How Much Patience Does it Take?

It's been some time since I last wrote anything. We have had a lot happen with J over the past several months. Between work and dealing with him, there is just not enough hours in a day. 

J's behavior has been escalating and esclating for quite some time. We receive a daily report from school that he has hit someone, punched someone, taunting his classmates, sent to the "refocus" room, refusing to do his school work, and the list goes on. For every 1 good day we have with him, there are  6 bad days. We have had multiple medication adjustments. He never goes a day without his medication. His case worker visits with him 3 times a week and tries to counsel him. This week alone J has bit a teacher rather hard, attempted to bite others, hit another in the stomach, charged at teachers, punched another teacher in the head 3 times, and punched another in the nose. Yesterday he refused to take a bath, would not go to his room and threw himself on the floor. He then proceded to "run away" and left the house with no shoes and run down the street. We had to call the police for assistance with him. 

For the past several months we have tried to convey to the doctor handling his medications that his behaviors are getting worse. We have let her know all of the steps we have tried to take to get J to control his behavior. Consequences, punshiments, privileges taken away, encouragement, rewards, motivation techniques, and even ignoring his behavior has not worked. He will repeat the behavior the next day or so. We currenlty have him seeing a therapist but I have little hope that it will have any positive impact. 

My husband and I have withstood J's biligerance, mocking attitude, and outright defiance. We have tried to reason with him, talk with him about his behavior, and explain what is wrong and right. We have bought him things in the hopes it will help calm him down. I have read books and articles in the hopes to find something that will help but have not been successful. In fact all these books say to care for yourself first but we can't because we are too busy taking care of him. My husband and I have had to walk away from him several times in order to prevent ourselves from doing or saying something that we will regret. I pray for him practically every day and still find myself hitting the same brick wall. We have done everything we could to help J and yet he continues to be profoundly disrespectful toward us. 

His case worker told us that she commends us for our patience with him. She went on to say how patient we have been with him, far more than she has seen with other parents. She insisted we have been good parents to him. It got me realizing how much I prayed to the Lord to have patience with J. I've also had to ask for forgiveness for some of my reactions toward J. However, patience has been one of my constant prayers where J is concerned. I just don't know how much longer I can keep praying for patience. 

How much patience will it actually take before J receives the help and evaluation he needs? How much more do I need to pray for peace to envelop J? When will someone actually do something rather than provide lip service? How much longer do I keep praying for help? At what point is enough  enough? I have been fighting for J 6 years now. My cup is running on empty. It has been quite some time since it was full. 

A Fine Line

 My husband and I were having a discussion the other day. It came about related to a recent school shooting or rather a bomb scare we became aware of. My husband and I are rather polar opposites when it comes to guns and gun control. Although, we do agree that if a hunter requires several rounds of ammunition to go hunting with, they shouldn’t be hunting in the first place. Despite our views on gun control, the heart of our conversation centered around mental illness. 

Despite the latest surge of self-help books, apps, and web-based therapies, there is still not enough resources available to assist with mental illness, especially in children. In the 1980’s funding for mental health services was decreased significantly. As a result, many hospitals and mental health units had to make some hard decisions. Many units closed down because there simply was not enough reimbursement for services to keep them open. Others switched to focusing on addictions as a way of keeping their doors open. It almost seems to be more acceptable to have an alcohol or drug addiction versus a mental illness. What many do not realize is that those with a drug or alcohol addiction have underlying mental illness. Many turn to alcohol or drugs to quiet the voices in their head or deal with the emotional roller coaster they may be experiencing. While addiction programs do try to deal with the underlying issues that leads a person to drink or take drugs, they still remain woefully inadequate. The amount of resources available to persons suffering from metal illness varies state to state. Adults have a hard enough time seeking these resources out, let alone resources for children. 

The latest surge of online mental health services had made things a bit easier for adults to seek help. If a person has access to a computer and internet connection, they can receive help via telehealth. However, if they are homeless, poor, or no health insurance that would cover, the person has to look for help by other means. For parents of children, it is much more complicated. 

The mental health services online do not cater to children. Many of the inpatient mental illness hospitals or clinics are for adults; only a handful have units for children. Whether you are an adult or a child, many of these hospitals or units will not admit someone for help unless they are a danger to themselves or others. Even then, they may still not admit them to be evaluated and treated properly. J has hit and choked his teachers and they still would not admit him. The main solution to help adults and children is to add more medications or make medication adjustments and hope for the best. We just recently added another medication to J’s regimen. A few weeks ago, I spent time trying to find a hospital that would take J and each one the state gave me to contact dealt with adults and substance abuse, not mental health behavior for children. The only solution I had available to me to help J was to increase his case worker’s visits to 3 times a week. 

The other issue concerning children is that professionals hesitate to apply certain diagnoses on a child despite all of the signs and symptoms that may be present. The standard diagnoses consist of ADHD, clinical depression and oppositional defiant disorder. I have been told many times that they do not diagnose certain conditions until they are teenagers. Unfortunately, as teenagers, their behaviors are set and can become very difficult to turn around. It is almost too late to treat them. 

