Evening. Background:
I'm a 35 year old father of four. I met my wife and our oldest child in 2001, when said child was 11 months old. There was a Social Services involvement, but ultimately we proved we were a solid family and she was eventually fully adopted. Between then and now we had a further three children; at present day the eldest is 14, the other children are 4, 6 and 7.
Today I'm a carer for my wife, who suffers with psychotic depression, hemiplegic migraines, stomach problems, contact dermatitis and fibromyalgia.
Issue in question
We noticed issues in the eldest from the age of 3, when she'd smear her faeces on the wall and think it was an awful lot of fun. Shortly after, while her mother was in hospital being treated for gall stone pain, she emptied a bag of flour into the kitchen sink at 3am and turned the taps on, causing a near flood of the downstairs. She deliberately raged at her mother and swore at her. We requested help from medical professionals but none was forthcoming. School at the time insisted she would catch up despite the fact that she was learning at an age several years beneath her. Only when we moved to a different borough was she correctly assessed as having learning difficulties and placed in a special needs branch of a local school, shortly followed by a special needs secondary school (age 11+).
Recent times:
Since then she has become vicious, underhanded and violent. She steals money and food when she can despite having meals and treats prepared for her. She becomes verbally aggressive when asked to do something she doesn't want to do (ie put something away), and violently aggressive when it's insisted upon. A year ago she absconded from the locally-funded transport from school. Around the same time, she ran away from school into a local town centre.
9 months ago she claimed that while she had run from school, she was raped. She later admitted this was just for attention.
7 months ago she claimed that her mother dragged her out of bed by her hair, and her mother was taken along with her by police to the local childrens hospital to check her over. No signs of abuse were found.
4 weeks ago she attacked me, and my wife called the police who restrained her as they saw her throw a dining table bench at me. She was released back into our care after a few hours of calming down at the home of a family friend. She apologised and all.
Just over week ago she flipped out and threatened to kill us. We calmed her down, and the following day (Saturday) I took her and her sister to see a movie, went shopping, had a family dinner, watched Dr Who, etc.
The Monday after she claimed that I had dragged her upstairs by her hair and that it wasn't safe to go home. She stayed with my mother for a few days before Social Services agreed that her claims had no grounds and she should be placed back in our care. The eldest kicked up a fuss about this, but eventually calmed down and came home.
Today:
We had another almost issue today. She kicked off at me because she wanted to go back to her dance club (which she told me she didn't want to go to any more) and I explained that I'd have to talk to the class instructor first. She teased and then threatened her younger siblings, threw things around the living room, punched me repeatedly and swore at everyone there. I held my temper and asked her how her day was. Her mum offered her a cup of tea and... well the rage melted away and she burst into tears.
We have the answers, to a degree, to handling our eldest's behavior now and that's all well and good for my wife. But when my day involves getting up at the crack of dawn, feeding our multitude of pets, washing clothes, dishes, ironing, cooking for kids, taking kids to school, walking pets, cleaning, mopping and shopping often before my wife gets out of bed, I'm not sure how much patience I can muster. I often feel like a single parent to a multitude of people and I honestly don't know how I'm to get out of this situation. I love my wife and I love my kids and I feel suffocated by the pressure of it.
TL:DR my life is not what I wanted and I don't know how to fix it.
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You said you have answers to handling your eldest's behavior, so I'm guessing that's not what you're looking for here (at least, not just that). So, what are you looking for in the way of help/advice?
Also, where are you located? Roughly, not specifically. It's possible there are some services that people in your area can recommend to help, but to do that we need to know the area.
It sounds like you don't even have a clear diagnosis. This is Step #1, because until then a lot of the third parties that would be able to help you will have their hands tied. More importantly, knowing what the problem is will will give you some guidance on concrete next steps, such as potential medication routines, the type of therapy you can seek out, how you can alter your behavior/structure at home, how you should be communicating with her, etc. etc. etc. Until then, anything we tell you is going to be second-hand advice from random people on the internet. Take her to a medical professional. The fact that her mother has been diagnosed makes it a very strong possibility that she herself is suffering from issues.
