OCD Siblings – Lost in the Shuffle… Or Self-Appointed Guardian Angels?

My intent with this particular post is to focus on what I surmise might be the effects on a family’s other siblings, from all the chaos created by this disorder (NOT the children afflicted with it), and how, so often THEIR (the siblings’) needs and wishes take a back seat to the rituals and sequencing required by all the family members to fulfill those rituals.  I’d like to acknowledge those siblings in the family that may not actually suffer from the disorder, but whose lives are profoundly affected by all the symptoms, side-stepping, confronting, do-over’s, doctor appointments, med trials, researching and discussions, etc.  My intent is NOT to imply that in my family or others’ there are “normal” children and “faulty”, or “broken” children.   That is simply not the case.  These children suffering with OCD and other co-morbidities are very sensitive, tender children with chemical imbalances.  To look back later, over years of accommodations made by their siblings, it must be downright painful to recognize the sacrifices made on their behalf.  I do also acknowledge that it must be very difficult to have to require so much of others to simply exist.  However, for other children in a family, also gentle and caring, it must be incredibly exhausting, if not hurtful to go on year after year, feeling somewhat left in the dust.  It’s kind of a squeaky wheel thing, I guess.  No one at fault.  No one to blame.  The grease gets spread around, hopefully, with as much love and fairness as is at all possible.  It speaks to the character and patience of all the family members, for sure.

As parents, this can cause great heartache.  Reaching any sort of balance of your own attention and time between your children in these varying roles can be more than challenging.  Let’s face it; the mere nature of OCD can cause a great deal of “ownership” issues.  In our case, with our daughter so terribly fixated on me in those early years, we had to immediately lay the groundwork from “ground zero” that her brother was just going to be excluded from all her insecurities and worries.  He would have to be allowed, in her mind, to have the same physical contact, emotional involvement – “momma and daddy relationships” as she had with us on every level.  This would have to include other family relationships as well where he was concerned.  These “understandings” required “refreshing”, as it were, from time to time, as she grew and her symptoms evolved, as well as getting together with family at different events, etc.

I honestly think that it might have been even more difficult for our daughter to make peace with this “arrangement”, ie: how things just are, if her sibling had been a girl, with whom she felt she must “compete”, or if there had been less of an age difference (making the comparison of classwork, etc. more painful for her).  Having a brother, I believe, removed many of the built-in worries that might have caused problems, and allowed her to bond with him instead.  This is, as it happens, what seemed to occur on a pretty normal level.  They seemed to have the usual sibling irritants and giggles for their age difference and pretty much right out of the gate, developed a very sweet, respectful, brother-sister relationship.  Our son seemed to sweetly accept his role as his sister’s advocate or “defender” as parents of his friends implied that she might be just “picky”, or perhaps even a bit undisciplined.  He was very kind hearted, and didn’t want to hear that nonsense about the inner struggles taking place inside his baby sister.  Truthfully, it hurt my feelings as well that people put him in the position of defending the difficult choices we’d had to make as a family, when they had no idea what sort of pain had gone into those decisions.  He always handled things very gently on her behalf as needed.  And she always worshipped the ground he walked on…from day one.

Our son is now married to a woman every bit as gentle and loving as he is, that “deserves” him (in my eyes, which is no small thing J ).  My daughter always wanted a sister, but knew it would be way too hard to come to terms with all her worries and troubles surrounding her relationship with me.  Now, she has a lovely sister with whom she can share all her sisterly thoughts.  She was mid-teens when she acquired her new sister.  How blessed we are.

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Cognitive Behavioral Therapy (CBT)- Two Experiences – Just My Perspective

If we could evaluate CBT based on our journey, it would include two completely opposite experiences.  Keeping in mind that our daughter’s medications were being followed closely by her psychiatrist in both cases, she was referred twice for CBT.  Looking back, both doctors had very different approaches to her therapy.  I’d guess that her age played a part in that regard, but still, noticeably a huge difference to how they developed a relationship with her and built on the trust necessary for her to confide in them.

The first time she entered into treatment, she was about ten or eleven years old and went to a child psychologist that specialized in beating OCD symptoms.  She was seen once a week, or every other week (it’s been a while!) for the better part of a year.

