we just tell her.
If she tries to do what we ask, but misses a step, we are to tell her that was a good try but she missed something and ask her if she knows what she missed. She then has to start over again.

If at any point she refuses, or has attitude, she has to sloppy sit until she is ready to do it correctly. If she refuses to sit by herself, we have to help her. That is called a takedown (looks just like a restraint to me). She shows us by using her body when she is ready to comply by changing from a sloppy sit to strong sitting. When she does, we say "It looks like you are ready to do your jumping jacks" and give her another chance to do them. When they are (finally) done correctly, we smile and say good job and life moves on. Wash, rinse, repeat.

The AT said it was going to be a long hard battle with Hope and that she was a really difficult kid already. She said she knew this even before she had to do a takedown because from the very beginning, Hope had an internal battle that could be seen on her face as the AT was teaching her what was expected. Even when Hope complied, it was obviously costing her a great deal of energy to comply.

We went back to the hotel to practice. Hope hated every second of having to ask for everything and do jumping jacks when she "forgot", She had three major meltdowns this afternoon, each one worse than the previous one. She was asleep by 7:30.

Tomorrow is a full day session with just The Dad and I. We are already exhausted.


stellarparenting.com said...

love you, you can do this, I can do this, you can do this, we are not alone.

Angela :-) said...

Love you, my dear!

Angela :-)

Sarah said...

Oh my gosh. That is so exhausting to read, and I feel that she is asking SO much of you! However, I truly believe that if *anyone* can do it, you can! *hugs* and know that I am thinking about you!!

Barb G said...

Love you, my friend. Praying this makes a difference for all of you. (((hug)))

Lori said...

I've been reading your blog for over a year. I don't think I've commented before. I want to wish you luck though. Hang in there. I cannot imagine what must be happening inside Hope's head, and heart, but you are amazing for trying to help her through this. Best with for you, The Dad, Hope, GB, and the rest of your family.

Diane Dawson said...

Wow. So intense. What is the theory behind this? I'm no trauma mama, I admit. But it seems so much like punishment to me, to ask her to do jumping jacks when she won't comply. Am I missing something? Why would this make her attach to you?

Mama Drama Times Two said...

Oh my stars...praying for some serious strength for you and Joe as you work through this...I agree - if anyone can do it,you can. hugs

TheLazyJ said...

Saying a prayer for all of you. Hang in there!

Joy said...

Just wanted to say a huge thank you for taking the time to post about all of your experiences! I am a psychiatry resident training to do child psychiatry and so appreciate your sharing your experiences and insights, for giving me insight into how incredibly difficult it is to live with children like this, how incredibly dedicated and hard-working parents like you are, and what the techniques are that work and don't work.

TwisterB said...

You can do it!

Patti said...

Sounds like alot of work for you!! But it will be so worth it if things get better :)

Anonymous said...

AHHH, compliance training. I am so happy for you- NOTHING gets accomplished without a child's compliance and not enough therapy in my area capitalizes on that fact. God bless and give you strength for the day.

Jennie said...

so hard! ((((((((((((HUGS))))))))))

Amy said...

Diane, the jj are for a few reasons. First, getting blood pumping to the brain! Physical activity is SO good for everyone. It shows the level of compliance the child is capable of at any given moment depending on how they choose to do them. Sloppy ones mean they are not following direction well and are not very teachable right then. They also "cost" the child something for their behaviors. Sort of like a deterrent. If I choose to be defiant or do thing my MY way instead of my parents way I may wind up doing jj and I may not feel like doing them. It's a long long road and we have been on it for a long time. Jumping Jacks are rarely seen at our house anymore but we're 2 years into AT.

I'm so so glad you are doing this for you and for Hope. Hang in there. It won't be easy. Any of it.

Gledwood said...

You say she's 7 years old with psychotic bipolar? That must be hard to deal with to say the least. God bless you :-)

Anonymous said...

Dr. Alan Sroufe, a researcher in attachment issues and William Harris professor of child psychiatry at the University of Minnesota, has serious doubts.

"Attachment therapy is about building a relationship with a child in which he can feel comfortable and secure, safe to express any feelings they might have. I don't know how holding a child down while he struggles mightily before capitulating to adult authority serves that end."

Nor does Sroufe understand how attachment therapists can claim their standard two-week therapy--which typically costs $7,000 and includes treatments such as "inner child work," psychodrama, corrective parenting (parents are involved too), eye movement therapy and cognitive restructuring--makes a significant difference.

"There are no quick fixes" to attachment problems, he said.


Diane Dawson said...

It is so clear to me how much love you have for Hope and how committed you are to her. This is so brutally hard for all of you.

I loved reading about Day 4 and the breakthrough moments.

Still can't wrap my head around the jumping jacks though. Sure, it gets blood pumping to the brain. And resentment. And fear of retribution if you don't do it right - I would imagine. It seems so punitive. I would have hated the the person who made me do them.