Local police witnessed her attacking me and social services were informed of what was happening, but they declined to take any action at that time. While they have agreed to give us support after the most recent issue, it's been with stuff like referrals rather than any sort of direct intervention.
We've had some other family support services help us with different parenting techniques and self-care exercises and while they're great for handling the youngest kids in the house, their effectiveness on the eldest varies wildly.
I've done a quiet self assessment this morning and come to the conclusion that this is just at the forefront of a whole bunch if issues I'm having. I think I might be depressed, drinking too much in the evenings and eating poorly as an escape is just making me feel worse and making these problems that much harder to deal with.
Vicious circle I guess.
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I'm sure your wife needs care 100% of the time, but can you get an in home care nurse to come just for a couple hours so you can go and catch a movie by yourself or do something you enjoy (shit even get a gym membership and go run on a treadmill for a bit). You need an outlet, bad!
As for your daughter, I wish I could help, but I have no experience with kids that have special needs. My wife worked at an international school in the Netherlands for a couple of years and whenever someone would call in sick she would help out with the special needs children so she has at least some experience with being able to calm them down when they are having a hard time.
― John Quincy Adams
tired of taking care of pets? get rid of them. they don't like it? they don't get a vote. if they want a vote, there's a way to get a vote, which is helping you
that's only one thing but it's a basic model for how to deal with the stresses that are mounting on you
what follows is even more controversial
Turning your teenager over to social services or public health services and letting them deal with it (by slapping her with a diagnosis and a prescription that will follow her for the rest of her life), I think, is a great way to ensure she spends the rest of her life as a ward of the state. What it sounds like to me is that she's craving a more attention from her parents, and acting out to try and get it. Probably because less serious instances of bad behavior failed to get your attention either, and the only thing she knows how to do as a shitbrained 14 year old is keep ratcheting up the drama. And every time you "hold your temper" and try to be the bigger person, it's wrecking her.
The things she is doing are extreme, but nothing in part or as a whole sounds to me like someone who is necessarily properly mentally ill. I think people are drawing a link between her early developmental issues and her present behavior that might exist but doesn't have to.
Have you tried: actually getting your daughter in an isolated situation and having meaningful conversations with her? Doing your own psych evaluation? Show her that you're someone other than the person who brings home the food and the money? Based on your apparent bewilderment of her behavior is sounds like the answer might either be "no" or "not nearly enough". You're the best person to solve this problem. You should try before you punt. Furthermore, without more details, it sounds to me a littile bit that on the parenting front, your wife might be null and void, which means you have to be the mom and the dad, in terms of your daughters needs. If you're not doing that, you should probably start, whatever the cost.
That's just an idea. I'm not psychologist, but not many here are, either.
I think you're way off here.
Teenagers who want attention, even troubled teenagers who don't know how to go about getting that attention properly, don't threaten to kill their entire family. Also given how many details the op gave about how much lengthy attention he's actually been giving her, your advice seems downright mean, ie, "if she's gotten violent with you it's because you ain't parenting right"
I disagree with your assessment and I think the other posts in this thread are much more helpful and less judgy to boot.
The one thing I learned after having been in a relationship with someone with a disability is to never judge someone who's basically given up. This shit is hard, even on the best days, and it'll take its toll on you. Someone who's actively trying to kill you and make it more difficult, well, I don't blame kneel at all for wanting to throw in the towel, so to speak.
First things first, like others have said, this girl needs to be seen by doctors and come to a conclusion as to what ails her. The best parenting in the world won't fix someone who has a chemical imbalance in their brain that won't even let them reason. She needs help. And social services, especially in the UK, are there for exactly giving you the help you need. Once she's being treated for whatever condition this is (bipolar or autism, etc), then you can begin the parenting part. It sounds to me like you're doing an okay job and the other children aren't suffering and are thriving.