The doctor wanted to meet with the family first (although, I can’t remember if her brother was expected to come to this appt. or not), to get an overview of how her treatment would proceed, and probably to see how much family support she had.  He would have me come in at the end of each appointment to go over what she’d be working on and explain the plan for how she was supposed to “approach” the specific symptom they’d chosen to work on, as well as how she was supposed to practice her “homework”.  At the time, it seemed as though she was responding pretty well to his method of treatment.  But it didn’t take too long till I started paying attention to which “symptoms” she was “offering up” to him to work on with her.  At first, I decided they were just symptoms she had been privately struggling with.  But, as more and more “new” ones surfaced as symptoms that deserved treating, I began to take note to see if she might “expose” any of those that we’d all struggled with as a family and that had actually laid so heavy on her mind.  Over the course of her treatment, I can recall two that fit that description.  Both of which, in the end, remained just as intrusive and painfully present.  Although, at the time, throughout her visits, she appeared to “fight the good fight”, and follow through with all the steps of his treatment, wanting him to think he was completely successful in “beating those OCD symptoms”.  I remember being a happy participant in some of this “treatment” and fanfare of celebration, just being so happy to support her through it and not wanting to doubt her sincerity, no matter what she was working on.  I was just happy she seemed to be actively engaged in acknowledging her OCD.

In truth, looking back, I believe this particular doctor’s methods (not to be overly critical) were not well-suited to her at all.  His treatment included role-playing as a super hero, zapping the intrusive thoughts in her mind whenever they began to take control.  I believe that she really did want to cooperate and follow through with his treatment, even though it seemed sort of silly to her.  We even chuckled about it as we went along.  Not to make light of his methodology, as I’m sure he’d had lots of success with many patients in order to gain the trust of our psychiatrist.  The big problem was that these symptoms were kind of like old friends.  Yes, they were “intrusive”.  Yes, they made her life painfully difficult most of the time.  BUT, it was all she’d ever known.  From the time she’d had cognitive thoughts, these were what filled her mind.  It was a lot more comfortable for her to allow her worries to just stay put.  She was just not ready to surrender all those things to this doctor at this time.  Again, I’m just a mom thinking back.

Her second round of CBT was prescribed by the same psychiatrist about five or six years later.  Again, he was following her meds and seeing her on her usual schedule as well.  This new psychologist was more of an auntie figure to her, it seemed, which was excuse me…just what the doctor ordered (sorry).  She had OCD as well, so she really “got it”.   She saw her every week for several years.  The two of them connected almost instantly, which as I mentioned in a previous post, was a smidge tough for me, since all of a sudden things were being shared between them that had been reserved for just the two of us.  Up until then, her OCD for the most part had been left up to me to defend and protect.  Finally, she’d found someone, a professional, that knew HOW to walk this road with her.  Her psychiatrist had always been very good with her and she knew she could trust him, having been with him for so long, but his function was clearly different than this would be.  This wonderful woman was going to listen, and listen, and give ideas and tools that no one had ever thought of (or at least taken the time to share with her).  They developed a wonderful relationship, and so did she and I.  I believe that even if she didn’t work on specific symptoms, she learned a lot about acceptance and permission to love herself from someone other than her mom.

Eventually, this doctor left our area.  This was very sad for our family.  I know she helped our daughter immensely and helped her build confidence.  This treatment took us up to a time when trying to get set up with a new doctor would have been more of a stressor than a help, as her high school schedule was filling up dramatically.  It just had to take a back seat to getting through her obligations.  More on that in posts to come…

Also, this lady was a tough act to follow, I tell ya!

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“I Need Some Help Here!?” – IN THE BEGINNING…

It’s true that our baby wasn’t formally diagnosed with OCD till she was three years old, but the events that led up to our getting her, and us, some help were nothing short of heartbreaking.  As we looked back, the most notable signs of symptoms began to appear around the one-year mark.  The most epic hum-dinger event that marked that age was really the first classic manifestation of OCD as we learned about it later.  Up until this day, we’d actually chalked the “incidents” we’d had up as fussy-baby stuff, and figured they were bumps in the road of pre-toddlerhood, waiting for her to outgrow them as babies “usually do”.  As it happens, this day was the beginning of literally a journey of a lifetime.

