Hysterical

One of the biggest problems, I find, with attempting to get other people to understand the emotional and behavioural needs of your child with SEMH issues is getting your points across without those people drawing the conclusion you are hysterical. I’m pretty sure I’m not being paranoid about this – I have read it frequently in people’s body language, facial expression and even in their choice of words. Here she goes again, being all over-anxious and fretting unnecessarily, they think. When I say people, I mainly mean teachers, though this isn’t exclusive to them.

When you do have a child with SEMH issues, you become adept at predicting their triggers. You know the sorts of situations that may challenge them and, in an attempt to parent them the best you can, you try to anticipate potential problems in advance so that tweaks or alternatives or supportive measures can be implemented to minimise their stress. For me, that just makes good sense. Why leave a child to flail and panic and worry, when you could prevent that with a bit of forward planning or heightened awareness? Obviously you can’t predict everything, but where you can mitigate potential problems, why wouldn’t you?

It’s this attitude that brings me to teachers, raising possible problems with them in advance of them happening. Unfortunately, what I see as a wise anticipation of issues is more often than not interpreted by them as over-anxious parenting. I’m pretty sure they have conversations about how I’m creating a self-fulfilling prophecy and bringing LB problems where he didn’t have any before. “Her anxiety will be rubbing off on him,” I can imagine them whispering, “It’s not him, it’s her”.

This has come to the fore because next week LB is going on his first residential. I do not feel it is excessive to say this is a big deal for him. Staying away from home without any of your family would be a big deal for most 7 year olds but is even more so when your early life has involved moving from place to place: staying away might trigger all sorts of difficult feelings and anxieties, not least whether you will actually return home again. This is compounded by embarrassment that you wear pull-ups at night when your friends don’t and the trip will involve you staying up way beyond your bedtime; a time that you already struggle to stay regulated for in your own home.

So yes, I think there are some very real concerns about the trip and in an attempt to help LB as much as possible, I have been pro-active in discussing my concerns with his teachers. I wanted them to be aware of his continence issues so they could help him subtly. I wanted them to know his bedtime is early so that when he starts to spiral they will be able to recognise it as dysregulation due to tiredness, not bad behaviour. I wanted them to be aware of the reasons why a trip away from home might trigger feelings from his past. I wanted them to be aware of all this so they could support him through it.

I thought this was all tickety-boo. They had seemed to listen and had been reassuring about how they would deal with it all.

However, as the time draws closer, LB’s behaviour is beginning to spiral. I have noted it at home. They have noted poorer listening, poorer compliance and an increase in fidgety behaviour at school. LB has started saying he doesn’t want to go on the trip. To me, it is obvious he is anxious about it. This anxiety is being expressed through the changes in his behaviour.

School, on the other hand, are scratching their heads about this change of mood. Why is he all of a sudden throwing things and threatening to kill his TA, they wonder. To help them out, I’ve tried to make the link between the two things for them. This has involved me having to elaborate on why exactly the trip might be anxiety-provoking now, before it has even happened. The problem is that I don’t think they’re really getting it, so I find myself harping on more than I’d really like. The more times I even reference the trip, the more convinced they become that I am a hysterical, over-reactive mother.

This morning, as a small part of the coherent explanation I was trying to weave on the spot, I mentioned that LB has only ever stayed with us or his grandparents (I thought the ‘since he’s been here’ part was obvious) so staying somewhere else might be quite triggering. “He won’t be alone in that,” his TA says, “many of the children won’t have slept anywhere else”, as if I am being quite unreasonable by making a point out of something common to all the children. What I want to say is something along the lines of, “Yeah, but, before these other children moved to their forever home, did they live with foster carers who randomly took them to other houses for respite, with people who were not always registered as carers? Did they get left there without explanation for inordinate periods of time? When they came to their forever home, were they just dropped off by people they had lived with for several years who would then just disappear never to be seen again? Before that, were they suddenly removed one unpredictable day from the family who conceived and gave birth to them? Where they? No? THEN IT REALLY ISN’T THE SAME!”

Obviously I said no such thing, smiled sweetly, took a deep breath, and attempted again to explain things in a calm manner that might actually get my message across. That’s how it was from my point of view anyway. I suspect that from theirs, they thought, “Oh, she’s still going. I’ve covered off that point so she’s trying to concoct more. Definitely hysterical.”

What’s infuriating is that when you don’t feel heard, there aren’t many options. I don’t believe in shouting or being rude (it’s all about the long game and building relationships) so I’m really left with repeating myself or trying to find other words or other arrangements of words to get the ideas to strike home. I often find myself reaching for more extreme or more shocking examples when the tamer ones don’t resonate. It is as though I have to escalate the severity of what I’m saying to get my messages heard. The thing is that if they are still not heard, I am surely seen as increasingly hysterical.

