Aggravated and humiliated (ridiculously long; sorry)

[Rannveig]

Some of you may remember how my easy child/difficult child 'tween son was saying he was having frightening thoughts that were keeping him from sleeping, and he thought suicide might be better than facing any of the horrible deaths he was imagining. He has also been tearful lately and not wanting to be left alone.

So I asked him about seeing a GP for a chat and to see what would be the best way to help him. He agreed, and I got the appointment for today and said I'd pick him up at home and take him. So I took off work and got home...and no one was there. I called his cell, and he didn't answer. I called the nanny (who mainly cares for my daughter but normally knows where my son is and also knew we had this appointment), and she didn't answer her cell either. Called husband at work -- he knew nothing. Went to the doctor's office in case my (very independent) boy had gone on his own -- no sign of him. Went back home -- he still wasn't there either. Returned to the doctor's office and figured I'd at least talk to the GP myself to give him all the information I could. After all, he'd generously rearranged his schedule to fit in my son.

But of course by that time I was feeling pretty fragile. I was embarrassed that my son was a no-show and that I had to admit I couldn't find him. And I was furious that I was missing work and getting behind on a project and not even getting my son in front of a doctor for my trouble.

So I was really in no condition to hear what the doctor had to say. He wasn't exactly unkind, but what he said really upset me. He suggested my son is talking about being depressed as a way of manipulating me to get attention and to get out of chores and that I need to be stricter. He even mentioned Munchhausen's at one point (which I guess by extension means I might have Munchhausen's-by-proxy; after all, I had claimed my son was seriously in need of help, but said child had dodged the appointment). He then seemed to conclude that my son doesn't get enough attention from husband and me, so we need to spend more time one-on-one doing fun things with him. But, he said, my son would have to be invested in the success of these activities, so we should draw up a contract with him.

I have no desire to enter any sort of contractual relationship with my child. But what really bothered me was that the doctor was spewing all this advice without having talked to the kid yet. And I didn't like him impugning my kid's character, either, saying he's manipulating me. I can see my son is in pain (he has been crying a lot) -- he's not perfect, but I'm pretty sure he's not a sociopath. And here the GP was saying, well, you know, it could be a personality disorder, not depression, but don't worry, maybe it's not a serious personality disorder. Oh, okay then. Well, actually, not okay! I started to cry.

Then after nearly an hour of this (during which time I again called home and got no answer), the doctor said he didn't think he was the right one to examine my son in any case, that I really should see another member of the practice. (Note that in requesting the appointment I had summarized the issue, so he met with me already knowing that he wasn't going to want the case.) I got even more upset then, because having just explained the whole disturbing situation I realized that I would now have to start from the beginning with this other physician. So I had just taken time off work and spilled all this very personal, painful information for nothing.

I left and went back to work. A little while later my son called. He had been playing at a friend's house (something he's allowed to do without special permission, as we know the family well) and simply forgotten the appointment. I had confirmed the appointment with him just last night, so getting distracted and forgetting about it was ridiculous, but I don't disbelieve him. He's always zoning out. The other night he asked me to check his homework, and while the work itself was fine, he'd forgotten to write the last two letters of his first name! He's just weird that way. Of course, he may also have wanted to forget. But he seemed genuinely remorseful and repeatedly apologized and was very solicitous of me all evening. I don't know, is that just manipulative?

I asked him if he wanted to see the other doctor next week, and he said yes, so I guess I get to try again. But now I'm dealing with a new layer of anxiety about whether I'm again going to be told this is about my being a too-absent or too-naive parent. And I feel like I never want to see the original GP again, even though before this I'd liked him.

Thanks for the space to vent. I'm sorry for your own troubles and hope everyone somehow has a nice weekend.