It was a normal evening with me in the kitchen preparing dinner and the baby was sitting in her high chair, facing me as I scurried around.  Daddy and big brother were busy elsewhere in the house with this or that.  Cheerios were being chased around on the high chair tray by the cutest little fingers, and all was right with the world.  In what seemed like the snap of your fingers, the air was filled with the most hideous, painful, hysterical screaming you’d ever heard.  I leapt across the kitchen, Daddy and big brother rushed into the room from where they were in the house, and we were all frantically trying to see what in the world could be causing this terrible outburst.  Surely, there must be something pinching or cutting her!  Had a bee stung her?!  The sounds coming from her were those caused from sudden, severe pain, not fussy-baby sounds.  Her little face looked fearful and panicked, and it was taking on the dark red, almost purplish hue that only comes from the deep gasping of hysterical screaming.  She was shaking, her little arms were flailing, and it had come on so suddenly that we were all desperate to find the answer… NOW!  She seemed to be looking past us and in the direction of the cabinets over where I’d been working before.  We’d checked every possible cause that we could think of; high chair straps, tray table, clothes, bib, teeth… Finally, desperate, and grasping at straws, I stepped back and tried to look in the direction she’d been looking.  I saw the cabinet door above the stove was ajar.  As a force of habit, I reached up and closed it.  Just like that… SILENCE!   That was it.  She went right back to her Cheerios.  Her little red cheeks were hot with tears, but that was all that remained for her because that itch had been scratched.

From there, we were much more tuned in to what might possibly qualify as similar “symptoms”, even though we still didn’t “get it”.  There just wasn’t any information about these sorts of things.  Even our pediatrician wasn’t able to really help us at that point.  This was the mid-‘90’s and OCD just wasn’t something he would naturally “jump” to, I’m sure.

That had been our first frightening encounter with her OCD.  It hadn’t had a name yet, but it was clear to us that she’d been suffering and needed our help.  And so began the commitment to our family’s quest to see her through.

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OCD and Triggers (a foul word)—Avoid them, or Prepare for Them

Some of the most reliable triggers in our house for causing havoc, and from what many other moms have discussed with me being the most common “monsters” in their homes too, include holidays and birthdays.  These became feared “beasts” in our home as the calendar clicked away.

 

Any holidays where kids are the main “beneficiary” ie: Christmas- (Santa…”Will he like me as well as…”, “Will the reindeer like me as much as…”, “Did I pick that out for Daddy?”, “Did I help wrap those presents?” “Did I hang that ornament…?”), Easter- (“Will the bunny like me as much as…?”, “Will I find as many eggs as…?”, “Are they prettier than…?”,  “Did I color my eggs prettier than yours / his…?”), Holloween- (“Did those people think I was cuter than the other princess?”, “Did you give that little girl candy?” “You need to give me the same candy you gave her, Mommy!”)…I could go on and on.  As they say, “For every season…”

 

Birthdays!!  Holy cow, birthdays, even someone else’s, are the queen mother of all OCD triggers for little kids!!  Talk about stress and worry producers!!  We have been known to avoid them altogether (misc. friends’ parties), and plan on suffering the consequences.  Sometimes you just can’t “go there”, knowing how long you will be dealing with the fall-out.  It’s a small sacrifice knowing how deep their feelings run and how many people are likely to misinterpret their behavior as “acting up” or being “spoiled” at the actual event, unaware that they were allowing their feelings to display on their faces (exchanging silent glances).  Sometimes you just want to “save them” from it and protect their little reputations.  With birthdays there’s just always something huge for them to worry about.– “Did I pick that out for …?”, “Did I help wrap that present?”, “Did she like what I gave her best?” (To scratch the surface…)  These concerns were always voiced to me personally, privately, and immediately!  And, as always, the expression on her face said it all.  She had her “picture-face”, then the face that showed her true “worries”.  I will always have that “troubled” expression etched in my memory, as it was very common on her sweet little face.  And there are bound to be games (an entirely different can of worms that deserves it’s own separate post).

