Therapy? Medicate? What to expect!

I know many of you are as confused as I was and still am about therapy and medications for OCD. What works for some does not work for everyone! Let's keep that in mind as we move forward! Let me just share our experience a little, then I will share many options, and ideas of how to find a professional to work with, as well as what medications are used to treat OCD.

 First meet Selena, she is our granddaughter, but through adoption she is our daughter. We love her to death just like you love your children! When did I first recognize something wrong? From day one! Selena did not like being swaddled, she couldn't stand formula even dripping on her hand. She was not colic, but these things just drove her into a screaming fit. When we started solid food, she preferred vegetables over fruits, she would never even think of touching her food with her hands! She detested shoes on her feet and preferred to go barefoot, yet she was early to learn to read, she taught herself by age 3. It really wasn't until we moved from a tiny house to the large house we live in now before OCD and it's true symptoms even appeared. She did not take well to the change, and still will cry sometimes if we drive by the old house. (right now I need to let you all know she is also on the Autism Spectrum, but that is besides the point of OCD)

Her OCD did not make sense, to us. She showed signs of not liking germs, but yet she did a lot of things that we found just discussing. She couldn't go into the barn, because of the dirt, yet she was thrilled to play in the dirt, and watch all sorts of insects and even hold them. Her diet consisted of only a few dishes, and non of her food could touch, nor any new food could be on the same plate, she always had two plates. You didn't dare enter her space, try to help her cut her meat unless she asked, couldn't help brush her teeth, the list can go on and on.

At a loss as to what to do, we went to seek help, the first psychiatrist we seen was all about medication. We were not sold on that idea so we kept seeking. The second psychiatrist misdiagnosed her, which again we did not agree on and searched for yet another one. The one we have now is excellent, I can't even imagine having him not treat her. He suggested psychologists to work with Selena. The first one had her office in a house, because of that Selena's OCD could not except that. She couldn't go to see this person, because she was suppose to have an office not a house. The second psychologist was more concerned with behavior then the OCD. The third depended totally upon dietary changes, WAIT we were already living on a very restricted diet, how could I restrict it even more? The fourth made Selena feel less then normal. We turned to alternative therapies. I am not stating these things to make any of you feel that therapy will not work, I am just saying that you have to sometimes go on a search until you find the right therapy for your child! Don't ever be afraid to question the therapist, their personality, their method, and how your child might feel.

There are different types of therapy for OCD, one of the most popular is ERP, Exposure Response Prevention. The idea with this therapy is to expose the child with the things that create the OCD, and address the behaviors or rituals and try to find better ways of responding. This may work for some, and at first you might see escalated symptoms or behavioral issues. Some do not respond to this at all. Keep in mind not every treatment is for everyone. Also I believe the therapist MUST be a fit.

Some like to use the book, "Talking Back to OCD" which is a combination of ERP but also tries to explain to the child that OCD is a monster talking to them. This also takes in dietary changes. Depending upon the child this is successful! The child just has to know that monsters are not real and not everything is a monster! We tried this but everything turned into a monster, we had to finally line all the monsters up and kick them out the door and demand that they NOT come back.

For us most traditional therapies made Selena feel "Not Normal!" Though I know many who go through therapy with great success! Again not every therapy model or therapist fits every child!

Medications to treat OCD mostly consist of antidepressants, mild antidepressants given at small doses in hopes to treat the anxiety. I am very anti medication, and found that most of these medications made the OCD worse. Probably in our case due to the Autism we had going on too. Do these medications make our child a zombie? I have to say in mild doses probably not. I don't know about you but I myself have had to take antidepressants before, they didn't make me feel like a zombie. Is it something we want to give our children? That is a personal decision.

Now I want to talk a bit about non conventional therapies. I began my research in this area when I felt I was running into brick walls. Keep in mind we are treating not only OCD but Autism, but I have discovered allowing the child to do something they love or are passionate about with a person who has an understanding of OCD is very effective. As I mentioned earlier, my child had a hard time going into a barn, yet she loved horses. We found a person very passionate in horse whispering and began horse riding lessons. She had to enter the barn, but through her desire to learn to ride horses, and communicating with the horses she now can enter a barn. Not only that it built her confidence and has helped her to communicate with us on the other aspects in her life that bothers her. Any activity that your child enjoys, swimming, martial arts, so long as the teacher is able to understand your child's difficulties and has a willingness to work with you, can be an alternative therapy. Keep in mind they can be expensive and because they are alternative they are not covered under insurance.

I want to emphasize that we all get to a point we feel like we are at a loss, how do we help our child. It happens through trial and error. Sometimes somebody else might know of something that has worked for them, that is a perfect fit for our child. I do not want to create a community like some where all we hear is the negatives, while these are real, but we can ask positive questions, and receive positive support. I will not address all questions myself, I am not a mental health professional, I am first and foremost a mom just like all of you who have walked the same walk. I am more then willing to post to the group questions you ask and encourage others to share their experiences.

Other Tips When Looking at Specialists

We met with Selena’s Psychologist last week to go over the numerous questionnaires we all had to fill out. The results were truly what we expected with Anxiety Disorders the main source of her problems. She was very different in his office from the calm we seen in the waiting room. We mentioned several times that her anxiety was high but the Psychologist misinterpreted her behaviors as not having the attention. He gave us a few things to try here at home to help her through the calming process.

We fully expected her to reject some of these things at first and that their would be other behavioral issues we would see. What we got though was not what any of us expected. I called and made an appointment for just him and I to meet. The morning of that appointment Selena was pretty anxious even though she was not going with me. She finally admitted to having panic attacks or in her words “Funny feelings in her heart.”