 

[confuzzled]

i am so sorry for you. thats awful, all of it.

and not a word the dr said sounds too right to me....what exactly would this dr base all of this on? (munchausen's by proxy is a pretty *serious* thing to throw out there---and is a very specific diagnosis, in fact, one that usually goes undetected for some time, not mentioned on a first visit, and i'd be as offended as you sound.).

i think if your difficult child is asking to go, you probably should--whether to the other person in the practice or someone completely new is up to you.

and i think i'd schedule it, if you can, first thing in the am, even if it means going to school/work late---in my humble opinion, he's kind of imperative to the appointment.

hope you feel better....its not you.

 

[Fran]

Definitely get another doctor.
There is a "Parent Report" archived somewhere on this site. If you print it out and fill it in, it will help you present accurate info to a professional. It's an excellent resource and will help you in a multitude of situations.

Any Dr. who mentions Munchhausen's when a parent is worried about their child should have their tongues fall out. (been there done that with m i l, many years ago). I'm glad he excused himself. Not every doctor is comfortable with psychiatry. Find a specialist.

 

[Marguerite]

He even mentioned Munchhausen's at one point (which I guess by extension means I might have Munchhausen's-by-proxy; after all, I had claimed my son was seriously in need of help, but said child had dodged the appointment).

Not at all. There is a huge gulf between Munchhausen's, and Munchhausen's by proxy. The perfect indicator that your case is NOT MbP is, your son was clearly not in your control. He failed to turn up. You can't have MbP if the child is not completely controlled by the parent. He mentioned Munchhausen's but you already said you weren't fully paying attention because you were so upset. He may have been saying, "Well, it COULD be, but I don't think so; we would need to rule it out." He sounds like he was desperate to help you and was probably grasping at straws.

But what really bothered me was that the doctor was spewing all this advice without having talked to the kid yet. And I didn't like him impugning my kid's character, either, saying he's manipulating me.

Don't be too hard on the doctor - he was doing the best he could, anything he said was prompted by what you told him. What else could he do? I know others advise moving on and finding a new doctor - you feel you want to, but a big part of your feelings I suspect are due to you having exposed yourself so much, perhaps showed so much emotion that you feel embarrassed to see him again. Don't be concerned by this. Often when the doctor sees this, they realise just how desperate we are and that desperation does not come out of thin air.

So I had just taken time off work and spilled all this very personal, painful information for nothing.

No, it wasn't for nothing. You got the chance to say as much as you could (the patient's presence would have helped - but you had done what you could) and you had told the doctor enough for him to suggest referring him on. It sounds like the doctor, if he had seen your son, would have said the same things to you anyway. When we are concerned about our difficult children, a GP is the first (brief) port of call; what we need is a specialist referral. You have that. Even if the person you have been referred to is another GP, it will be a GP with more experience in difficult children and hopefully better able to help you find the right specialty, trying to shortcut your trek to a diagnosis.

The process of getting your child assessed and diagnosed is not linear. It is tedious, it is distressing and it is very frustrating in the ay you bounce form one referral to another, hopefully each time getting closer. It is like walking a maze; there are dead ends and wrong paths, but each wrong path explored is a path ruled out. WHat remains reduces in the number of possibilities and this is a GOOD thing, because it means you are more likely to get onto the correct path, when you have eliminated more of the wrong ones. And with a maze, when you are really lost - put your hand on the left wall (or the right - pick one and stick to it) and keep your hand there. Very few mazes cannot be solved that way eventually. It takes longer, you cover more of the same territory, but eventually you will get to the end of it. OK, enough metaphor.

But he [difficult child] seemed genuinely remorseful and repeatedly apologized and was very solicitous of me all evening. I don't know, is that just manipulative?

Not necessarily. He does sound like he has serious attention issues rather than being manipulative. It would fit with what happened.

Next time - hang a note round his neck. Seriously. Get one of those ID necklace things, inside the plastic sleeve put a note which tells him where he is supposed to be and when. Hang the thing around his neck before you leave for work. Make the note prominent so even if he fails to remember, whoever he is with will notice. If he isn't with anybody, he will hopefully be at home to answer the phone. Another option is to get him a mobile phone so you can always get on to him. If you're worried he could abuse the privilege, there are phone types which can be greatly restricted in the uses that they can be put to. A good example is the Tic Talk phone. I'm sure there are others.

