Thank God.
Dec. 16th, 2013 10:34 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
gansjeI took Jo to the (fabulous, love, love, love her) psychologist today, and she let me stay in the session because I'd called ahead to strategize; I didn't want Jo shutting down over fear that Dr. Lipshutz was an alien replica, so I asked to sit in on the session as long as Jo was comfortable having me in the room. I wanted her to feel safe and protected.
Jo did marvelously through her session and told Dr. Lipshutz everything that's been bothering her, answering her questions freely. And Dr. Lipshutz, for her part, was amazing, never once looking nervous or concerned, which reassured Jo that she was just Dr. Lipshutz and nothing but. She was warm and kind and inscrutable. L said tonight that he would not want to play poker with her, and I heartily concur.
Overall the whole session made me feel infinitely better: it turns out that Jo hasn't exactly been seeing the words she claims to have seen, but is picking them out of shadows and reflections, not unlike the way we lay back in the grass and try to find out images in clouds. This, apparently, is the difference between hallucinations and visualizations driven by intense anxiety/panic. Jo also admitted to "rule following," which starts out as a belief such as, "If I don't eat all my dessert, I'll go to hell." This leads her to finish her dessert even if she's full from dinner, which relieves the feeling of anxiety, and then reinforces the anxiety and the behavior (and which we absolutely don't want on any level). So there we have the "C" -- and with this and the set of beliefs and fears Jo was describing, it became very clear to Dr. Lipshutz that it's most likely OCD, related to puberty and intensified, awfully enough, by Jo's asthma inhalers, which we knew can cause anxiety, but not in this way, to this degree. We have a very nice choice: breathing or a bit extra sanity. Nice.
That's not to say there aren't any environmental factors. It also came out that Shasta has been saying extremely hateful things about me again, as well as telling Jo I'm not L's wife, but his girlfriend, which is very confusing for Jo. This could be causing her added stress, particularly as Shasta has also been mocking me and encouraging Jo in doing the same (such as encouraging her to laugh at me, and discrediting her fears at my expense). This same behavior caused Jo insomnia the last time it went on in earnest, and I can't imagine it's causing any less conflict now. Jo and I are very close and love each other a great deal, and her mother demands her to prove her loyalty and love for her by betraying me. I know from experience that this causes Jo a great deal of anxiety, and can't possibly be helping her.![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
lostasia, you called it.
So, the diagnosis: OCD, complicated by albuterol derivatives and Shasta's unyielding need to cling to fury and punish everyone near her for her own misery. Dr. Lipshutz and I sat together discussing next steps for a bit while Jo sat in the waiting room reading a kids' magazine about foxes and worrying that Dr. Lipshutz actually might be an alien and might be abducting me, but I came out and she asked me for the pass-phrase, and all was well. She even did a little happy dance. <3 My baby.
Next steps are to meet with one of the psychiatrists Dr. Lipshutz recommends and probably start Jo on an SSRI, which have been shown to be very effective for OCD. L will take Jo to her pediatrician on Wednesday and see about a different kind of asthma treatment, if possible. And finally, we'll both meet with Dr. Lipshutz on Thursday and learn some CBT skills to practice with Jo at home. The best part: OCD is highly treatable, and with intensive therapy and SSRIs, we'll be on our way to making Jo feel like Jo again. It was a stressful experience and I was worried about what the outcome of today's visit would be, but ultimately it was encouraging and I feel much better about Jo's future.
