Therapy isn't to challenge them. WHAT??

Discussion in 'General Parenting' started by JJJ, Feb 1, 2008.

  1. JJJ

    JJJ Active Member

    The nurse-therapist told me that I shouldn't challenge Kanga's perception of reality during our sessions (in complete contradiction of all previous therapists). So, I'm suppose to pretend along with her in her altered reality????? How does that help?????

    She said we should just accept "Kanga's reality" and teach her how to behave based on that.

    Does this sound crazy to anyone else???????????????????
     
  2. busywend

    busywend Well-Known Member Staff Member

    That depends on the reality! I mean are we talking - 'green is blue' or 'it is not dangerous to play in traffic'???


    Seems 'out there'!
     
  3. Jena

    Jena New Member

    hmmm seems a bit wacky when i read your post initially not your post what you said.......then again i reread it and i guess maybe possibly what he's trying to do is possibly have you both gain trust in the process more right now and her gain trust in you by you taking the time to understand her "reality" and working with that initially instead of saying no it should be this way, or that way.

    maybe he's viewing it as a foundation to begin laying before the real work begins???

    what do you think?????

    i dunno that's what i got from it

    Jen
     
  4. klmno

    klmno Active Member

    My bet is that he's thinking it would be futile to try to convince her straight out that she is thinking irrationally- and she would rebel against those efforts, too. In some therapies, you start out wherever the patient's mindset is and then use round-about ways for the patient to realize themself that there is a better way to look at things.

    I'm just speculating- can't know for sure. Have you thought about calling to discuss your concerns without Kanga being around?
     
  5. JJJ

    JJJ Active Member

    I have a meeting on Monday with the nurse-therapist before we see Kanga.

    Her reality is very skewed - she hears voices, sees things, is paranoid, etc. So the therapist wants me to let stand accusations against others THAT I KNOW ARE NOT TRUE and just help Kanga deal with her anger OVER THESE IMAGINARY EVENTS!!!! Wouldn't it be better to teach her to join us in the real world?
     
  6. meowbunny

    meowbunny New Member

    How do you teach someone that something they are convinced is real isn't? I think I understand what the therapist is saying. For now, teach her how to cope with these issues -- imaginary or not, she needs to deal with them and survive them. Telling her they are not real is irrelevant -- she believes them and you're not going to convince her otherwise. However, maybe if she learns to deal with the fear and other emotions that caused the hallucination, she will be able to cope with the fear and the hallucination will go away? Just a consideration.
     
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Is she out of touch with reality?
    I don't know...sounds weird to me.
     
  8. DammitJanet

    DammitJanet Well-Known Member Staff Member

    JJJ....I think I get what the therapist is doing or meaning.

    For example, if a person is paranoid and feels that people are watching them and talking about them just TELLING them that this isnt the case isnt going to make this paranoia disappear. Talking about this in therapy, empathizing with the patient about how this makes them feel, where they are when they feel this way...etc etc...then giving them skills to help overcome some of stressors that bring on this paranoia is far more therapeutic than just trying to force or drag a person into "reality."
     
  9. klmno

    klmno Active Member

    JJJ- this might be a stretch, but remember the saying "there's nothing to fear but fear itself"? Maybe the "world" she's living in is her worst fear or maybe it's just how she added things up in her mind for some other reason. The point is, this is HER reality in HER mind, and if she #1 deals with those problems, that's a big step for her- probably the biggest- then she goes on to other steps, until she does see the reality more like everyone else.

    Shoot, if saying "you should look at it this way, this is the way it really is" was enough to change the way our difficult child's think, none of us parents would need a therapist!!

    LOL- I'm not trying to be harsh- the therapist might really be a quack for all I know, and I'm sorry you're spending the eve. so frustrated. Try to keep an open mind- remember that whatever has been tried already obviously hasn't worked, and maybe you can have a discussion with therapist that answers some of these questions for you-
     
  10. susiestar

    susiestar Roll With It

    My anwer is that Yes, it seems off. I have seen to many quacks, esp at hospitals, and have had to persevere after they did their damage and said my child is "fine" and sent him home.

    Talk to this person, think about what they say, but then follow your instincts.

    and what does this person think about all the testing, or lack of it? Shouldn't this person be on the side of testing, given this stuff???