I've been keeping my eyes open on your posts because some things concern me. What difficult child has been saying is definitely a concern, it could be manipulation. Or it could be serious depression resulting from extreme frustration with himself, not able to stay focussed and on task. The kid is the first one to suspect something is wrong, and generally they catastrophise much more than we as parents could do. Getting a diagnosis can be a huge relief to a kid who may be thinking he has a brain tumour, or is going mad. Extreme anxiety alone could explain a lot of your son's behaviours. Add in the concentration issues (losing track or not paying attention is not always a matter of concentrating hard enough; sensory input in general could be causing overload) and you have what you describe. There can be other totally different explanations for this, which the doctor was understandably unwilling to discount, in the absence of the patient.

You also describe him as a little professor - that scrams at me that Pervasive Developmental Disorder (PDD) needs to be on the table. ADHD or simply ADD often can overlap with Pervasive Developmental Disorder (PDD) in some form. I can't remember if I suggested you do the Pervasive Developmental Disorder (PDD) questionnaire on the website www.childbrain.com. It can't be used to diagnose - nobody can diagnose in absentia, that includes your GP. But you can print out the questionnaire results and take them to the next appointment, regardless of the results. It could be of use for the doctor and if you are concerned that the GP may have got things wrong, then the Pervasive Developmental Disorder (PDD) questionnaire will provide a balanced summary of what is a concern and what is not.

Don't beat yourself up over this mix-up. It is a pity you had to duck out of work and a blasted nuisance, but the fact that this happened is also a valuable bit of information. More and more, I think your son's scary thoughts are his own fears, and even his own fear of himself, coming to the fore. I remember difficult child 1 being scared of his own very strong feelings at times. HE could get very angry and when younger often very violent. But when calmer, he was genuinely scared of what he felt he was capable of when angry. He was genuinely scared that one day he would hurt someone he loved, and knew he would have a hard time living with himself if this happened. I found this very distressing.

Don't apologise to us - we are all parents like you, with our own concerns. If we don't understand, who will?

Marg

 

[Rannveig]

I went to bed last night very sad about everything, and then I woke up this morning and found these responses and felt a great deal of relief. Thank you Confuzzled, Fran, and Marg.

I went to that website you recommended, Marg; thanks, it was really good. I found my son doesn't fit the Pervasive Developmental Disorder (PDD) criteria at all but definitely would seem to fall on the ADD-Inattentive spectrum. When I say he's like a professor it's because he has deep (for his age), philosophical thoughts and in general is very reflective...and a bit dreamy, or "off in the clouds." He's not a professor in the sense of reeling off lots of facts. If anything, he's very strong at remembering emotions. As I was writing this he came in and said unprompted that he doesn't need a contract with me to know that I love him.

Anyway, in reviewing the ADD info on the site I was reminded of one useful thing the doctor said. I told him how Odin's teacher last year complained that he didn't pay attention in class (though he was not disruptive) and got little done when the children were given class time to work. I had asked the teacher whether she thought he might have inattentive ADD, and she said no because he scores very highly (98/99th percentile) on standardized tests, and inattentive kids can't get far enough on such tests to score highly. The doctor disagreed, saying that sometimes the inattentiveness only becomes apparent when the material becomes more difficult, while in fact it has been there all along. (And if Odin is only beginning to realize he has such a problem, wouldn't that explain at least part of the anxiety and depression?)

I give the doctor credit for referring us on; I guess he knew he was grasping at straws and out of his depth...and it's never a good sign when the metaphors start to pile up like that. Yeah, I still think that even uttering the word Munchhausen's in a preliminary consultation is unconscionable, but you all helped me realize that I need just to let it go. The important thing is to move forward and get the right help for Odin.