Unfortunately, the rest of the day was highly stressful too, from waking up to the lovely strains of the iPhone email alert telling me that an old consulting client needed data I analyzed some two years ago. I don't even know where data I analyzed last month is, much less data from two years ago. I knew that given my current schedule and workload (60-70 hours of work a week for the next two weeks), I'd forget unless I found it immediately, so my first bleary moments of pre-coffee wakefulness were spent tracking down, zipping and emailing huge data files. Then Jo called -- she and Henry had stayed with their mother's visiting family over the weekend and Shasta apparently didn't feel like driving past our house on the way to the school (our house is oh, I dunno, ON THE ROUTE SHASTA TAKES TO THE KIDS' SCHOOL) to pick up their backpacks, and Jo was panicked that her mother would be upset, so I drove to the school and dropped off the kids' backpacks. Then I ran back to the house to finish up a recommended study plan, then remembered I hadn't had breakfast and managed to make and eat it, though doing so took approximately 35 minutes between panicked phone calls from colleagues needing help with study planning and data interpretation.
Then I ran to McDonalds and got Jo a Happy Meal so she had a fun lunch and toy and would be full and also happy and might open up more for the psychotherapist. I took her to her session, came home, answered emergency questions about a study design, hopped on a series of client calls, and finished a few more slides for a project on, ironically, asthma inhalers. I didn't have any time to process anything until L got home, and then I admittedly let him have it, because Jo also said that Daddy had told her that I killed her gecko (I accidentally got 10 or so crickets in its cage, which apparently can stress them out -- can we please find a pet for Jo that doesn't match her in its propensity for anxiety?), and Shasta had mocked me for it (she told Jo that maybe the "U Pay" in the gecko tank that she imagined were really crickets arranging themselves into a threatening message for me). So I took my anger at Shasta out on L, which was unfair. We made up, but things were tense there for a few minutes.
We made up, there was beef chili had for dinner and dishes done, and food put away and martinis made and drunk (which is why I can be quite so open about having been awful to L for my own anger) and more slides made. As I said, a stressful day overall. But though I know it'll take us a long time to get Jo's care right, I'm hopeful. She isn't hallucinating, OCD is extremely treatable, and she may not even need treatment beyond adolescence. We caught it early, and Jo trusts Dr. Lipshutz now and was really open to some of her "early CBT" exercises. I think Jo will be okay despite a really miserable disease. If one SSRI is bad for her, we'll find another. And CBT may prove extremely helpful on its own. Finally, we have a great support system, of which you all are an essential part. I, for one, wouldn't have made it through the weekend without you, and I'm infinitely grateful.
<3
Jo did marvelously through her session and told Dr. Lipshutz everything that's been bothering her, answering her questions freely. And Dr. Lipshutz, for her part, was amazing, never once looking nervous or concerned, which reassured Jo that she was just Dr. Lipshutz and nothing but. She was warm and kind and inscrutable. L said tonight that he would not want to play poker with her, and I heartily concur.
Overall the whole session made me feel infinitely better: it turns out that Jo hasn't exactly been seeing the words she claims to have seen, but is picking them out of shadows and reflections, not unlike the way we lay back in the grass and try to find out images in clouds. This, apparently, is the difference between hallucinations and visualizations driven by intense anxiety/panic. Jo also admitted to "rule following," which starts out as a belief such as, "If I don't eat all my dessert, I'll go to hell." This leads her to finish her dessert even if she's full from dinner, which relieves the feeling of anxiety, and then reinforces the anxiety and the behavior (and which we absolutely don't want on any level). So there we have the "C" -- and with this and the set of beliefs and fears Jo was describing, it became very clear to Dr. Lipshutz that it's most likely OCD, related to puberty and intensified, awfully enough, by Jo's asthma inhalers, which we knew can cause anxiety, but not in this way, to this degree. We have a very nice choice: breathing or a bit extra sanity. Nice.