    Hugs,

    Susie
     
  11. slsh

    slsh member since 1999

    JJJ, when I first read this I thought "what?!?!?" But then ... I think I remember that Isabel was told something close to this at one point when her son was just really not joining them in reality, tho' their therapist didn't go so far as to suggest that they actually *validate* the distorted thinking. (Anyone else remember this?)

    If I'm remembering correctly, the idea was to reduce the conflict. In Izzy's situation, I think the advice was to not disagree with his distorted statements but to just let them slide. I can kinda understand that... in fact, actually have done that when thank you was truly truly psychotic. No point in arguing with a kid about whether or not a leviathan actually can come and "change places" with him if he's absolutely convinced it has happened and will happen again. If the thought process is so messed up that they're convinced that what they think is real, it's really futile to try to change their thinking. Does that make sense?

    I do think it's a bit of a stretch to suggest that you help her learn how to behave based on her distorted reality, at least as a long-term plan. To me that doesn't make any sense whatsoever because then Kanga would essentially never be able to live outside of a very protected enviroment. I would think the goal is to get her to reconnect with at least a closer version of reality.

    I don't know - I think it actually does make sense when you're dealing with a kiddo who isn't "lying" or deflecting or just making stuff up, but with a kiddo who truly and absolutely believes what he/she believes in spite of the fact that there's no basis in fact. I would hope the treatment plan would address what strategies would be used to help Kanga develop a more reality-based train of thought.

    Just my 2 cents.
     
  12. Marguerite

    Marguerite Active Member

    I have learned with autistic kids, that the best starting point is to meet them where they are, and work from there.

    I recall in "A Beautiful Mind" John Nash COULD NOT accept that the delusions weren't real; logically he could understand (eventually) but it didn't stop them. I remember the scene where he bent down to talk to the little girl (who wasn't really there) and say to her, "I can't see you any more, baby girl." Although he knew the hallucination was not real, he still had to talk to her to say goodbye. He couldn't just switch off and walk away without looking back. It was an interesting point. And the delusions didn't stop.

    I also saw in that film - it didn't matter how much he was told that things were not real - he had to see it for himself, he had to get to a point of realisation for himself.

    Sometimes you need to say to someone, "I accept that this is your reality." That doesn't necessarily mean you are entering their delusion. But if constantly telling someone, "Honey, this isn't real" is not working, then maybe it's time to try something different?

    Some time ago I was closely involved with some children who were in hospital for Chronic Fatigue Syndrome. The parents were restricted in when they could visit. The kids were actually being treated by a psychiatrist who was also a pediatrician. The parents were only told the "pediatrician" part. The kids were 'encouraged' by a reward/punishment system, to get up and about. Get active. A kid who felt too exhausted to get out of bed was penalised by not being permitted a letter from her parents. This treatment forced the kids to push themselves. Maybe some of those kids COULD do it if they pushed themselves, but others could not.
    With time, the children learned that when asked how they felt, if they told the truth they would be punished. But if they lied and said, "I feel fine," that increased their chances of being allowed to go home.
    The doctors thought they had cured the kids. Instead, they just taught them to hide their illness and to lie about it. Lying to their parents as well, because a kid's mother might go to the doctor to say, "You've bullied my kid into lying that she's well when she is not, you've denied her access to the TV I've been paying for, you won't let her friends visit - how do you think this is helping her?" This would result in the child being punished later on by the doctor, and also would teach the child to not tell the parents.

    If we keep insisting to a delusional person that they are delusional, then we risk those delusions seeming more real than what we say. If I look at my table and see a cup of coffee there, if I can smell it, can pick it up and drink some - and you come and tell me it's not really there, who am I going to believe? You, or my own senses? And am I more likely, or less likely, to believe anything else you say?
    But if instead you say to me, "I can't see the coffee cup, but I accept that you can see one," then the situation has changed. I feel less urgency to hang on to the delusion - it's not longer a "tis", "t'isn't" exchange.

    I would be much more nervous if the therapist is saying that you have to drink an imaginary coffee too. I don't see how that can be in any way moving towards a return to reality.

    But bear in mind - I am not an expert.