Thanks again for being/maintaining such a wonderful community here.

Warm good wishes to you all, Ranny

 

[confuzzled]

I had asked the teacher whether she thought he might have inattentive ADD, and she said no because he scores very highly (98/99th percentile) on standardized tests, and inattentive kids can't get far enough on such tests to score highly. The doctor disagreed, saying that sometimes the inattentiveness only becomes apparent when the material becomes more difficult, while in fact it has been there all along. (And if Odin is only beginning to realize he has such a problem, wouldn't that explain at least part of the anxiety and depression?)

i'd agree with the doctor on that one.

consider the fact that the teacher is comparing him to the other students in the class.
i may have told this story before, so forgive me if its a rehash.
when mine was learning multiplication, i was worked into a frenzy because she just couldnt seem to get the higher numbers consistantly and it was clear she wasnt fully getting it, at least to any reasonable adult that memorized the times tables and knows them by rote.
teacher said she was doing fine.
i was dumbfounded...i kept saying, but she doesnt KNOW them.
until the day that a stack of test papers accidently got stuck together and all came home with my daughter.
she was on the 8's, and missed two after studying hard and practicing at the bus stop.

the other papers?

were all on the 2's, with the majority wrong.

so my point is, when the teacher compared my daughter to the rest of the pack, well, sure...she was doing beautifully.

maybe O is a genius in the land of the average, and his natural intelligence is overcompensating for add-in.
i can tell you from my experience--my youngest does exactly that--she has crazy retention *WHEN* she focuses. she has an inate ability to extract the important and zone on the rest of the material.
we only realized just how much this impacted her during a specific class, one in which she was taught 5 ways to do 1 thing at a variety of times....she knew it alright, she just had no idea when to do what with which variety, LOL. so she missed the big picture, so to speak. i suspect she wasnt alone, but i know mine well enough to know it couldnt go on a second longer, and we intervened immediately.

she's also in the 99th%tile, and has been an honor roll student every quarter of her young academic life. and not only has add-in, or combined (its up for debate which variety, and/or if its a primary diagnosis or a symptom of others--take your pick, treatment would be the same), but has more pull-out than a person humanly should, and zones out on the drop of a dime....she cant sustain attention if her life depended on it.

your O might be a similar master of overcompensation, and the question, regarding standardized testing might be what is the test testing? it would stand to reason if he's very bright and can rely on his intelligence on an intelligence testing standardized test he'd be fine. if the test is testing acheivement, it would still be reasonable to assume that underlying intelligence could help one deduce the right answer....i might not know the definition of X word, but in a field of 4 choices, i'd probably be able to narrow it down if i knew the meaning of the parts of the word...that example shows how my natural abilities would not necessarly correlate with my yearly acheivement, Know what I mean??

 

[TerryJ2]

I'd blow off most of what the dr said. I'd find a new dr.
It makes me mad, just reading what you typed.
Can you arrange to pick up your son from school when you go to the new dr appointment? (And I mean "new" as in completely diff dr.) Since you're taking time off from work, you may as well make it worth your while!
Many hugs.

 

[Marguerite]

...inattentive kids can't get far enough on such tests to score highly...

You said the doctor disagrees with this. So do I. Especially if the child is bright. The testing environment is generally a low distraction environment. The room is often darker, quieter, and low-movement. A classroom is generally a bright, stimulating place. But testing usually requires all stimulating (and also educational) material to be removed, for fear of students using it to find answers.

So formal testing and exams, ADD kids often do a lot better.

One thing to watch for, and to NOT let teachers blow you off about - if Odin is very bright, he will be frustrated with himself even while achieving at average level. For a bright kid, average is under-achieving. But too often, teachers will say, "He's doing OK, don't worry," when the child should be doing a lot better. And they feel it inside and begin to behave badly and also often feel anxious and depressed.