Obviously, you can’t avoid having birthday parties for your own troubled little birthday girl/boy, so (at least, in our case), less seemed to be better.  I found that having several parties with the different groups honoring her separately seemed to be a little easier on her.  That’s not so say that it will necessarily be easier for you, since this is such a sized-to-fit disorder.  My only comfort was that I only had to deal with this particular issue once annually.  I have to admit that I didn’t brave the little girl party every year.  I did, however, have the family friend/family party every year.  Some years she had even decided on her own that she only wanted the family/family friend party, and would forego the little girl party.  This happened for a number of years.  I also found it seemed to be easier on her for me to plan her “kid” party somewhere besides our house.  This would practically eliminate the “worries” about me giving so much personalized attention to other kids (even her own friends, which was a huge issue).  I could just “hand the party over” to the fine McDonalds’ (or other kid-friendly option) party professional (then taking, of course, only photos including the birthday girl).  Then, when it’s over and you head back to “birthday central” (that would be home), you’ve got one party under your belt!  I did, one year ONLY, make one virtually fatal mistake.  I planned the kid party and the family/family friend party on the same day (A veritable “kiss of death”.)   The only thing worse than a small child with OCD on her birthday would naturally, be an exhausted, over-stimulated child with OCD on her birthday (A very bad idea indeed.)

Anyway, the more you can identify triggers, the more you can help work-through them.  Of course, the goal is to give your child the tools to see there is no need to fixate on these issues; that birthdays come and go for everyone.  Some of these particular triggers, as the birthdays roll on, due to the need to be accepted socially around classmates, etc., your child will seemingly outgrow (or internalize and hopefully, make peace with over the years).  As I’ve said, I’m only a mom, but this is my take on it.  Happy Birthday to us, every one!! …More on TRIGGERS (excuse me…), later.

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Energy “Use” in the OCD Brain-Very Interesting

I found this to be a real eye-opener for a disorder that seems to be otherwise intangible.

Pet Scan of Brains With and Without OCD

I found this on one of the bazillions of informational  and treatment sites for OCD.  I’ve added a link to it below as it has lots of good, basic information about OCD and anxiety disorders in general.  This is also one of the few sites that actually acknowledges the existence of  “PANDAS”, or pediatric autoimmune neurobiological disorders associated with streptococci, which is the onset of childhood OCD associated with strep throat (to simplify), and a high fever at an early age.  It kinda gets your mind going trying to remember, huh?

Anyway, there’s a lot of good info to explore and ponder on this site.  I’ve come up with some decent questions for our doctor by perusing sites like this.

http://www.hope4ocd.com/autoimmune.php

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Spoiled Baby or “Budding” Rituals?

As I mentioned, we’d already had a son with all of what we’d considered to be the “usual” high-energy”, “creative”,  “do it myself”, squeal in a restaurant, and won’t go to bed stuff and felt like he was turning out wonderfully.  So, naturally, we thought we were prepared to start over when our baby daughter arrived on the scene, ten years later, with the help of an excited big brother!

This was a good-natured, sweet little baby that loved to play and cuddle!  I can’t say exactly when we started noticing “differences”, but it was definitely within her first year.  (Please forgive my overlapping previous posts from time to time) We started noticing that some of the regular daily routines were taking on more importance to our little daughter.  She seemed to REALLY like/need them to take place in the exact sequence, and when they didn’t, for instance if the phone rang or you just forgot to have something laid out in the exact spot you were supposed to lay it in, she would begin the red-faced, “my arm is stuck in the car door” (as if), kind of scream.  It was the “I’m REALLY in pain, here!” cry.  She’d be throwing herself the direction of where the sequence started.  The first few times it happened, we looked all over her to find what was hurting her before we finally put together that something broke the sequence.

I’ll never forget the first time we figured it out.  We were relieved and horrified all at the same time when she was instantly pacified by our starting over right at the beginning. It was pretty much up to us to figure out which “irritants” in her day, were building into more than regular “fussy baby” things.  Turns out these rituals escalated till they took over meal time, bath time (and on into bedtime), car seat (in and out), comforting after getting hurt, reading a book, and so on.  To say we shouldn’t have all jumped through her hoops is just (excuse me for being blunt here…) ignorant.  “Until you’ve walked a mile in my shoes”…you know what I mean… You are, after all, playing a complete guessing game.  You’re trying to teach basic manors to a baby (not some diabolical, master manipulator-oh wait,…a baby:D ), while at the same time keeping peace in the household and being fair to your other child.  You’re trying to discern which things are just “spoiled baby” things and which things are these “mystery ritual” things. It also seemed fair to attempt to balance some quality of life for the family as a whole in there somewhere.  She had to learn to respect all of our rights as well.  She was just SO young and had all the basics of life to learn in addition to negotiating around these “worries” popping up everywhere.

Don’t get me wrong, we had plenty of sweet times.  We had/have a very loving family.  We just tried to be cautious and really didn’t have a clue what we were dealing with at this point.