    Marg
     
  13. dreamer

    dreamer New Member

    Hmmmm. I am thinking that um.....maybe therapist is thinking that challengeing her reality makes her too defensive to work on ways to cope with whatever her reality is? Many of us can learn to cope with things, no matter what those things are.....and maybe thats the true goal------to learn to cope and live in spite of whatever reality? Learn how to live with it.
    And maybe there is some "you get more flies with honey" in there, too?
    Challengeing what Kanga thinks is her reality takes focus and time and effort away from learning to work on how to cope in spite of what the reality might be? MY son sees colors very different than we do-----we no longer challenge his perception, and since we no longer challenge his perception of colors, he has begun to simply "go with the flow" and accept the colors are what we say they are....and none of us get sidetracked by being put into a position of feeling defensive. He has then been able to use his focus to identify the colors in a way that makes it possible for all of us to know what he is trying to say about what color is what. It has freed up his energies to learn how to identify important colors in other ways, becuz we no longer get sidetracked about what the color is or isn't. Kangas realities might always be skewed, but if she is given the chance to not have to be defensive, she may still learn positive acceptable ways to react to her perceptions.

    When I read the title of the thread, what came to my mind is-----depends on what you mean by "challenge" A person getting therapy needs to buy into the therapy, or it is not going to work. giving them ever increasing goals to meet seems to me to be a positive kind of challenge. Enagaging in an I'm right, you'rs screwy might not be the best kind of therapeutic challenge?
    When I worked with ALzheimers patients back in 1990 reality orientation was popular. Our unit stopped useing heavy duty reality orientation. We would be butting heads with patients who thought we were stranger danger when we were trying to bathe them etc. It did not matter how many times we TOLD them we were only trying to help them......what we found worked better for meeting goals and getting desired behavior was to work with them, find out what their reality was and work with things from there, and then, batheing and dressing and feeding became possible.
    People are going to trust what their own senses are telling them far more easily than they are going to trust someone elses say so.
    When my easy child began to drive, I told her NEVER EVER "go" at a stoplight just cuz the person behind her honked or becuz her passenger was in a hurry and SAID it was OK to "go" I told her she needs to make that judgement for herself. Go if SHE feels it is good and right to go, trust HERSELF. If there is an accident and crash, it is going to be her that has to live with those ramifications.

    Maybe Kanga is makeigng accusations, and maybe they are wrong.......maybe she can be taught how to handle it when she has an accusation to make-----how to talk it over with someone she trusts. She may be far more willing to work at it from that direction than from just being told, no, thats not true.
     
  14. Shari

    Shari IsItFridayYet?

    Wow. Um...well...

    First and foremost, I'd want some serious sit-down time with this dude before I turned him loose to start therapy-ing my kid. I'd want to REALLY understand his rationale, intentions, and goal with this.

    That said, however, I can see where this could be a valid approach. If you're dealing with a person who is schitzophrenic (sp?) or the like, it is my understanding that there are very many times that the afflicted person can not differentiate what is real from what is not. So until the symptoms are under control, telling them that what they are seeing or hearing or experiencing isn't real is like me punching you in the face and telling you "I'm not punching you, its not real."

    To you, its very real.

    To them, its very real.

    I would also say, even once symptoms are controlled, that anything they perceived to have happened to them in their past would have to be dealt with and treated as tho it were real, because to them, it was.
     
  15. timer lady

    timer lady Queen of Hearts

    JJJ,

    I have to tell you that I've dealt with this when kt was at her worst (dissociative state wise). While we did our best to keep her "here" we had to deal with the reality she was dealing with.

    In the hospital & in Residential Treatment Center (RTC) we saw a lot of the staff working with kt during her dissociative states & they had to work with what she was presenting - not what should be present. A difficult concept for a parent to grasp. We're supposed to be pushing for the here & now. I'd let therapist do what he/she can for the time being & see where it goes. Reality will hit Kanga soon enough.

    Take care of yourself right now. How's the pneumonia? Feeling better?

    Please keep us updated when you can. :flower:
     
  16. JJJ

    JJJ Active Member

    Thanks all. I've been working and taking Piglet to her games this weekend so I haven't been on line all day but I have read all of your responses and I now have a better idea of what she may have been getting at (thank you).

    Going to bed to try and rest my lungs...
     
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