I suggested today that we must monitor LB. Yes, some anxiety is to be expected. But as he is already at threatening to kill people levels, perhaps we don’t want him to escalate much more. Perhaps, if he does seem to be spiralling out of control, we might need to come up with a plan to soothe his nerves. Perhaps, and I was just throwing things out there, we could reassure him that we would not make him stay somewhere he doesn’t want to (trust and all that) and we could offer to pick him up from the day-time part so he can sleep where he feels safe: at home. Though, to me, this makes perfect sense, I can see that school find it an outrageous suggestion – the kind that would only be made by a mother struggling to loosen her apron strings. “She doesn’t even want to let him out of her sight for one night, for goodness sake,” I can imagine them commenting. The response from the TA only confirmed my feeling they had been talking about me in this way – “Mr Teacher doesn’t want you to do that,” she said, when I suggested it.

It really is quite a challenge to remain dignified in these situations. It is a constant balance between persisting in getting messages across and presenting like a non-hysterical, credible source of information. I do a lot of internal swearing.

I understand that they have taken hundreds of children on trips and that every parent gets a bit worried about it and that they will do their best to look after LB and that if he gets upset, they will deal with it. I know they haven’t had to call anyone’s parents before, but, if we’re honest, that’s more of a gauntlet than a reassurance. When they say, “he’ll be fine,” I hear, “we’re not taking this seriously enough”. If only they could acknowledge this is a huge deal for him, we’d be grand.

Obviously we are doing all the prep stuff and giving reassurance at home. LB does seem to be coping better now he’s realised they aren’t camping outside (you really can’t anticipate all the issues) but I am typing this outside of his door as we have another tricky bedtime. I intend to monitor him/ his behaviour over the weekend and should things have worsened, I shall be back at the classroom door, making myself look hysterical again. And I don’t really care what Mr Teacher thinks about it – should LB be crying and hanging from my leg when I drop him off for the trip, I will be picking him up at bedtime.

As tempting as it is to just pack LB off with them, with little instruction, to let them deal with whatever happens themselves, I can’t shrug my shoulders of all responsibility. He’s our son and it’s our job to meet his needs as best we can. If that means occasionally having to overrule school and to lose street cred over being anxious parents then so be it. LB’s needs are paramount and if that makes me hysterical, then I guess I am.

 

 

*The irony of me writing last week about how much I love the school is not lost on me. I should have known that singing their praises would nudge the universe into trying to prove me wrong

**The word ‘hysteria’ derives from the Greek word for ‘uterus’, suggesting that to be a women is to be hysterical; that being overly emotional is an intrinsic failing of having a womb. Marvellous. I wonder whether any of the dads out there experience a similar thing when they have worries or if this shrugging off of concerns is more prevalent when they are raised by mothers?

I’m not really trying to make a feminist point, I’m genuinely wondering.

 

 

 

 

 

 

 

Hysterical

Continence Issues

This week’s post has been inspired by a fairly innocuous seeming comment from a friend. He said, in reference to his newly adopted 2 year old, “he’s fully potty-trained now, day and night!”, with just the teeniest hint of competitive parenting lacing his voice. He’s rightly proud of the achievement but I have to confess that part of me thought “oh FFS!”. I think I managed a polite smile and no eye-rolling…

It is just that toileting is something of an ongoing situation here with Little Bear and, at 5 years old, we are fairly far from reaching the golden pinnacle my friend speaks of.

When Little Bear arrived, aged 3 and a half, he wasn’t toilet trained. His foster carers claimed it was because he “wasn’t ready” but in all honesty I don’t think they had really tried. Obviously tackling toileting wasn’t very high on our agenda in the first weeks of placement either, as bonding and behaviour issues were much more pressing. We also identified fairly quickly that we would need to sort out Little Bear’s digestion before attempting to get him out of nappies.

On his arrival he was taking prescribed Movicol for constipation and he created several very effortful and repulsive nappies each day. It was distressing to see the discomfort he was in and at night he seemed to be suffering from stomach cramps (he would writhe about in his bed whilst asleep and sometimes fall out). On reading the Movicol packet we established that this could be the cause of the pains.

We also observed that Little Bear barely ate any fruit or vegetables which might well be accounting for his sluggish gut. It was strange because I always assumed that during Introductions we would be given a list of food likes/ dislikes but we weren’t. When I pressed the foster carers on it they were vague, as though they didn’t really know what he liked. Either way, fruit and vegetables weren’t really mentioned or visible and whenever we gave them to Little Bear he certainly didn’t appear familiar with them.

Another observation was that when we first met Little Bear his tongue had a very unusual appearance: kind of lined and cracked looking. It looks normal now so in retrospect we have concluded he was dehydrated. We certainly didn’t really see him drink and if we tried to give him something he would only take tiny sips.

