adoption, mental illness

Where There is Hope: Psychiatric Service Dogs

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“I don’t think I can be safe at home.” These were the heartbreaking words of my 10-year-old daughter. Overhead florescent lighting blinked in and out, highlighted her face as she stared dejectedly at the linoleum floor.  We were spending yet another night in the emergency department at the local children’s hospital. A clinician was determining if we were safe to go home. We weren’t. Mary would need another inpatient stay in the children’s psychiatric unit. The questioning always goes something like this:

“Why aren’t you safe at home?”

“I throw things, I hit things, I run away. I’m afraid I will hurt Mommy.”

“Why do you think you will hurt Mommy?”

“I don’t know.”

“Do you remember what happened tonight?”

“No.”

“Do you usually remember what happens?”

“No. When I get scared I don’t remember. I get really mad and scared.”

So she was admitted for her fifth inpatient stay this year. Luke and I answer the same questions every time. Yes, she has an amazing trauma therapist. Mary has completed TF-CBT (Trauma-Focused Cognitive Behavioral therapy.) It was a huge success. It erased her specific, most intense, trauma triggers. Her therapist is always available by phone if we need her. My husband and I work with her partner to better our trauma parenting super-powers.

Mary has also had many, many other therapies. Partial Hospitalization, Intensive Outpatient Treatment, talk therapy, family systems therapy, art therapy, OT and many more. She has a sensory diet, we parent therapeutically, and we now have intensive in-home services. She is taking a multitude of medications because the one that worked, stopped working when she began puberty. Now she is having intense flashbacks and short periods of psychosis. She runs away from an unseen enemy into the woods or onto a road.  Mary has scabs all over her scalp where she’s picked off the skin in anxiety.

Right now she craves my attention with ferocity. She needs attention, she must have attention, she is terrified of losing the love that she has found. So we make art projects. We cuddle. We play endless board games together which she mostly lets me win! She tells me, “Mommy? I wish we could love each other more than any other type of people.”

But human relationships are tricky. They have nuances, and nonverbal cues, and require space at times. Mary cannot navigate these tricky things. Is Mom happy with her? Mad? About to abandon her forever? At times, Mary honestly cannot tell. She will alternate between being my shadow and then kicking me away or screaming at me for being a “Skank a** be-otch (sp?)”  I have, in fact, checked my rear end in the mirror. I assure you that I found not a trace of skank!

If primary caregiver relationships are so hard, might there be another way? If we cannot keep her safe at home, is there another way? If fear hijacks her brain so often that she blacks out, is there a way to help? There is. I just don’t like it. She may be safer at a short term residential facility. Or a long term clinical facility focused on trauma. I hate this way down into my very bones. The thought of not tucking my daughter in at night leaves me in a cold sweat.

So I found another way. Because that’s what parents do. We find a way. Maybe I can’t catch the onset of her panic attacks in time to “ground” her. She never knows when one will hit. We are often scrambling to pull her back from the memories of trauma and into the here-and-now. Psychiatric service dogs are trained to alert their human before the panic attack/dissociation occurs. We don’t know when she has intense nightmares, so we can’t wake her for deep-pressure calming techniques. But a service dog would. I can’t run after her when she bolts into potentially dangerous places where she may get lost. I’m not as fast. But a service dog is.

Enter “Blue.” After seeking a service animal large enough to help Mary, we found Blue. We were just plain lucky to stumble across this perfect dog. Right now Blue lives in Tennessee. She has a few more weeks to train while hanging out with Mary’s dirty clothes (to get used to the scent. Hopefully she doesn’t pass out from the socks!) A psychiatric service dog has to be trained specifically for the person they are working with. Enter an amazing trainer in Connecticut who is ready to privately train us all, humans and dog alike. Let’s face it, we all have a lot to learn. This trainer had a child who died years ago. She was touched by our story. In order to keep our family together, she is willing to provide Blue’s “finishing” privately. For free.

With Mother’s day coming up, I want what every mother wants. I want what is best for my child. So, Blue? I’m counting on you! Keep my daughter home with us. Keep her safe. Please. That is what I want for Mother’s day.

 

*If you like this post you can vote for it at https://fulltimetired.com/roundup/

**Names have been changed to protect the privacy of those involved. Except for Blue the dog. She should be famous for all of the hard work and bonding she’s about to do!

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family, mental illness

She’s Back! : Transitioning Home From Inpatient

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She’s back! In true to Mary fashion she is as stylish as ever. Ever the dramatic celebrity-in-training, she bursts through the door shouting, “I’m here!” Photos are snapped, even though Dad and Mom are a poor substitute for real paparazzi.

She bounds up the stairs, two at time. “I’m coming for you, Mama! I’m here!!!” She has promised me during our last phone chat that I may squish her and kiss her and squeeze her for 60 full seconds. Luke feigns starting his iPhone timer and I attack! I hug and I squish and kiss her cheeks and her head and her hands and even her stinky little feet. My Mary is home!!! She rolls her eyes in mock annoyance but then offers me another full minute, “if I need it.” I do.