The aim is for each child to be the best they can be. That means a child who simply isn't that smart, needs to feel OK about this and to feel encouraged about what he can do. And a bright kid who for various reasons can't stay on task, needs to be helped to find ways to manage, in order to do as well as he should, even if he is already doing well.

He will develop his own strategies.

difficult child 1 is very ADHD (as well as Aspie). The ability to focus is intense, once he can avoid distraction. He taught himself to avoid distraction by mentally cutting down on sensory input. When he concentrates, it is so intense that he really can't hear if you talk to him. We had to go touch his shoulder and turn his hear to look at us and make eye contact. And even then, we had to write a list for him of things to do, and not rely on verbal messages.

Don't be fooled by the awareness of emotion - difficult child 3's first 'game' he played with us as a baby and toddler, was "display the emotion". We would say an emotion and model the expression on our faces. it was stylised, it was fun. And it was the only imitative game difficult child 3 could play. You know how you can say to a baby, "Where is baby's eye?" and then teach the baby to touch his eye? "Where is baby's nose?" and he touches his nose. And so on. Well, difficult child 3 could not play that game. He could not learn the parts of the face or body. But he COULD learn to model expressions ins response to them being named. "Show me - happy!" and difficult child 3 would smile. "Show me - sad!" and difficult child 3 would quiver his bottom lip. "Show me - angry!" and the baby face would scowl. We went on to add other expressions - confused (finger on chin, looking quizzical), surprised, scared, excited.
Years later, difficult child 3 would use these modelled expressions to communicate his feelings to the world. His teacher in Kindergarten said to me, "He's clearly not really angry, he is just pretending," because the anger expression was clearly assumed by difficult child 3, put on like wearing a mask. But I made her understand, difficult child 3 had no understanding of natural expressions. Putting on his angry face was the only way he could communicate to her that he really did feel angry.

difficult child 3 is now 16 and although Maths & Science (plus computers and related topics) are his best subjects, he also has a knack for poetry and can discuss poetry at a sophisticated level. In some areas. This has really puzzled his teachers, who have a hard time "getting it". It's just not typical.

Your findings on the reading do indicate that Pervasive Developmental Disorder (PDD) is less likely. But don't totally rule it out. Keep it on the backburner, rather than in the bin. Focus on the ADD-inattentive as the working hypothesis, also on what I'm fairly sure is a high (but not easily accurately measured) IQ. Encourage him, tell him you believe in him and that he is smart regardless of what he sometimes feels or what people sometimes say. If he finds something he loves, support him in it. It could change to something else - it happens. Follow him, support him. It can really help a kid who is otherwise feeling anxious and depressed, to have a hobby or interest he loves, and parents who support him. For example, difficult child 3 loves to take photos. We couldn't afford to let him have free rein with our film camera, or we would have been paying a fortune for film development. Then we bought our first digital camera, and we couldn't risk a little kid breaking it. But when we could, we let him 'play' while I took him for a walk in the bush. WHat we saw in the photos that this little kid too, blew us away. We quickly found that photography was helping him learn patience, too. If you want to take a photo of a bird, you first have to go where the bird is. But the bird will fly away. So you sit quietly, not moving, and wait. And wait. Eventually, if you can be still long enough, the bird will come back and you get your photo. We never thought difficult child 3 would ever be able to sit still for so long!

Whatever your child can handle, stretch him. Work that brain. He's going to need every advantage yo can give him.

Marg

 

[TerryJ2]

Don't be fooled by the awareness of emotion - difficult child 3's first 'game' he played with us as a baby and toddler, was "display the emotion". We would say an emotion and model the expression on our faces. it was stylised, it was fun. And it was the only imitative game difficult child 3 could play. You know how you can say to a baby, "Where is baby's eye?" and then teach the baby to touch his eye? "Where is baby's nose?" and he touches his nose. And so on. Well, difficult child 3 could not play that game. He could not learn the parts of the face or body. But he COULD learn to model expressions ins response to them being named. "Show me - happy!" and difficult child 3 would smile. "Show me - sad!" and difficult child 3 would quiver his bottom lip. "Show me - angry!" and the baby face would scowl. We went on to add other expressions - confused (finger on chin, looking quizzical), surprised, scared, excited.