That's not to say there aren't any environmental factors. It also came out that Shasta has been saying extremely hateful things about me again, as well as telling Jo I'm not L's wife, but his girlfriend, which is very confusing for Jo. This could be causing her added stress, particularly as Shasta has also been mocking me and encouraging Jo in doing the same (such as encouraging her to laugh at me, and discrediting her fears at my expense). This same behavior caused Jo insomnia the last time it went on in earnest, and I can't imagine it's causing any less conflict now. Jo and I are very close and love each other a great deal, and her mother demands her to prove her loyalty and love for her by betraying me. I know from experience that this causes Jo a great deal of anxiety, and can't possibly be helping her.
lostasia, you called it.So, the diagnosis: OCD, complicated by albuterol derivatives and Shasta's unyielding need to cling to fury and punish everyone near her for her own misery. Dr. Lipshutz and I sat together discussing next steps for a bit while Jo sat in the waiting room reading a kids' magazine about foxes and worrying that Dr. Lipshutz actually might be an alien and might be abducting me, but I came out and she asked me for the pass-phrase, and all was well. She even did a little happy dance. <3 My baby.
Next steps are to meet with one of the psychiatrists Dr. Lipshutz recommends and probably start Jo on an SSRI, which have been shown to be very effective for OCD. L will take Jo to her pediatrician on Wednesday and see about a different kind of asthma treatment, if possible. And finally, we'll both meet with Dr. Lipshutz on Thursday and learn some CBT skills to practice with Jo at home. The best part: OCD is highly treatable, and with intensive therapy and SSRIs, we'll be on our way to making Jo feel like Jo again. It was a stressful experience and I was worried about what the outcome of today's visit would be, but ultimately it was encouraging and I feel much better about Jo's future.
Unfortunately, the rest of the day was highly stressful too, from waking up to the lovely strains of the iPhone email alert telling me that an old consulting client needed data I analyzed some two years ago. I don't even know where data I analyzed last month is, much less data from two years ago. I knew that given my current schedule and workload (60-70 hours of work a week for the next two weeks), I'd forget unless I found it immediately, so my first bleary moments of pre-coffee wakefulness were spent tracking down, zipping and emailing huge data files. Then Jo called -- she and Henry had stayed with their mother's visiting family over the weekend and Shasta apparently didn't feel like driving past our house on the way to the school (our house is oh, I dunno, ON THE ROUTE SHASTA TAKES TO THE KIDS' SCHOOL) to pick up their backpacks, and Jo was panicked that her mother would be upset, so I drove to the school and dropped off the kids' backpacks. Then I ran back to the house to finish up a recommended study plan, then remembered I hadn't had breakfast and managed to make and eat it, though doing so took approximately 35 minutes between panicked phone calls from colleagues needing help with study planning and data interpretation.
Then I ran to McDonalds and got Jo a Happy Meal so she had a fun lunch and toy and would be full and also happy and might open up more for the psychotherapist. I took her to her session, came home, answered emergency questions about a study design, hopped on a series of client calls, and finished a few more slides for a project on, ironically, asthma inhalers. I didn't have any time to process anything until L got home, and then I admittedly let him have it, because Jo also said that Daddy had told her that I killed her gecko (I accidentally got 10 or so crickets in its cage, which apparently can stress them out -- can we please find a pet for Jo that doesn't match her in its propensity for anxiety?), and Shasta had mocked me for it (she told Jo that maybe the "U Pay" in the gecko tank that she imagined were really crickets arranging themselves into a threatening message for me). So I took my anger at Shasta out on L, which was unfair. We made up, but things were tense there for a few minutes.
We made up, there was beef chili had for dinner and dishes done, and food put away and martinis made and drunk (which is why I can be quite so open about having been awful to L for my own anger) and more slides made. As I said, a stressful day overall. But though I know it'll take us a long time to get Jo's care right, I'm hopeful. She isn't hallucinating, OCD is extremely treatable, and she may not even need treatment beyond adolescence. We caught it early, and Jo trusts Dr. Lipshutz now and was really open to some of her "early CBT" exercises. I think Jo will be okay despite a really miserable disease. If one SSRI is bad for her, we'll find another. And CBT may prove extremely helpful on its own. Finally, we have a great support system, of which you all are an essential part. I, for one, wouldn't have made it through the weekend without you, and I'm infinitely grateful.
<3