I look into her eyes and it’s all I need to see that Mary is back, really back, mentally and physically. I don’t mean that she is “cured.” Not by a long shot.There is no such thing. What I mean is that she is stable and safe. She has switched over to a new medication altogether, and she should be at the therapeutic dose. She’s had a lot of therapy.

She is ready to be home with us. I am choking back tears looking at my daughter’s face after 2 weeks away from us. After all the medication adjustments, the family therapy sessions (I had to FaceTime in), all the paperwork, our family is together again.

This is my chance to shower her with all the love and delight she deserves. She immediately sets about showing me all of the work she’s completed at the hospital. She got school work, and an anger thermometer with coping skills. She’s made these type of rating scales a million times over the last several years. She really wants to show me how ready she is to be here. I am so proud of her that I say it in 3 different voices and burst into spontaneous, ridiculous song. She beams

The next day is Saturday, and she begins the day with her trauma therapist. (Bless this amazing therapist for seeing my child on Saturdays!!!) Everyone is ready for her routine to resume. Her Partial Hospitalization afternoon program will resume on Monday. Her school is ready and notified, and we’ve had a meeting to discuss a safety plan  (if necessary.)

She spends the weekend cuddling me, cuddling her dad, and attempting some “team work” with Carl. He is pretty upset that she is home. Not because he doesn’t love his sister. It’s just hard to share the attention again. It triggers his fear that their won’t be enough love to go around. That his caregivers might get so caught up in Mary we leave him in dire straits.

You don’t have to be perfect, honey. Just be here. Be my Mary.

**Names have been changed to protect the privacy of those involved.

 

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mental illness, parenting

Having a Child With Mental Ilness: Adventures in Living on a Prayer 

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I love this little girl all the way down to her little pinky toe. I love her to the moon and back. I love her like a jelly bean at Easter. These are the things I have to say to her over the phone. So far away. “I miss you major,” I tell her.

Unfortunately Mary is back at the inpatient unit in the psychiatric hospital.She only made it home for about a week. I am just home from 5 days in the hospital after having spinal fusion surgery. We had a few days together before it just got to be too much for her.

Maybe my surgery was a huge trigger. Maybe the onset of puberty is like a freight train running us all over. Maybe her medication just isn’t there yet. There are so many pieces to this complicated puzzle, that is part of our daughter.

Mary slept over at a friend’s house one night and told her friend’s mother she was too scared to sleep upstairs. She claimed she could see her biological parents waiting for her up there. Her visual delusions have been increasing.

Friday at school she had an outburst, yelling at a girl who was absent (presumably for being absent.) After school she has another tantrum at her Partial Hospitalization Program. She was screaming and kicking and generally unsafe.

When calm, Mary was able to tell them she hears more voices than she admits to anyone. The voices tell her to kill me and she is afraid of them. She has drawn and written a lot more about my death lately. She is so afraid her mommy will die. After all, her biological mother left. I am sure these are all fears pertaining to her trauma that are flooding back now to take control of Mary.

Over the weekend, she had another melt-down. Papa wouldn’t let her touch something dangerous in his workshop, she was defiant. When he raised his voice and repeated his direction, she lost control. She ran out of the house to the road. She wasn’t wearing shoes or a coat and it was winter. 

My husband was able to pick her up and bring her home.  I was locked in my room, my parents had Carl, and Luke was keeping Mary safe.I Face Timed her from my locked room to talk her down, and try our deep breathing together. Luke was able to give her a PRN to calm her. She fell asleep in her room still adamant that nothing was wrong and she didn’t need to wear shoes. Ever.

As Mary slept, the crisis worker gave us a safety evaluation. We reviewed the safety plan we had with him.  We explained why we locked up our knives, removed  sharps from her room, and activated the locked door plan when she was triggered. He looked at us for a long time, silently, and then asked us if we felt safe. Not, “Do you feel safe with the plan?” But just, “Do you feel safe?” 

The answer is no. We mulled it over until the next day, but truthfully, we weren’t safe. Mary has not been physically violent or disassociating since 2014. Her medication isn’t working anymore. Therapy is an ongoing process, but without the right medication, she is trapped inside this cycle. We made the decision to send her back to the inpatient  unit while her new medication continued to be titrated. We will not take chances with her safety. We cannot take chances with mine. This is nonnegotiable.

All of this happened as I lied helpless in bed. I felt like we were suddenly back in 2014, watching her fall apart all over again. To be honest, I felt a bit defeated. She’s had ups and downs but she hasn’t had these kind of meltdowns in years. She’s been living a relatively normal life (albeit with a the help of medication and therapy.) It’s very hard for me to admit that things have been spiraling with her for a short while now. It’s just that she’s overcome so much. She’s living such a full and happy childhood. For the last few years she’s been so in control of her moods.

As I hobble around in my walker, or lie prone in my bed, I get a sense of helplessness. I need to recover. I need to be strong enough to be the mom she needs. Lying helpless in bed behind a locked door is all I can physically do for now. So here is where I pray.

“Please,” my prayer starts, “Please let the medication help her. Please don’t send us back to the starting line. And please, please, let me be strong enough to be the mom she needs.”

**Names have been changed to protect the privacy of those involved

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