Wow, you were way ahead of most people.
We did the eye, ear, nose touching, but I didn't do expressions until my difficult child was in elementary school.
Oh well, better late than never.

 

[Rannveig]

I think Odin intuits and responds to emotions rather than mimicking them, but I gratefully take the point that I need to keep my mind open. That will take courage, and having this board's support very much helps in that respect. Thank you again, Confuzzled and Marg, and also Terry!

Odin came into my room in the middle of last night and said he couldn't sleep because he felt something was very wrong. He couldn't define what and didn't have any physical symptoms (other than not being able to sleep) to suggest a panic attack; he hadn't had a bad dream. He just felt some sort of foreboding (not his word). This is just so strange. Or maybe it's not. I'm not sure I never had that happen to me as a kid; I just wouldn't have dared disturb my mother's sleep (long story). So maybe it's another symptom of depression.

Anyway, thanks again, and I hope everyone has a good, encouraging week.
-Ranny

 

[TerryJ2]

I think you may be right about depression and panic attacks being related to a feeling of foreboding. Unless he's got a spot-on history of psychic accuracy , I would stick to the emotional clues.
I am so happy he feels safe enough to wake you up. Doesn't do much for your sleep patterns, though!
Were you able to soothe him?
I would have a conversation with-him and try some cognitive therapy, if you think he would be receptive. Simply state that unless a feeling "that something bad is going to happen" is proven correct (especially with-repeated occurances, a trait typically acquired by ACOAs and war victims), he needs to 1) recognize the feeling, 2) recognize the lack of threat by assessing his surroundings, 3) stabilize himself, again, by recognizing his surroundings and validating that they are safe and secure, and then 4) replacing the misplaced feeling with one of calm and peace.
No easy task for a kid or an adult!
I would not suggest that he validate his feelings by checking all the locks. You don't want one thing to lead to another.
As a creative person who has long dealt with-nightmares and odd thoughts (but lucky enough to be able to put them to use!) I have learned to pick up on cues around the house such as whether the dogs are barking and whether the power is still on.
You know how you wake up in the middle of the night because something is wrong? But it's so quiet that nothing is really wrong? And then you realize that something is wrong--because it's too quiet? Because the power has gone out?

It could be little things like that, that he is hypersensitve to.

Is he able to create anything from his fears or thoughts? Artwork? Stories? Music? I would encourage him to. It will help him express himself, put his energies to good use, and give you a clue as to what's going on in his mind.

 

[Marguerite]

Show me - angry!" and the baby face would scowl. We went on to add other expressions - confused (finger on chin, looking quizzical), surprised, scared, excited.

Wow, you were way ahead of most people.
We did the eye, ear, nose touching, but I didn't do expressions until my difficult child was in elementary school.
Oh well, better late than never.

Terry, we weren't ahead. We just did what worked. The usual baby games didn't work, and difficult child 3 was non-verbal. We had jargon speech and that was it. I give easy child 100% of the credit for starting that game with difficult child 3 - somehow she found the chink in difficult child 3's behaviour that opened up room for this game. No other game worked except "peekaboo" which was only one-way. difficult child 3 would laugh if we did peekaboo, but wouldn't do it back.

Ranny, what I'm saying here is to keep looking for these chinks or openings in your connection to him. Where possible, meet him where he is and do what he does, be with him doing what he likes. And from there, lead him towards what you like (quid pro quo) as much and as far as he can tolerate. It shows him that you care and want to connect, and that also shows him that he is worth caring about. That's an important message for a kid who is beginning to hate himself.

Marg

 

[TerryJ2]

Oh, Marg, I had forgotten that difficult child 3 was nonverbal.

Interesting about Peekaboo. Now that I think about it, difficult child did not do it back, either. Hmm.