It became a fairly major priority of mine to get him to eat and drink properly, with the end goal of getting his digestion working properly without the need for Movicol. It was possible that there was a physiological reason for his constipation of course but we just weren’t convinced, given the other things we had noticed.

Tackling Little Bear’s diet wasn’t easy as we also had issues with getting him to sit at the table and actually eat. It turned out though that Little Bear would eat pretty much anything if it was mashed or pureed or hidden by gravy and if one of us would feed it to him. Looking back, it seems we might have still been at the weaning stage. The benefits were that I could get vegetable soup or pureed casserole or pasta sauce with hidden vegetables into him and he was having lots of tastes of different foods without knowing it. I also tried smoothie lollies which worked well until he got fed up of them.

It was difficult because Little Bear did and still does use food as a means of control and whilst I felt it was in his best interests to improve his diet, I was also wary of putting too much pressure on him to eat. I did do things like withhold chocolate or pudding until he had at least tried his proper food or eaten a few bits of veg. I know there are a lot of opinions out there about whether this is the right/wrong way to approach things but it turns out that healthy eating and the wider impact of it on health, alertness and behaviour was a big deal for me. It wasn’t something I could overlook.

I also found Little Bear’s behaviour at mealtimes one of the most challenging things to manage in a calm way. Everybody finds certain behaviours particularly triggering and for some reason this is what really pushed my buttons. I have had to work hard at finding a happy balance between meeting Little Bear’s nutritional needs and working on his table manners. As much as it pains me that he gets up every 3 seconds and will do anything but eat at the table, I have recognised that sometimes it doesn’t matter what else goes on, as long as he has eaten something. Little Bear is perfectly capable of feeding himself and sometimes he does so without issue but there are other times where no matter how infuriated I get, he just won’t. On those days it is more important that I swallow my issues and feed him, as then he will eat and if he has a full belly the world is generally a better place. I can just thank my lucky stars that he no longer screams, throws his food about the room or head butts the table.

Anyhow, after a couple of months, we had managed to successfully wean Little Bear off the Movicol and he had developed a regular, healthy bowel habit. It was around this point that we turned our attentions to toilet training. Little Bear knew when he needed a poo and was able to say so, so it didn’t take long to get him into the habit of using the potty. It would have been good, given he was nearly 4, to go straight to the toilet but he was quite wary of it so I went with what he was comfortable with and made that transition later.

It wasn’t long into potty use that Little Bear wanted “big boy pants” so we just went for it. In the early stages everything seemed to be going well. Little Bear was sorted with his bowel movements from day 1 and if we prompted him to go for a wee regularly we didn’t have too many wetting accidents. It was only when we tried to move on to Little Bear going off to the loo as and when he needed it that it became apparent there was a problem: he didn’t ever seem to need it. However, he clearly did as he was wet all the time. Little Bear didn’t seem bothered by this and didn’t tell us. I wasn’t always sure he was aware he was wet.

It feels to me as though some sort of developmental window has been missed so Little Bear has never developed the sensations warning him he needs to go and has grown so used to sitting in a wet nappy that being wet feels normal.

We have had to manage this by going back to regular prompting to help Little Bear stay dry, even though he is not always keen to comply with the requests. We have bought him a special watch, which you can set to vibrate at certain times to remind him to go to the loo and to help him become more independent in his toileting. I do think it’s good and I would recommend it but ideally your child would want to be dry and would be more motivated to do what it tells you than Little Bear. It worked well for us for a while but then he couldn’t help pressing all the buttons (even though it does have a child lock system) or constantly taking it off and losing it. As he is a little bit oppositional the fact that it was telling him to do something just made him want to do the opposite.

However, we have persevered and worked on Little Bear telling us when he is wet. If he does tell us, we praise him for that and try not to comment too much on the actual wet pants. He has made lots of progress with this and mostly does tell us now if he’s had an accident rather than us having to detect it from the smell!

We have also figured out that the first warning sign Little Bear gets is when a dribble of wee comes out. It appears that he can then stop the rest from coming until he chooses to release it. We are working on Little Bear taking himself to the toilet after the first dribble rather than just doing it in his pants. This is definitely improving and just this week, over a year into toilet training Little Bear has said a couple of times that he needs a wee and taken himself off for one. This is a big deal for him and I’m grateful that signs have started appearing to suggest we will eventually get there.

As we are not yet secure in day time dryness, we haven’t even thought about attempting night time dryness. Little Bear’s pull up is completely sodden in the morning and occasionally overflows during the night so I know he isn’t ready.

As with many things I write about Little Bear, none of this is his fault and I can’t help feeling sorry that he hasn’t been afforded the same chances as his peers, who were probably beginning their toileting journeys 12 to 18 months before he was. So, whilst I’m glad for my friend that his little one is gifted with exceptional bladder control I do wash a lot of urine-soaked clothes and bedding and hopefully you will forgive me for also being a teensy bit irritated by his comment.

Continence Issues