Should I Let the New psychiatrist see the "Real" difficult child?

[DaisyFace]

Hello everyone--

Long story short, we had our intake appointment yesterday with a psychiatrist at the university who has agreed to do extensive "psychometric testing" with difficult child. Not sure exactly what it all entails, but the testing will take place over several sessions in 2 1/2 hour intervals.

Overall, I have a great feeling about this doctor. She seems very intelligent, experienced and understanding.

However, this psychiatrist does some "equine therapy" and said that most kids love horses and she would take difficult child out to the stable and expected to really bond over taking care of the horses.

Naturally, husband and I shared our experience with difficult child and horses. We told her that our attempts to get her involved with horses had gone horribly bad because difficult child was all attitude and ended up having more fun throwing rocks at them and chasing them over anything else. And this was just a few months ago!

And though the psychiatrist was very nice about it--we could detect that slightly smug "O well, clearly you two didn't know what you were doing and I know that I could get her very excited about working with animals" attitude.

In light of this, I am thinking about having difficult child come off of her medications for these tests. I think this psychiatrist should get a feel for the "real" difficult child instead of the highly medicated one.

I do understand that there are risks of increased depression by stopping these sorts of medications.

But at the same time, what will the value of this assessment be if the psychiatrist does not get to see the child's true nature?

What do you think? Am I just over-reacting to a psychiatrist's smug attitude? Or does this seem like a reasonable strategy to get an accurate diagnosis?

I'd love to hear your opinions and experiences...

Thanks!

--DaisyFace

 

[susiestar]

How is psychiatrist supposed to treat her if she cannot see the problems? If you have some time I would taper her off the medications. Just me. Wiz never let the medications interfere much with the problems he wanted to cause. Several docs (both kinds) concluded that he WANTED to cause many of the problems. He recently said he enjoyed the times when we were angry. It gave him a thrill to be powerful enough to make us lose our cool. It is why no matter what we did he would keep pushing and pushing.

The smug "she won't be like that with me" attitude would very much have me removing medications so she could SEE. I would also let her have difficult child for the equine stuff. Stay and watch. Maybe even chastise her for something in the car on the way to the barn and emphasize that she needs to behave during the session. It pretty much will ensure that she acts out, esp if you tell her you will be so embarrassed if she acts out.

That might even work while she is on eher medications.

Yes, it IS devious. It also will ensure that the doctor really knows what is going on and can come up with a realistic pplan for treating her. Just in my opinion, of course.

 

[Josie]

On the other hand, taking her off her medications might produce an even more unstable difficult child than before. The very worst days we had with difficult child 1 were when we forgot to give her her Lexapro the night before.

I would have a problem with a smug attitude and feel smug myself when difficult child showed the behaviour to the psychiatrist. I think it wouldn't be a bad idea to push her buttons before the appointment.

If the medications are helping and she is better around horses, then you have part of your answer anyway.

We successfully weaned difficult child 1 off from 20 mg of Lexapro, but we did it over a year. Every time we decreased the dose, there was an increase in symptoms which would have led her psychiatrist to think she needed it. The symptoms started in the 3rd or 4th week after the decrease and lasted a few weeks. We kept on because we had changed her diet and had faith that it would work due to my experience with it. She has been off for 3 years so it is clear she doesn't need it and her increased symptoms were withdrawal effect.

Withdrawal effect would also give the wrong picture.

 

[gcvmom]

I believe that for some medications, it's not necessary to take her off for the psychiatrist to get an accurate picture, especially if the testing is looking at numerous facets of her behavior/personality/cognition/etc. I would consult with this psychiatrist before doing anything with her medications.

 

[DammitJanet]

I dont think a bit of button pushing is a bad thing. On the other hand, I never had to do this. Cory was an all around PITA. He could never honeymoon at all. I guess that was a blessing...lol. I always worried I would get the call saying "oh I cant understand why he is here" but I never did. I got the calls saying they were amazed we hadnt killed him yet...lmao.

 

[Marguerite]

Seriously - check your motives. If you want her to see difficult child at her worst so she knows how bad things are, and if this is appropriate, then do it. But if you want to prove a point, then don't.

I understand the temptation to cut through the smugness to a faster "get real" from the therapist, but the main issue here must always be, how to accurately divine what the problems are with difficult child, and from there how to get the most appropriate help.

So to that end - ASK the therapist if she should be medicated or unmedicated for the testing. It could be very important, and on the one hand you could be doing exactly the right thing, but on the other hand you could be doing exactly the wrong thing. The main aim is to get the RIGHT picture and for this, you really need open and frank communication between you and the therapist.

If the testing required difficult child to be medicated, then do it that way. You WILL get the chance for therapist to see her unmedicated.

When difficult child 1 was having a very important neuropsychologist exam, we accidentally missed his medications that day. It was important. And it was not a good thing, from the point of view of them getting an accurate picture of his diagnosis. They got it wrong, because of this.

If in this case the therapist can get through to difficult child with horses even where you couldn't, that still is a win, even if you feel it leaves you with egg on your faces. Chances are at some stage, difficult child will show her true colours. But even if she doesn't - for her to finally accept hippotherapy, is a good thing.

difficult child has to be the one to benefit here. All the embarrassing/frustrating stuff - save it up to trot out for her 21st and embarrass her publicly with it then. So if by her 21st, difficult child is an Olympic equestrienne - then remind EVERYONE publicly at her party, just how bad she used to be with horses.

To embarrass your kids at their 21st, or their wedding - it's a parent's job. But to keep it honest and real with a therapist and put the embarrassment aside for now (and grit your teeth at the same time) - that is also a parent's job.

I do understand the temptation, though.

We can dream...

Marg

 

[DaisyFace]

Thanks everyone!

It makes me feel better to see that I am not the only parent who has thought of such a plan in light of a psychiatrist's attitude...

Susie--You described exactly how I felt!

Hope--You are so right. Withdrawal symptoms is a worry...

Marg--You hit the nail on the head exactly! You and GCVMom both recommended speaking with the psychiatrist first before making a change...

Janet--LOL! I envy you....and I don't! Isn't it terrible when we wish for our kids to be a PITA???

So...

I "slept on it"...and as I woke this morning I realized that as much as I want the psychiatrist to see the "real" difficult child....and I do, regardless of smugness...I really don't want to LIVE with the "real" difficult child while we are going through the testing process over the next several weeks.

While the medications are not a cure...they have certainly tempered some of the violence. Do I really want to bring that back, full-force just for this?

Honestly, my answer is "NO!" and "Heck NO!".

So, I called the psychiatrist and asked whether difficult child should be medicated or non-medicated for testing. She would like to start WITH medication...and go from there.

So, it sounds as though I will have a chance to show her the "real" difficult child later if the child's issues are not apparant at the early sessions.

So, I guess we will wait and see for now...

--DaisyFace

 

[Marguerite]

Eventually, sooner or later, therapist will see the "real" difficult child. it will be just as satisfying, maybe more so, the longer it takes.

Hold that thought and hang in there.

Marg