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Baby OCD Rituals?

Toddlers with OCD haven’t learned about “germs” yet.

Soooo… they don’t know the “right” way to have OCD (the hand-washing symptom that most people expect), but they know stuff around them just isn’t right and the people around them don’t seem to “get” what it takes to “fix” things.  The frustration builds in them as they can’t articulate what they need to have done, which of course manifests to people that don’t know what’s going on as behavior issues and manipulating the entire family.  Of course, this is kind of the case, since they are too young to carry out their own rituals and their care is in the hands of their family.  We HAVE to enable their OCD rituals when they are so small, for their sanity.  That is my momma “take” on it.

At least in our case, in the beginning it was really trial and error in figuring out what was necessary to get, or keep things settled down.  As I’ve mentioned before, our entire day was filled with rituals already.   At the risk of repeating myself from previous posts, I’ll go ahead and give you an example of one of the earliest ones that appeared when our daughter was still in her crib and young enough to require a hand to hold when toddling through an open space.  Keep in mind that we had no reason to suspect that there was anything out of the ordinary going on in her little head.  She was smart as a whip, bright-eyed, and right on schedule with all her cognitive and physical development.  We’d already had one child under our belt (more on him in posts to come–a true angel) ten years prior, so felt we had a pretty good point of reference on relative “normal” kid behaviors. — BTW, our daughter was then and continues to be an angel as well.  If only we could lift these clouds from our children.

Anyway, our day began with our little one waking up in her crib calling for Mommy.  Now, Daddy or her brother  could go in to greet her and “pluck” her happily from her crib, and bring her down the stairs, she’d be laughing and sweet and happy…UNTIL…(drum roll)…she saw MOMMY.  Woops…you’d think she’d be happy to see Mommy, since Mommy is pretty much “where it’s at”.  Instead, (and we’d all try our best to encourage happy feelings) her eyes would lock onto mine and the expression on her face would change to one of complete devastation.  The tears would flow, the screams of actual “pain” would fill the room, and she would DEMAND whoever brought her down, to take her back up to her crib where she would lay back down and cover herself back up with her blankie, complete with a binkie in her mouth.  She’d want the door closed so she could start the entire process over again with Mommy coming in to pick her up.  Of course, when I heard her calling for me, I would run in to get her.  I would hold her tight and rock her right there in her room.  By then, I’d be choking back the tears (not doing so great), and her little face was red and tear-stained, but so sweet and happy, and looking up at me as if all was right with the world and there was no memory of the horrors that had happened moments ago.

Enable?  You bet’cha!  Whatever it takes to give them some peace.  We had no clue what was happening, but we knew there was some sort of trouble brewing.  When it’s you and your baby, you do anything you have to do.

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HAS to be Best

What a heavy burden to carry, to always HAVE to produce the most beautiful  or appealing craft, art, or piece of work.

From the very beginning, for as long as I can remember with our daughter, every time any of us was playing with/helping her… in the early days; stacking blocks, coloring, pasting, sorting, etc….then as she grew, making cards, painting pictures, etc., hers HAD to be the very most perfect.  By everyone’s standards, HERS HAD to be flawless and we ALL had to say so.  For example, if her block tower was teetering and we dared to touch it to steady it, she’d come “unwrapped” and have to start over with the blocks back in the toy basket.  This made for less than enjoyable times with MANY toys and games that would have been considered very age appropriate and fun for other “care-free” kids.

Of course, I know that there are plenty of “persnickity” kids that like to have their artwork appreciated above all others.  This is just normal for little kids.  That’s what made this SO much more hideous when she was playing with other kids and producing projects!  It wasn’t just a “spoiled kid” thing.  She HAD to be the best.  She couldn’t bear to even have my eyes “see” other kids’ work.  I wasn’t allowed to make eye contact with any other kids at school or daycare (the two days a week that I tried to work), or speak to the other kids.  This is more difficult than one would think.  In fact, sometimes she would test me by asking me which art I liked best.  If the kids had put their names on the front, I was in good shape.  If not…yipes!  Sometimes, I’d just tell her I was in too much of a hurry and I couldn’t take the time to look at all of them, so she’d better help me out, or we’d have to just leave without me seeing her work at all.