Once that's done, find out about getting your wife/family a nurse so that you can get time to yourself. Everyone needs a recharge day or even just a few hours to relax and not have any responsibility.
That is why they are recommending that he involve professional help. Instead of just telling him he's a bad parent.
My family has a history of mental illness, and the OP's daughter sounds a lot (eerily so) to my uncle, especially with the timeline. Therapy did help him a good bit, while he consented to it. Eventually he didn't and got increasingly paranoid and violent (eventually ending his life and a few other people's along the way). The one regret most of his siblings and my grandmother have is not getting him into professional help early. They waited until he was in his 20s and really probably too far gone to be helped. You are at a point in time where this can be very productive. Please seek professional help for her.
For example, it's also my understanding that it's pretty difficult to get the state involved with a child that may have serious mental health issues. There's not always a way to "just turn them over to the state." Be careful with your advice if you're not really that familiar with the topic.
OP: You should probably look at getting some therapy for yourself. You've got some heavy shit in life, and you don't have great support because you're the support rock for your family. You're a good person working to care for your family, and that's heavy. Make sure to look out for yourself too.
I am operating under the assumption that he came here, having already done that, not to be told to just do that harder. It's not unreasonable for a parent to try to take a domestic route to this problem.
And this:
is absolutely not helping. This behavior is in no way, shape or form normal for a 14 year old looking for attention.
Kind of a red flag, but I'll be the first to admit that 3 year olds do some weird shit.
Here we go, deliberate destruction and rage at parents. Red flag.
Huge red flag.
Holy cow red flags. I bolded the biggest one.
I'm noticing a pattern. Huge, rage-filled peaks followed by calm and remorse.
Same pattern. Violence followed by a low.
This is not a "shitbrained 14 year old" ratcheting up drama looking for attention. OP gave multiple examples of him giving attention. Holding your temper and leading by example is a fantastic way to parent are you kidding me. OP, you need help, for both your daughter and your family's sake.
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I have experience living with mental illness and those lows. My sister had to be committed for two days when we were in high school because someone was threatening to take out a restraining order and she literally couldn't help herself from sitting outside his house and pulling out her hair. At what point exactly should I start speaking from my own experience with mental illness as a teenager, dealing with that on a personal and intervention level, and self-care as an adult?
Not to mention as the actual parent of an actual child who is neuroatypical?
Not everyone here is a psychologist, but many here on this forum have diverse experience with at least aspects of this type of situation, where you, Jasconius, do not seem to. Sometimes "be a better parent" is appropriate. This is so mind-bendingly far from that that your advice is actually damaging. Maybe don't double down when that's pointed out to you.
There is such a stigma placed on commitment that many don't even see it as a valid option. But it is, and can be so worth it. It's very rarely forever, most often just 24 hours for observation, 72 hours, or a week. It doesn't mean dropping your kid off at the loony bin and fobbing them off on professionals so you don't have to deal with them. That time is often invaluable for giving the individual the ability to step back, calm down, and do so in an environment where they don't need to be scared of being a danger (and yes, it probably secretly terrifies her). It gives professionals the opportunity to observe her cycles over a longer term than an hour or two, or have only her memories of them to go on. This girl needs real help. It could very well be time to consider something along those lines. It's not punishment. It is much, much needed help.
I have to concur with Ceres advice here. Recently there was a very similar situation that happened to a family in this neck of the woods. Unfortunately, local policy made it very difficult to get them into a program for observation and sure enough, things came to a head where an emergency occurred and finally the young person was admitted into a program for observation and assistance.
Looking into an option like this isn't giving up. That's not it at all. It is getting help that is sorely needed and that most of us are ill-equipped and not trained for whatsoever as a parent. I can recall a few times seeing Kneel posting about things going on with their child and I whole-heartedly hope that there is something that can be done to help the situation.
Having worked in an emergency department. This is excellent advice. Once (in the USA) first responders or police are involved it gets much more complicated and mental illness doesn't excuse a crime like assault.
Your daughter needs help you don't have the capacity to provide. It isn't a matter of your capabilities or compassion as a parent. You have both in spades obviously.
