Friday, August 6, 2010

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.


  1. i'm so sorry that things have come to this point for you and big guy right now, but you can't hear this enough: you aren't giving up on him by asking for psychiatric help. i hope that they will be able to help transition his meds so that he can get through the self-hate enough to start healing it.

    i love you, and i will be praying for him and for you this shabbas.

  2. Wow. Sounds like much is going on in your world. Before coming to us, our freckle faced guy had spent months hospitalized and had lived in psychiatric placement. When done properly, it is an opportunity for a "tune-up" in a safe place. We still talk about it openly in case he should need a "tune-up" in the future. Thank you for commenting on our blog (and faith!). I will need to make several cups of tea and find some quiet time to read all about your family.

  3. Sorry I didn't comment on these when I read them last week! I'm glad you were able to get him somewhere safe, and you should congratulate yourselves for that. You were all in such a tough situation, and I'm glad to hear that this little guy is in a place where he can get some of the help he needs. I hope the weekend has given you time to forgive yourselves a little, go easy on yourselves. You've done some good work for him and had a positive impact on his life, I can tell, but that doesn't mean you could have kept him from needing this.

  4. OMG! Thank you so much for your posts about Big Guy and the psych ward!Just thank you for taking me into that world, and your heart.

    This work is so hard. People don't get it, but I really feel we all can try.

    Your act of love is needed and appreciated.

    Thanks again.

  5. Oh, friend. How incredibly tough.

    It's really difficult when someone needs help of that nature to know if it's the time to deliver them to the safety of a hospital, and I can't imagine having to make that sort of decision about a child. I'm sure, though, that you've done the right thing. I only hope that the hospital can also do the right thing and make some adjustments so that both this lovely kid and you can have some peace. You are doing awesome things.


  6. Thank you everybody. It's great to have all this support.

    Lee: I'm finally feeling much more positive about everything, and less scared. Thanks for reminding me I'm acting out of love.

    Mama Drama: I love the "tune up" idea and plan to use it. Someone else mentioned that in another comment and it really resonated, especially for a 9 year old boy because we can compare it to cars! I look forward to talking to you more.

    Motherissues: Your comments always make me feel so supported. Thank you.

    USGirls: your comment really moved me, thank you for appreciating what we are doing, which as you know is often such thankless work.

    Cat: Thank you, friend.


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