Monday, July 1, 2013

A New Therapeutic Approach for My Son

After my son’s last episode, we were fortunate to see his therapist the following day. After looking at the situation with a fresh pair of eyes, our therapist recognized a pattern with our son’s behavior. She explained that he’s easily triggered by situations and as a result, his limbic system is turned on, thus the fight-or-flight response we see activated in his body.

For our son, he typically goes to the “fight” reaction. She explained that once this system is turned on, there is no turning back and all of our previous efforts to de-escalate, such as telling him to take a walk, or take a shower or when younger, his time outs, are all seen through his limbic system as threats.

As a result, he responds by fighting for his life. Which is why he tends to become violent and fight against us. Our therapist explained that over the years, his response has formed neural pathways in his brain, causing him to go this direction more easily and with smaller triggers. So with a little brainstorming she advised us to try a new approach.

Instead of offering him ways to calm down, or worse, removing him from the home when he escalates, we should instead come together and show him that we’re on his team, hoping to disengage his limbic system from revving up. The important part is to not appear afraid of him or go into protection mode over the other kids, because this too will further engage his “fight” response in his brain. Easier said than done.

I find this technique interesting because it does make sense logically, but I know that it won’t be easy for me because I too have formed neural pathways in my brain to go into the “protection mode” whenever my son becomes threatening. So for me to respond in a way that is nurturing and supportive when I feel threatened and scared will be going against my instincts. The same goes for his siblings. How will they avoid running and hiding and instead surround him with support when they themselves feel unsafe? Unfortunately at this point, I don’t think I can change my son’s reactions, only the environment around him, which means we have to change. Our hope is that in time our son’s neural pathways will change and his response will be less threatening.

I’ll let you know how this goes...

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I want to sincerely thank everyone who reached out to me after my last post. I think I cried through most of your comments and emails, it was very theraputic for me. I also appreciate those close to me who have offered their support and willingness to show up at my house whenever I need it. I am blessed to have you all in my life.


14 comments:

  1. It is lovely that the therapist thinks remaining close by and loving to a kid who is extremely violent (and getting bigger by the day) is the way to head off a rage... but please, please be careful. As a mom, your job is to keep all your kids safe and I'm certain as to how one would do that by remaining physically close to an out of control aggressive, in the process of trying to hurt you kid.

    Also, does this sort of rage happen often? What are the triggers and can they be avoided? Because otherwise I fear for your sons classmates.

    (Full disclosure: my 4th grade daughter's very best was B, a little boy who'd been her classmate since kindy who just happened to have a mood disorder... until he cut her with a protractor badly enough to require six stitches. He's a sweet kid, had a truly bad episode but I'd no choice but to switch my kid to a different class and ban B from my house. B is devastated, B's mom is beyond devastated, my daughter is devastated but I flat-out refuse to let her assailant into my home. Get help before your kid hurts somebody else's.

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    1. I understand your concern. No my son does not act out in school, he holds it together until he is home. This is a common trait with kids who have mood disorders. In school he withdraws and is typically bullied by other kids.

      We are getting as much help as possible. Thanks to his medication and years of therapy, these outburst are rare now. Unfortunately most triggers can't be avoided. The ones that can be are avoided, this is why we are isolated a lot.

      Our goal is to get him calm before he is dangerous. My body is just sensitive to the smallest changes in his moods that I can sense a rage before it comes, thus my fear. (maybe something only a mom who is going through this can understand) I would never allow my younger kids to be at risk in doing this, if I feel he is too escalated, I will keep the kids safe at all costs. The therapeutic approach mentioned above is addressing the situation very early on, not when he is "extremely dangerous".

      I can appreciate the fear you have about kids like mine, particularly after what you experienced with your daughter and the classmate that hurt her. It must have been devastating for all involved.

      I promise you, we are getting all the help we can for our son.

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    2. I'm praying for you and your kids. My heart goes out to you -- it's got to be so so so tough.

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    3. Thank you SallieKaye, I appreciate it.

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  2. Hi Mama Bear -
    I am very apprehensive about this new way of dealing with your son's rages. My 11 year old would never agree to do this for my 9 year old when he is acting "crazy". My older son is very resentful of the situation he is in and would be very angry to be asked to put himself into a dangerous (physically and emotionally) situation. As for myself and my husband, I honestly don't know if I would fully be able to trust that either of us would be able to remain calm and supportive through thick and thin. What if one of us would snap?
    I know I sound negative now, but I actually do hope that this works for you - Maybe it's that we've tried so many techniques that at this point, I am not so optimistic about new ones.
    Good luck! And stay safe

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    1. I hear you Shamama, I too don't know if this is going to work and if we are even able to do it. I am willing to try, but if it doesn't work, we won't stick with it. I do remember having a follower share with me that she had a lot of success whenever her son appeared to get agitated and elevate to go the opposite direction and calmly ask, “what do you need from me—how can I help you?“ I hope we see the same result.

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    2. Also, I might add, at this point I don't plan to bring the other kids into the situation, I am hoping to de-escalate on my own.

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  3. I'm glad that your kids won't be involved at this point. I think a lot about how "unfair" it is to my older son to have so much attention put on his younger brother. He sees his brother throwing things at me, he basically is watching me be abused. We sent my older son to sleep away camp for July, and I think he really needed a break from his brother. I want to protect each of them without neglecting the other one. A good friend of mine told me that when she was younger she was so embarrassed by her brother who has significant developmental delays. It is only as an adult that she has enough confidence and maturity to accept him and be proud of him. I can't expect my 11 year old to be as mature as an adult, or to be able to deal with things like this in a different way than he is currently capable of. Right now he either locks himself in his bedroom or goes to a neighbor's house. He is miserable during these episodes and I don't blame him. (so am I)

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    1. You share some very valid points, we do need to protect the siblings so they can thrive under the circumstances.

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  4. I highly agree with the therapist on this. We have the best success when we are on the side of our son even when he is really acting out. That said, you will still have to put a boundary on it (as I'm sure you know). There are times when the only way I can deescalate my son is by saying I love him and I want to help him but enough is enough already and if he cannot get in under control he is going to have to go to the hospital via the police. And we have had to call the police and have him taken to the hospital. The point being that you are always on your son's side but he cannot put you and your family in too much danger or he will have to go a safer place. If he cannot calm himself down after 10 minutes or so, he needs to be in the hospital or take a prn (which usually they won't do if they are that our of control).
    Hugs, Meg

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    1. Thanks Meg, I remember hearing about this approach first from you, I’ve just never been good at doing it and would forget what you advised in the moment. Recently, I have had the chance to try this approach once and it worked. It took a long time and a lot of my patience, but we got there.

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  5. I also agree with this approach. We've been using something similar, (and with what seems to be the right medication)things have vastly improved. It does take some balancing between being over indulgent and setting boundaries--the system started working for us best when we set up a tiered "discipline" approach that had the supportive stuff at the front end to try and diffuse the situation, and call the police at the back end if it escalated out of control. I have noticed that when my son rages it looks like he's fighting for his life, even if the trigger was something minor. So this makes a lot of sense.

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    1. So far, we are seeing success with it! Thank goodness!

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