It's a matter of a lifetime of experience and education specifically dealing with mental illness and behavioral sciences.
100% agreed.
1) Find a group, or organization in your area that deals with autism. You need to find other parents in your situation, and collaborate with them. There are other people who are going through what you are currently, and chances are they have a better understanding of how to get the help needed. These types of children are very rare, and most people are simply not going to have the experience or perspective to help you, whether they work in the public school system, the police department, or the local hospital.
2) Talk to a local attorney or advocate (an autism organization may have knowledge of who is specialized in this area of the law). If your country is anything like the United States, you will have to navigate through a sea of bureaucracy and learn the lingo. Its not beneficial to be adversarial with the system, but you need to know what you're entitled to, to negotiate and work through the institutions you are seeking help from.
3) When you know what services you are legally entitled to, you need to seek them. You need to research the various behavioral interventions (ABA is one type of behavioral program), and find out what your local school system can provide you. If something like in-home training is available, it is something I recommend you seek. In the United States, this is essentially when a specialist provides you strategies at home for you to implement to reinforce the behaviors the local school system is working on at school. Children with autism need very structured environments, are very black and white in their thinking, and everyone has to be on the same page when addressing the behavior.
4) Realistic Expectations. There is only so much government institutions and you will be able to achieve with your daughter. The reality may be she will have to lived under some supervision for the rest of her life.
Few issues getting her out of bed in the morning lately, I've been offering to take her to dance club despite her saying earlier she didn't want to (she changed her mind). Trying to ratchet up the attention some more - racing her home on foot for a laugh, her mum sitting with her to watch a shitty horror movie that they could both laugh about afterwards. Trying not to make demands she might see as a huge deal (and those that she would see as huge, we try to break them to her gently or conditionally). Honestly it's like walking on eggshells but she's opened up a little bit more lately.
The main thing at home is to recognise when she's starting to veer towards the angry, destructive behaviour and pull out all the stops to steer her away. This can be difficult as fuck since we've got all these other criteria in the household but, for the moment, it's working. I mean, it's always working until it's not, and all we can do is try and hope she doesn't become so determined to have an explosion that all our efforts fail.
Can't do much else on the autism side of things until we hear back from the local CAMHS team about her referral.
Sorry for the ranty nature of my first few posts, but thank you all for bearing with me, and for your advice. Some days I roll with it all, other days it crushes me.
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@Sir Landshark - I'm in Knowsley, one of the nicer boroughs of Merseyside, UK (well, this bit of it is anyway).
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It appears we're already following almost every avenue for getting help, and the ball is mostly in the court of the local council. It's just a question of holding on until then.
Again, thank you everyone.
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I know the idea of it is not appealing in the slightest might I just say that, and I'll first state I am in no way a professional that can provide insight into this, someone with experience and training may suggest the idea of placing her in care is the best option. Not that I in any way endorse it, but I just think that it should be something that you and your wife be prepared on hearing as an option during the course of things.
My post was just in regards to the fact as soon as "a rage attack" means assault it becomes a crime. You may not report it as a way of protecting her, but eventually it will be someone else and it will be out of your hands. It's already beyond your control. You don't get an award or medal for suffering in life. Accept help where you can.
I am not a psychologist. I am working towards it, but its not there. In the mean time I an experienced social worker who, amongst other things, has a lot of experience with child protective services in the state and mentally or emotionally disturbed teenagers. He has moved so far beyond your advice that it is incredibly insulting at best. He has clearly sat down with her multiple times to try and work this out, and the child has even gone so far as to breakdown crying over her own personal lack of control. She knows there is something off, but can't work out how to piece it all together due to some combination of mental illness, and age. While I see you obvious good intentions I would encourage you to avoid giving advice on the extremes of child rearing until you look more deeply into what social services actually does, and what kind of services are routinely offered to help situations like this.
