How we ended up in the psych ER

Yesterday neither Sarah nor I could work because it took two of us to keep Big Guy safe, and even then he was hitting and trying to jump out the 2nd story window, and things like that. This is after a week that included him running into the street and refusing to come back to us (once on a street that had little traffic, once on a street that has a lot of speeding traffic)... Having tantrums every day... and saying things like "Do you hate me? Do you want me to die?" in a sad little voice while in the bathtub. His tantrums just escalated and escalated. He broke a lamp and threw a lot of our (and his) belongings across the house. He cried, he yelled, he threatened. He refused to leave the house every morning. But the worst part was that he is so, so sad. And so, so frustrated with himself.

For a kid with ODD it can take a LOT of sadness for it to come out as child-like (i.e. appropriate) tears and sobs rather than just angry wild-animal tantrums. But we've had a lot of both recently, and we knew something was not right. Obviously we don't know what "right" is with this boy, since he's only been with us 2 months so far. But we knew something was different than usual in the way he was acting. The difference was that he was excessively sad and even his acting out seemed to stem from that instead of just from testing. In addition, he was unable to stop his tantrums, or recover from them. Instead, I think as he'd start to come down from them he'd start to realize what he'd done (in other words he'd perceive that he had physically hurt the people he loves, destroyed his room, made us upset, exhausted himself, etc) and then feel so bad about himself that he thought he deserved to be punished... So he'd act out even more, seemingly trying to get us to punish him. We have gathered that he thinks he deserves to be beaten, kicked out, or have the cops called on him. So "punishment" means one of these extremes, which are the things he is accustomed to. When I have told him during his tantrums, "Baby, you deserve to feel good. You deserve to be happy. Please stop punishing yourself,"... his response is things like "No, I deserve to feel bad. I deserve to lose all my privileges. I deserve bad things."

I called Big Guy's care manager, and said that our rope was really fraying and we needed help, pronto. I explained that being held hostage by this child, and having him continue to try to harm himself or us, was not an option for us... but that we did NOT want to give up on him, and didn't want him to think we were going to abandon him when the going got tough. I said I didn't know what to do. She quickly recommended that we take him to the psych ER for an evaluation. He hasn't had a psychiatric evaluation in quite a while and when we tried to make an appointment, we couldn't get one until the end of September. We have tried to convince his doctors to tweak his meds, but they hemmed and hawed over it. What the care manager explained is that in the psych hospital he can stay for a few days while they change his meds. It's easier and safer than going through med changes while living with us, as they can observe him carefully.

I really didn't want to do this. I was so fearful he would hate us, that it would set him back in terms of his progress emotionally, that it would undermine his trust in us, that things would be worse when he got back to us instead of better. But I called all the people I know who have professional and personal experience with this stuff, and they all reassured me that it was the right thing. As I said to the caseworker "This really isn't about his behaviors. His behaviors are unmanageable right now. But it's really about the fact that he deserves to feel better than this." It is physically painful to see your child hurting and unable to talk about it, and unable to stop themselves from acting in ways that get them further into trouble emotionally and in terms of family consequences.

The horrible part is they don't have visiting hours today, so our boy is going to think even more that we're abandoning him. We're trying to get through to the psychiatrist to fight for an exception to the rules due to his history of abandonment issues and his being in foster care for only 2 months with us, because we think not seeing us every day would be very damaging for him. But they haven't returned our calls.

I wish I could stop feeling like I've failed him somehow by needing to take him to psych hospital. I wish I could stop feeling like a bad mom because I couldn't magically handle his behaviors and help him feel better. I know better than this. But my brain hasn't yet convinced my heart that we did the right thing and that he'll be okay, largely because he has two dedicated foster moms who can't wait for him to get out, who will advocate for him to no end, and who would do almost anything to help him continue to heal and grow.