Her psychologist felt horrible that he had not picked up on how bad her anxieties truly are and misread her behaviors. He literally grabbed the information about the other psychologists there in the office. We could switch if we wanted to. Of course that was not something I wanted to do so I asked him to put the information back on his desk and just talk with me first. As we talked and I shared more about what behaviors we had seen, and about her panic attacks, he realized I was not in there as a mom under attack mode but more of a mom just saying you need to understand her more, listen to us more, and we need a new direction.

I can’t emphasize enough when ever you are looking for a specialist for your child first do your homework. You need someone who is going to be willing to say I am  human and do make mistakes, but we can still change. To often specialists just take the attitude that they know it all, but remember not any one  method will work for everybody especially when your dealing with a child.

Find someone who wants a relationship with you the parent, while their main job is to help the child, who knows that child better then anyone else…you the parent. They should always make time to listen, talk, and brainstorm with you the parent the options that will best fit the needs of your child.

We are glad that we took the extra time to meet one on one with our psychologist to discuss our concerns especially when we truly did not feel he was perceiving the whole picture of who Sunshine is and how she ticks.

My next posts will be on what we are doing, how they are or are not working. Just consider this as the beginning to a new life for Sunshine. 

Choosing a Psychologist and Our First Visits

When I began my search for a psychologist to work with Sunshine, I of course did a lot of research before selecting just one. I expected certain credentials as well as expertise in working with the areas we were concerned with. I wanted someone who would be experienced in all aspects and who would pick up on things that we might not be picking up on. With that said I found a psychologist who not only brought to the table the things I was looking for but also who was experienced in  many areas of a child’s development. Yes, what you see in the picture below is just what you get, a man who is kind, gentle, caring, and who takes his job very serious. He not only knows how to communicate with children, but has very good communication skills with the parents. I love the way his tone can go from the adult to the child in the matter of the same sentence, so that he is not only talking to the adult but also bringing the child into the discussion to confirm to them that they need to hear too. I admit at times it was confusing for me and I had to really watch his eye contact to make sure he was indeed talking to me, and not to Selena. Though I know she didn’t miss a beat in the discussion and came home able to tell me exactly why she is seeing this psychologist.

Meet Dr. David Callies and read about his experience:

His focus at Madigan was on the treatment of children and adolescents with emotional and behavioral problems, attention problems, anxiety, problems adjusting to life circumstances, depression, developmental delays, pervasive developmental disorders like Autism and Asperger’s Disorder, deployment-related problems and youth with chronic medical conditions and illnesses.

As the Chief of Child & Family Services at Madigan he provided outreach services and training on child resiliency to service members. In addition, Dr. Callies routinely collaborated with Developmental-Behavioral Pediatricians in the treatment of pervasive developmental disorders and was the lead psychologist in the Diabetes and Hematology & Oncology clinics at Madigan to meet the psychological needs of children with Diabetes, various cancers and other medical conditions.

While he is no longer at Madigan and has joined Gyro Psychology, he continues to strive in the health of a child. He also does a lot of work in the schools, educating staff, parents, and assisting with the children in his care, though he does not work in our school district.

I can’t emphasize enough the importance of seeking whoever you feel will be the best for your child. Don’t just rely upon who your Pediatrician recommends, who the school recommends, but do your homework, ask around and visit virtual websites to learn more. It is OK to disagree with your Pediatrician and schools and to seek outside treatment based upon what you feel is best for your child.

The very first visit was without Sunshine. Dr. Callies and I sat down and we discussed why we were seeking assistance. We also discussed what services he provides as well as to his techniques and views of what therapy should look like. He then sent me home with questionnaires for myself, Papa, and Sunshine.

Our second visit was for Sunshine to meet Dr. Callies, and to learn why she was there. He explained this to her while I was in the room stressing that Mom loved her very much, and acknowledges all her strengths including how smart she is, but that mom sees times of too much stress and worry which cause her to break the rules, and act out inappropriately. He then turned to her and told her that she was there to learn to understand this stress and worry and to learn how to make better choices when dealing with these things. At this point he asked Sunshine if it would be OK for Mom to leave the room reassuring her that Mom would be in the waiting room. He even told her that she could come and see Mom at anytime she needed to. She had a hard time letting me go, but gave me a big hug for reassurance and a huge kiss. She did have to come out and check on my one time during their visit. They played card games, worked puzzles and visited the entire time. I was brought back into the room at the end to go over his observations.

He complimented Sunshine on her communication skills, her attention to detail, and while he noticed her fine motor skills were a little behind, nothing out of the range for a child her age. No surprises there. He did get a good look at her photogenic memory when she asked to do one of the puzzles again, he was trying to show me how they broke it into 4 sections. Half way through his explanation she already had the puzzle put together and was ready tear it apart and restack the pieces back in the box ever so neatly.

From here now we begin to map out or journal her days, the times we see her OCD and stress, what we see as the trigger if we can pin point it. We will also begin to put some things together in our home for her to do during these times that will hopefully help her to calm down. A play dough area, a coloring area, reading area, and limited computer time. He really wants to see us get her a tablet, something that is more mobile then a computer so long as her time on it is limited.

On a side note his view on the public school down here was not the best. His opinion definitely matched ours in that they handled the situations of Sunshine very inappropriately. He said we did the right thing in bringing her home. I know for us should we choose to ever look at Public school again we will be prepared to pack up and move to an area where we have more options. We doubt we will ever put her back into the district here.