I also deeply object to the sly degradation to people diagnosed with mental illness. Would you be worried if the child had a fatal heart defect diagnosis follow her around for the rest of her life? Diabetes? Or would you want those treated and worry about "labels" afterwards? Maybe off topic, and I apologize, but please don't let fear of a label prevent timely and needed intervention in any part of your life.
May I ask a general idea of where you live? This is not a great situation for anyone at all. It is good that you are making this much progress, but I think there could be better interventions in the meantime. These are the exact situations mental health rehabilitation was designed to engage and help in, and there might be a few ways to fast track it depending on your area. If you are, as noted earlier, out of the USA I am uncertain what I can do, but I don't mind poking around. I have like a contact or two over there, but I don't believe they have any expertise in this particular area. Might be able to get something useful though.
MHR (mental health rehab) would basically be in home services that would help you do a lot of what you are currently doing. The upside is though that a lot of the stress can be off loaded, and better interventions designed by someone who isn't smack dab in the middle of a crisis. It often involves medication, but does not involve placing her in a inpatient facility necessarily. I won't speak to specific recommendations, but it sounds like you could manage all out patient due to the ABSOLUTELY AN AMAZINGLY PHENOMENAL JOB YOU ARE DOING SO FAR! Seriously impressed by your composure and passion. Keep on plugging away and it will get better.
We're living in the borough of Knowsley, in Merseyside UK. Up until recently all of the support we've received has focused on how we as parents handle our daughter's behaviour but, after being told that we're effectively employing every tactic available, they're supposedly moving on towards address the child herself - especially as her behaviour threatens her younger siblings.
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Hum. I will see who I know near there who might be familiar with the system. It sounds like you have started the process to get her therapy but I will look into any shortcuts available (there is always a way to move up the list). May I ask how rational she is when calm? The cycle depicted seems to indicate some emotional regulation issues (warning this is not to be taken as professional advise so much as friendly advice) which cause a bit of a loop after the disconnect from reality kicks in that sends her into an overload. Very much sounds like she is triggering a fight or flight response once she goes haywire. As you have observed the only way to work through that is to not have it happen.
Anyways hosptilization tends to fast track out of hospital care rather quickly, and is not typically the worst thing in the world. Having had to do that to my own child trust me when I say I know precisely how painful it sounds, but adults suffer so children don't have to. If she can be brought on board, and If she is ok with it I would seriously consider the maybe week long problem to expedite the process if for no other reason than to not have her suffer through this. By all signs she is miserable right now and I can't imagine she wants this to end more quickly than anyone else involved. There are alternatives though.
Could you go to the local pediatrician with complaints of extreme anxiety? Would that help any? It truly sounds like an anxiety disorder to me combined with a little something else, or maybe not. The only odd part is how violent the anxiety seems to make her but that is not unheard albeit extremely rare.
Can you directly go to a therapist without the eval or is it mandatory? I know a psychiatrist would be out of the question, but at least state side you can still get therapy without a formal evaluation. At least no more formal than whatever the therapist in question needs to make the paperwork look good as a diagnosis is not an essential part of care often so much as a useful guideline for potential interventions.
She's... rational, but has a lot of difficulty keeping her attention on anything that doesn't already have her interest. Myself, my family, school staff and social workers all note that she tends to nod a lot and say 'yep' when you try to engage her in conversation, but ask her to repeat what you just said and she shrugs. She's definitely operating at an academic level of age 6-10 despite almost being 15.
The reality disconnect after being triggered is an absolutely accurate description of what we observe at home. We get repeated statements like 'I wish you'd all fucking die' / 'I'd rather live on the street than live here!' / 'I'm going to burn this house down' / 'I'm gonna go live on my own' / 'If you call the police I'll stab them all' / 'You'd better shut up or so help me' etc. She spouts and acts out whatever threat springs to mind no matter how ridiculous given her capabilities or surroundings
I'm in the mindset of exhausting all the other alternatives to that. When she was saying at her grandmother's last week, it was very difficult to get her back home again even when the social worker and school agreed she wasn't at threat at home - she told the bus driver (she gets picked up and dropped off from our front door every schoolday) that she was to be taken back to her grandmother's house instead of home which caused more stress). If she were to have any sort of prolonged stay outside of home I'm concerned that getting to be the center of attention for that length of time would cause more disruption to her routine and lead to a refusal to come home.
