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Re: Home-bound education

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Seems like your situation has turned a corner and the way cleared for making

progress against the anxiety and OCD. Let us know how things are going for

your son and family.

Take care,

Kathy R. in Indiana

----- Original Message -----

> As of yesterday, DS has begun interim home-bound education. His

> anxiety started to climb as the time drew near, but as he spoke of it

> at dinner last night, it started off VERY well. A teacher from the

> school (not his regular teacher thank goodness), will be coming by

> the house M-Th for about an hour each day to keep him up on grade

> level work. For the time being, the focus is only on two subjects,

> Math and Social Studies. DS was happy he got to choose as those are

> his current favorites. He seemed very taken and comfortable with the

> whole thing last night, but he wasn't given any work to do yet.

>

> As a side note, we think we're finally seeing some progress in

> lowering his base anxiety levels and some of his handling of anxiety-

> laden situations.

>

> The daily 30mg dose of Lexapro MAY be helping.

>

> The nightly 15mg dose of Remeron is DEFINITELY helping in that we

> don't have ANY fights/stress/fear at bedtime. Within two hours of

> taking it, he's ASKING to go to bed. His sleep seems more restful,

> and as long as we give it to him by 7:30p, he doesn't experience the

> dizzy head, zombie feeling from it.

>

> Currently, these are the only meds he's on. He's not been able to

> start any form of CBT/ERP because the base anxiety level was too

> high. If we can get that under control with these meds, THEN we can

> actually start working on getting the OCD managed.

>

> Holidays were a bit bumpy, but meltdowns are getting fewer and

> farther between (thankfully).

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> He's only working in (2) subjects and they are the ones HE chose.

>

Just as an aside, as a homeschool Mom I can tell you that he may only

be " working in " two subjects but he's learning more than just those.

There's plenty to be learned in everyday life. While he's coasting

along letting everyone else do everything for him, he's learning about

about love, patience and self-sacrifice through your example. That

will go a lot further in life than, say, knowing how to add fractions.

He has a problem and the people who care about him the most are

stepping up to bat for him. And, sure, he needs to know math, social

studies and a lot of other things but there are times when those are

way down on the list of priorities.

Hoping your son's situation changes for the better real soon,

Esther

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> You mentioned in your note to Dr. Geller that

> you find the relaxation techniques are not working. Relaxation is

> unfortunately not helpful for OCD although it can help other anxiety

> disorders. I have GAD (now in partial remission) and notice that

> relaxation is not as helpful for that as are keeping busy and

> distracting myself.

>

> With relaxation our kids tend to find that OCD thoughts come into

their

> minds more forcefully than when they are busy and distracted. This

is

> why OCD symptoms can get worse at bedtime when our kids are more

> relaxed. In fact researchers use relaxation techniques as the

control

> or non-treatment arm when comparing treatments effective for OCD as

they

> know relaxation does not work very well for OCD.

>

> How are things going with CBT?

***Kathy,

Thanks for the reply. Its not even that the relaxation isn't

working, its that he won't even attempt it. He won't attempt it

because of the rest of what you describe. For DS, trying to relax is

MORE stressful than being stressed.

Things are not going at all with CBT. What I mean is his therapist

has not even begun any sort of ERP/CBT because his anxiety remains so

high. She feels its not possible for him (or anyone else with such

high anxiety) to learn anything until the anxiety is adequately

managed. He stonewalls and " I can'ts " his way through everything we

try to do with him to help.

The Med doc we switched to came as the single most recommended in our

area by the local chapter of the OC Foundation. The therapist is a

nurse who has worked with this doctor for nearly 3 years specializing

in kids with OCD.

Thanks again for your insights.

Bill

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HI Bill:

I remember all to well the time when it seemed our son, Steve, was

too anxious/depressed/non-functioning to benefit from treatment.

What broke the log jam was partly medication to take the edge off and

also psychoeducation for us about the treatment that was effective.

Dr. Penzel gave very good advice when he suggested that no progress

after five visits is a strong signal to find a new therapist.

Sometimes there just is not good chemistry between a patient and

therapist.

It is the therapeutic alliance that a skilled and experienced

therapist can establish that helps to elucidate where the transition

zone is that can be the target for E & RP. This zone is where

sometimes OCD/anxiety wins and sometimes the sufferer can win. Even

when things look very bleak and our kids seem to be ritualizing 24/7

there are some things that they can boss back. It is important to

focus on their success, no matter how small, in the face of the

multitude of things that appear impossible.

I know this may seem hard to believe, and I remember when I could not

believe this myself. Nevertheless this is how treatment can start

and continue to be effective, when the therapist engages the patient

in small successes and builds them into bigger ones.

Successful OCD treatment can demand tremendous patience and

resilience from the sufferer and from the family. However this

striving is very well rewarded when you see the payoff from

treatment. Please hang in there and let us know how things are

going. GOod luck, take care, aloha, kathy (H)

kathy.hi@...

> ***Kathy,

> Thanks for the reply. Its not even that the relaxation isn't

> working, its that he won't even attempt it. He won't attempt it

> because of the rest of what you describe. For DS, trying to relax

is

> MORE stressful than being stressed.

>

> Things are not going at all with CBT. What I mean is his therapist

> has not even begun any sort of ERP/CBT because his anxiety remains

so

> high. She feels its not possible for him (or anyone else with such

> high anxiety) to learn anything until the anxiety is adequately

> managed. He stonewalls and " I can'ts " his way through everything

we

> try to do with him to help.

>

> The Med doc we switched to came as the single most recommended in

our

> area by the local chapter of the OC Foundation. The therapist is a

> nurse who has worked with this doctor for nearly 3 years

specializing

> in kids with OCD.

>

> Thanks again for your insights.

> Bill

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