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1st psychologist appointmentand questions...

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We have our first therapy appt next week. I was thinking of sending

on ahead some of the information I believe has helped me to

understand my daughters and which pertains to their conditions. Has

anyone given their therapists printed info? For instance one daughter

(12) has " tic like " compulsions " (plucking eyebrows till virtually

gone, picking at blemishes, nail biting) in addition to obsessiveness

about appearance and spells of very high anxiety/negative thinking

and catastrophic thinking (her common phrase that indicates a bout of

anxiety and panic coming is " there's no time! " and she wishes to go

back in time to correct things). So I printed out the info about HRT

posted here (thanks).

How does one distinguish these behaviors from normal teen behavior in

helping relatives to understand? My in-laws visited and they think

she needs to lighten up and needs more discipline, what do I tell

them to get them to help my daughter and to maintain their

relationship with her (has been good in past). My husband tends

towards this view as well.

They also think my other daughter(9) should be in school (is

homeschooled). To just abruptly drop her into school now would be

devastating, but they can't know this. What do you tell involved

family members or friends- just hand them a diagnosis? Then they will

pass it on to all the siblings and cousins (my m-i-l- has already

told my s-i-l that my daughter over plucked her eyebrows, heaven

forbid!-does that mean she is becoming a tramp?) which I feel will

color my daughter's future interactions with everyone. I.e they'll

think of her as a " disorder " rather than as who she really is. I

believe it will be very difficult for them to accept a " label " that

is a " disorder " especially when the symptoms aren't classic. The in-

laws are involved in our family to a degree, annual visits, birthdays

etc (has mostly been in a positive way- btw, I think my m-i-l has ocd

type cleaning/order/symmetry etc but has seemingly not recognized it

because she has had total control over her house, so thinks she is

quite in the right about cleanliness, orderliness etc and so on, and

everyone else is lax and failing to live up to proper standards.

Obviously it is no fun to visit her, she spends alot of time wiping

the floor on her hands and knees, and won't let me help with dishes

etc. So she visits us instead and it goes ok).

My parents are also involved and understanding because they are still

dealing with my adult brother. Undiagnosed anxiety disorders in two

of my siblings had awful results, but now my parents see the truth

and are trying to do what they can. I also think my Dad has had ocd

tendencies, maybe more of an obsessive personality disorder that

makes him a high achiever-perfectionist. (Reminds me of my daughter-

very fastidious about appearance, has his own shelves and cupboards

for his towels, toilet paper, soap, and stuff, spends a looong time

in the bathroom so on, he hints at admission of it. Plus my mom had

many phobic fears that kind of went unnoticed by me as a child.

Myself I was extremely shy and perfectionistic, but not fearful or

phobic and did manage to function normally it seems.

To recap:

Any suggestions as to passing info on to the therapist (what about my

own written thoughts, as well, and my daughter's poetry and at times

morbid art)?

Suggestions as to telling relatives without going into great detail?

What about when they visit us? (My older daughter feels under

scrutiny, plus I found out they pressed her to suggest to us that my

other daughter should be in school). Also, my younger daughter gives

up her perfectly arranged room for guests and this can be hard,

though now with practice she has accepted doing it. She also has

sudden dramatic mood changes that are hard to explain.

How do I explain when I am confused myself? I have trouble separating

the obsessive behavior form normal teen anxieties. This confusion

feeds into my husband's and my in-laws need to deny that there is a

real problem, or to question my parenting or our lifestyle. Guess for

me, the degree of misery I have observed tells me the girls need

help. (Don't wish to keep trashing my DH I hope he'll come around

after therapy).

Thanks!

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Has anyone given their therapists printed info?

At the first appointment, your therapist should be asking you all

kinds of questions about your daughters' Os and Cs. If this is a

person familiar with OCD, s/he will recognize the symptoms right away,

and will also be asking the appropriate questions. OTOH, it certainly

wouldn't hurt to send the therapist a checklist of symptoms you see in

your girls. Remember, though, to keep it short and sweet. They are

busy people and are more likely to focus on the important info if you

stick to the facts, i.e. what you observe. You want to be as

objective as possible.

For instance one daughter (12) has " tic like " compulsions " (plucking

eyebrows till virtually gone, picking at blemishes, nail biting) . . .

This is called trichotillomania and is a common form of OCD.

> How does one distinguish these behaviors from normal teen behavior

in helping relatives to understand?

Sometimes discreetly placed literature helps. If they are open to

learning about OCD, you can recommend books or give them info you have

printed out from the computer. Kissing Doorknobs is an excellent book

(fiction) about a girl with OCD, and it's short. In fact, your

daughters would probably enjoy it.

What do you tell involved family members or friends- just hand them a

diagnosis? Then they will pass it on to all the siblings and cousins

I think the simplest explanation is best. For example, X has a

neurological brain disorder called OCD. It's like a hiccup in the

brain that causes her to do or think the same things over and over.

She is seeing a doctor who is helping her with this.

Also, my younger daughter gives up her perfectly arranged room for

guests and this can be hard, though now with practice she has accepted

doing it.

Your daughter should be congratulated on giving up her room. But I

would make sure that the therapist knows about the " perfectly arranged

room " as this is a classic OCD symptom.

How do I explain when I am confused myself? I have trouble

separating the obsessive behavior form normal teen anxieties.

As parents we have all been confused (and still are occasionally)

about what is WNL (within normal limits) and what is OCD. Sometimes

you have to ask your child about a certain behavior: Is this

something you HAVE to do? Other times you can tell because of the

amount of anxiety produced when you ask them to stop or to explain

their actions to you. My two NT (neruologically typical) teens might

have gotten mad about my questioning them, but they didn't get anxious

about it.

The best offense, of course, is a good defense, and for that you have

to educate yourself. There are many excellent resources both onlline

and in the library. You can find a list of them in the archives. I

especially like March's book OCD in Children and Adolescents, and

Kopelwicz's book, It's Nobody's Fault. One you might suggest to your

husband is Shadow Syndroms, about the subclinical forms of many mental

illnesses.

Jule

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