I think this is our next step. We'd been putting this off as we were under the impression that an ASD diagnosis would be forthcoming, but clearly that's not the case in the forseable future. My wife has already been increasingly concerned that it's an anxiety reaction, especially considering that she herself suffers from anxiety-related psychiatric disorders. While my wife believed that they largely stemmed from childhood abuse, she's now concerned that they may have been hereditary in some part.
Thankfully, our three youngest children show no such symptoms. Our six year old son is headed for the ASD pathway and some occupational therapy, but he has been visibly growing out of behaviours that flagged the first concern, while the latter was largely due to fine motor control and some minor speech-forming issues.
There's some therapy in school as well as one-on-one sessions with school teachers from a personal development standpoint, but for a full psych eval we've been told it needs to go through the local child and adolescent mental health services (CAMHS) as a referral, which is currently underway via social services. What's frustrating is that she was being attended by CAMHS three years ago and was discharged by the services with worksheets and exercises to practice at home. You can probably imagine how successful that was.
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I will not try to push you into something you or your child do not feel safe doing (re hospitilization) but I will say the transition would be much smoother. Once she is stable she won't have the same fight or flight triggers constantly going off and thus will be less inclined to attempt to avoid home. If it is still not for you that's fine as well as long as everyone's safe. I just want you to have all the info so to speak.
So question, how long has your wife been fully disabled? Has it gotten worse recently? I notice you make little reference to your wife's work history but the way you phrase it you make it sound as if that were a more recent development. Am I wrong in this assumption? I think I see a pattern but I am unsure.
Well I wasn't necessarily thinking a full eval, but I am familiar with a system from a completely different country. Here you can get a variety of different services while still waiting for an eval as medication is the only part truely dependent on it. I would recommend asking your pediatrician sooner rather than later. ASD diagnosis can take a long time, and there is no guarantee that is the answer. Severe anxiety disorder plus learning disability could produce the same results pretty easily as an example. I won't dare try to diagnose over the internet, but I will say it is better to keep an open mind to possibilities at all stages to help better find the services that work best for her.
My wife hasn't worked in over ten years due to her health. She's suffered from seizures and depression for as long as I've known her. She suffered from gall stones and took anti-inflammatory medication for the pain but wasn't given anything to keep the lining on her stomach, and in 2006 she began bleeding out from perforated stomach ulcers and had to have emergency bowel repair. Since then she hasn't been able to eat without pain and has a lot of scar tissue on her stomach. In 2009 she suffered a stroke and was left with right-sided muscle weakness, becomes confused and now suffers with hemiplegic migraines under stress which cause blurred vision, auditory hallucinations, aphasia, loss of sensation down her right side, blinding pain and loss of consciousness. When unconscious she often suffers a seizure. She also hears voices, was recently diagnosed with psychotic depression and personality disorder, and currently takes anti-psychotics, anti-depressants and medication to reduce the incidents of the migraines.
Oh and she was diagnosed with fibromyalgia earlier this year.
Thank you. I'm going to get her book to see our family GP next week.
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I am trying to do a mental timeline here between your kid acting out, and your wife's health. It isn't clearly lining up for me, but it appears to at least be an influence. My thought here is fear of loss triggering anxiety triggering meltdown and lashing out. It would explain the fear of going home and why she is testing your boundries more than your wife's as she is kind of resigning herself to the loss. How do you treat the chronic illness with her? Like explain all of it or just try to keep them calm with few details? If this is a trigger it may help to explain it more fully to her. This is a bit of a wild guess though on a couple of data points backed with anecdotal evidence of how my kid is processing loss and my fibromyalgia issues through her severe anxiety disorder world (If that makes sense).
Best of luck with the GP. I hope you get the tools you need as soon as you can.