Thankfully, the parents of her best friends were just the most wonderful, loving people.  They understood that many of Jilli’s symptoms and insecurities were centered around me with other children.  When kids are really young, Mommy is their world (or their primary care-giver, which happened to be me).  We really couldn’t have kids over to our house because there was no way to avoid me talking to them and making eye contact with them.  If I gave them a snack, my daughter had to be the one to actually hand it to them.  You just don’t know how many of those things are natural reflexes and you do without thinking!  I broke her heart a number of times before I started thinking FIRST.  It was just easier to let her go to her friend’s house.  There, she seemed to rest from her symptoms, because she didn’t want/need to carry out her rituals there.  When she got home, she’d be exhausted and VERY crabby.  Her OCD would be in full-swing.

As she’s grown, my daughter has clung to the “if I made it, it has to outshine yours” thing.  This, I will admit, has put a lid on many of my crafts.  I’ve pretty much stopped most of them because they are just not as enjoyable if I can still sense, even now, some level of contest.  Sometimes, after I’ve been “crafting” and all seems to be well, hours later, I’ll hear her up in her room crying.  When I go up to see what it is, it’s the “Is mine as pretty as yours?” thing.  It can take as long as a couple of hours to work through.  Usually, she comes to terms with me having the right to knit or felt, or ?.  Mostly, I just try not to do crafts that she’s interested in, but when I explore one, she usually wants to try it out.  I can’t blame her for that.  She doesn’t want to feel those hurtful feelings.  I love her so completely.  I want her to develop tolerance for things that everyone enjoys doing and takes pride in and the people that do them.  Everyone likes to do their best and be appreciated.  She’s very creative, talented, and gifted in many things.  There are others in the world that are as well.  No one person IS BEST.  God made each one of us BEST at various things.  Best is relative.  She is so precious.  So is everything she does.  I want her to experience the joy of “doing” things, not the judging and being judged part.  I want her to learn to exhale.

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Cognitive Behavioral Therapy (CBT) for Kids With OCD and Letting Go…

For all these years, I’ve felt responsible for “remembering” events accurately, and feeling like I was “telling on” our little girl to her various doctors in order to learn how to help her, or teach her how to maneuver her way through her symptoms and give her the “tools” to get through her day when we weren’t together.   Now, she’s finally reached an age that she can speak for herself to someone she can entrust all her most personal “secrets”.  The things she’s only spoken to ME about all her life can now be shared with a specific someone that knows how to actually “help” her.  All the love I hold in my heart for her cannot offer her as much help as this person can.  It’s a strange feeling for me  since I’ve lived through so much with her, since the very beginning.  I’ve been the defender of her privacy, having to decide who needed to “know” and who to leave guessing, and now I feel like I’m “handing-her-off”.  These symptoms that have almost taken on a life of their own over the last 16 years.  Hmmm….

We were REALLY lucky to be referred by our daughter’s psychiatrist to a clinical psychologist specializing in OCD.  The best part, in my opinion, is that she has OCD herself!  This completely validates everything she has to say and it has opened the door for pretty much any conversation.  My daughter spends the better part of an hour with her, then near the end, they invite me in to discuss what they’ve covered during their visit.  I’ll admit that I feel like an outsider for the first time in her life, but I’m trying to be a “big girl” and be thankful that we have this additional help when, just maybe…, reinforcement is not a bad thing.

It’s weird how I long to have help for her and am so thankful to have the help we have, but am also afraid that no one really knows how she actually “ticks”, deep-down, but me.  There are so many things that she won’t be able to articulate but that could change the whole “picture”.  I need to be available to help when I can but back-off when appropriate.  This is a learning experience for both of us.  One I wasn’t expecting for myself.  I’m confident it’s a very positive thing.

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Connecting With Your Doctors

There have been fewer things along our “journey” as critical as having a good relationship with our daughter’s psychiatrist.  Having her feel completely comfortable, knowing she can walk into his office and update him on exactly how she’s feeling, medication-wise, or keeping him posted on new rituals or symptoms without feeling he’s judging her or will  even “react” no matter how “crazy” she thinks it will sound, has been invaluable!  She’s totally comfortable sharing whatever she’s having trouble with and waiting to hear what ideas he may have for her to try.  They discuss how her meds make her feel and if she still feels good, etc.

Never underestimate this relationship.  My girl feels normal and empowered every time we walk out of his office!  We appreciate him more than we can say!

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