Wednesday, February 6, 2013

A bit of Psychology: {Discipline}

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After a bit of a long wait, we finally got back to the Psychologist this week.

There were some issues that I wanted to talk to her about, even though I knew what her answer would be -- we have to get her to an anxiety free state first! -- I wanted some ways to deal with some of the issues we have been having.

We have been consistently doing our yoga and massage and warm buddies. When we don't do these things, Lilah will ask for them. So even though she may not recognize her pain, on some level she knows that doing these activities make her feel better.

We go through spurts, where we have a great week, she is cooperative and we get along without the constant battles. And we have rough weeks, where everything, everyday is a challenge with her. I have been trying to teach Lilah to take some responsibility in what she needs to get done in her day. The simple things, like cleaning up her toys and room. Brushing her teeth. Getting her hair done. Getting dressed. Packing her school snack. Eating her breakfast. And practicing her violin.

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My girls are in afternoon kindergarten and it is a challenge almost every. single. day for Lilah to get these done in time. My instinct says she is purely being stubborn. She would rather play. I can see her watching me, to see if I am noticing that she is not doing her jobs. And she recently started manipulating Silas into being distracted, so that he also, will not finish his jobs and she won't be the only one to get into trouble. Anxiety always equals defiance and control in everything.

So we tried a few different discipline techniques. None of which worked. And I was feeling extremely frustrated, extremely drained and emotionally exhausted. I wanted to give up and honestly, didn't care about what the outcome would be for her in the future.

We tried letting her not do her jobs and then when lunch time came (when she would jump up to the counter to be fed like Zoe and Silas), she would not be fed until her jobs were completed. And if those jobs weren't completed by the time we had to leave, she went without lunch. This did upset her somewhat, but not in the way she usually reacts with the screaming... I will explain more about what the Psychologist said about this below.

We then tried having immediate consequences. Time outs, when her jobs weren't done on time. (Our time out spot is our stairs, where the littles can see us at all times). She would get very upset, as usual, when put in a time out. But every step and every job was a struggle, because she was working herself into a very anxious state, starting to shut down, not be able to think clearly and then not caring, whether the other jobs ever got done. The Psychologist agrees that the consequences do need to be immediate, but that it was time to try some new techniques.

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There are some signs that a child is dealing with anxiety. You can see it in their physical state. The worry lines in the forehead. The lack of balance. The fidgeting with hands and clothes. The unevenness in their shoulders. And the colour and shininess of their skin. And (this was a new one for me) a distended tummy. And anxiety constricts the voice box. Which I hadn't been told before and it makes total sense. Why, when we talk to Lilah and ask for a response, we can barely hear her answer us, it is always in a whisper. Another thing that I had taken as stubbornness, but now realize this was one thing that was physical. Also, that when her anxiety rises in situations where food is involved (which we had HUGE struggles in) she likely feels emotionally full and physically can't eat.

Lilah is now being encouraged to self soothe. It is important to know that we still want to do some of this for her, but as she gets older and isn't always around us, she needs to know how to recognize her anxiety and try to calm herself in these situations. I am teaching her to massage herself. Rub her forehead, when her head hurts. Rub the back of her neck, when her neck hurts. And while she rubs these spots for her to say to herself... My name is Lilah. My name is Lilah. My name is Lilah. I like my mommy. I like my mommy. I like my mommy. I am pretty. I am pretty. I am pretty. I am loved. I am loved. I am loved.

We can also use a hot or cold cloth to soothe her or put on music to change the dynamic in the house.

So how do you discipline a toddler who is dealing with anxiety and trauma?

Calmly. This will be a challenge!!!

With physical touch. Also, a challenge for me!

Lilah does need immediate consequences, but nothing is going to work unless she is in a relaxed state first.

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So it was suggested that we have a little chair that she can go to when she is feeling anxious -- which will be me telling her when she is feeling this way, since she doesn't recognize it yet. This little chair should be near me. She will sit in her space and I will sit down in my own space and we will sit together -- but apart-- quietly for a few minutes. When our time is up, I will call her over, rub her back and I will remind her that we have rules that need to be obeyed and that when these rules aren't obeyed there are consequences. Also, that HER special little chair is not a time out and that she is not in trouble right now, but that when we are done sitting quietly and calmly, that those rules will need to be followed. We will be using a timer for this, so that she knows that when it dings, the time is up. This is still somewhat like a time out, except that mommy also gets a time out and we do it together. Sometimes we need to repeat our time outs... long enough that she can converse and hear what is being said.

When asked by the Psychologist if she ever forgets to do her jobs... she said no.

When placing the toys into the sand table, she picked the same items she always picks. Three little houses, some miscellaneous people and some other cute objects. She still mixed up all her family members, including extended family members into the three different houses, showing she is still confused about family dynamics and where she fits in.

Object constancy:

Object constancy is very interesting! So in Lilah’s case, the objects (mother, caregivers, even places and familiar things like blankets or toys) that should have been constant in her life kept changing. She probably wanted to attach (I think all babies do) but would have been confused and frightened (we know she’s very bright/aware, and would not have been unable to process all the changes, either consciously or subconsciously). Throw in some physically painful experiences, and it’s easy to see how traumatic her first year would have been. It seems to come down to trust – what should have stayed the same and provided love and stability didn’t – and so she’s afraid – probably (on some level) that we will disappear too. Shutting down is self-preservation.

Lilah doesn't have me in her yet. She hasn't had that strong mommy attachment that should have taken place in those first six months of her life. Now at the age of five, and with her anxiety and trust issues, that attachment takes a lot of work. The Psychologist says she is attached to me, she can see it in Lilah's actions and body language, but she does not trust that I always love her or will never leave her. This will take some reassurance.

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Sensory Issues:

Our senses are a powerful thing. And smells, sounds, music, etc. can bring forward unexpected emotional responses that we can't explain. There will always be triggers for her. Hopefully, as we work together, she will learn to deal and recognize these times.

The Psychologist has decided that she would like to meet Zoe for an assessment and then to work with the two girls together for a couple of weeks. She believes that a strong bond with these sisters would be very benefit to Lilah and her feeling of belonging in this family. I am not sure where this will go... the girls already act like twins. They rely on each completely and are very bonded.

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6 comments:

Sara said...

Paige, your Lilah is blessed to have a mommy who is determined to get her the help she needs. Just sent up a prayer for you both!

Monica said...

Oh I'm so sorry to hear how difficult the situation still is. I'm very impressed though with all that the psychiatrist has recommended. It sounds like he or she is a great fit for your family. I'm also in awe of all the therapies you consistently do to manage Lilah's anxiety. She is very blessed to have parents who are persevering in all of this to ensure an emotionally healthy future for her.

Marie said...

So glad that you have found a great psychologist. Praying that Lilah's anxiety will lessen and that she will understand her place in your wonderful family.

Jerusha said...

I recognize some of these same behaviors in my son. Grace and endurance to you. :)

Denise said...

I love these posts, Paige. There is so much information - so many little tips that parents can read and think "Oh! That fits my child" or "That might be good for us to try". They are truly a treasure trove of tips and information. I am glad that you have some new strategies and tips on how to help her overcome this stage she is going through. I hope and pray for you to be able to have the patience you need to bring her through it.

arnie&bekah said...

Thanks for sharing Paige, I will pray for you and Lilah when it comes to mind :)