With J, I am persistent, so there is some hope for him. However, I think about all of the other parents dealing with a child like J who do not know how to be persistent. The case workers only have access to limited resources themselves and can only help parents to a certain extent. It primarily becomes the parents’ responsibility to make sure their child receives help. I was even told I would have to become a “squeaky wheel” if I wanted J to get help. 

I work full time which makes it difficult to be that wheel. I have  spent time making phone call after phone call to no avail. When I do find someplace, J is placed on a waiting list and it requires I drive an hour or more to take him to receive services. This means I have to take time off of work in order to do this. Like many other parents, I cannot continue to take time off. I am willing to bet that many parents cannot afford to take time off of work to help their child which makes their situations more strenuous than mine. Being a “squeaky wheel” is exhausting and at some point you even get tired of your own noise. 

When massive shootings occurred regardless of the location, there is an abundance of discussions centered around gun control. These discussions occupy mainstream media and make no room for the real reasons behind why these individuals commit mass murder. Although I am for better legislation around acquiring guns and removing guns that hold more than 30 clips off of the market, it really doesn’t address the issues behind why these individuals would commit a mass shooting. The guns are a means to an end for these individuals. Guns can easily be acquired. But, I often think, if guns were not available what else would these individuals use? 

Mine and my husband’s greatest worry about J is that he will do something that could injure himself or others. We walk a fine line when it comes to disciplining J. If we give hm to much discipline or yell at him one too many times, will he snap? If we give him too little, will he think he could do whatever he wants without paying consequences? If we say or do the wrong thing will it contribute to how he sees himself and others? When we tease with him or joke around with him, will he take it literally or see it as a harmless joke? Unfortunately, he takes things most literally so we have to be really careful what we say or do around him. We have not always been the best around him. Call it frustration, tiredness, anger, whatever; I still hope that the good we have done will out weigh all the wrong and J will not snap or do something terrible. 

We walk a fine line with J. Everyday it is something different, a new challenge. We do not always respond in the best manner or say the right thing in the moment but we try. Just the other day J threw a massive screaming fit because we needed to go to the store and he did not want to go. We sat around for 40 minutes waiting for him to getting out before we could leave. He had to stay in his room until he calmed down. We did not react other than to send him to his room. It is hard to say what J will grow to become or what he will do. All we can do is pay attention to J and respond in the best way we can. It’s a fine line we walk.

It Takes a Child

The amazing thing about children, at a certain age at least, is their uninhibited way of making statements which make a person acknowledge certain truths. J statements he made the other day to me had their nuggets of truth. They were trite, overused statements. The kind you read about in self help or self awareness books. In fact they are the kind of statements you hope your children take to heart but we as adults often fail to follow ourselves. 

We were discussing about finding new people to meet, attend a new church, etc. I am hesitant due to past hurts and recent experiences. I also do not want to be in a situation where I have to change myself or accommodate others while sacrificing my own feelings. It never ends well. However, J stated to me that I should not have to change myself to meet new people or attend a new church. He said I should just be the way I am. 

Sometimes as parents, whether we realize it our not, we live vicariously through our children. We push our children to be stronger, smarter, better, achieve more, and be successful. As parents we often say to ourselves that we push our children for their benefit because we want the best for them. Then we stand back and make boastful statements, “my son did this in school,” “my daughter got this award,” my son made straight A’s,” “ my daughter did this…, “my son did that…,” and on and on. We make these statements and beam when people react and respond with positive affirmations. It becomes a reflection on our parenting skills and abilities. Before we know it, we as parents begin to define ourselves by the actions of our children and loose ourselves along the way. 

The way I am. I have spent the past 5 years trying to teach J lessons, to change his behaviors, teach him how to respect others, and so on. In the beginning I would be mortified over J’s behavior and worried about what others think. I would try to change or redirect J’s behavior, explain it away to others, provide explanations on the steps I was taking to address the situation, anything to receive affirmation from others that I was a good mom. I worried about how his behavior projected on myself and my family. It really has affected the way I am and in the past couple of years I’ve realized, “who really cares.” 

I used to see parents in the store with their children who would scream and cry and think, “ they must spoil their child, “ don’t they discipline,” and the worst of all “they are not great parents.” I was judgmental of those parents. Now, I completely sympathize with them. 

J in our lives has helped me to see how much stock I placed in the thoughts of others. I felt others would judge me the same way I had previously judged. We are warned not to judge others unless we be judged by the same measure. Ironic. I measured myself by my own judgments. 

It was really absurd. My whole life has been spent restraining myself worried about what others think of me. It has caused me to hold back, only show certain sides of myself, take the criticism lying down, and not stand up for myself; all in the hopes of pleasing others. My actions and reactions were based out of fear of what others thought of me. This fear drove me to place pressure on my two older boys and then on J. However, it took J to help me realize just how much emphasis I placed on the thoughts of others and how ridiculous I have been. 

J stated to me the other day that I should not change myself for anyone. I should just be myself and not worry what others think. J stated that people should just accept me the way I am. He said the exact same things to me he is repeatedly told by others. These are the same things I have told J to take to heart but have failed to take them myself. 

It is difficult to change one’s thought processes that have been imbedded for decades. It has taken J being a part of our lives for me to see how ridiculous it is to base my self worth on the thoughts of others. Even though I realize this, it is hard to change decades of imbedded habits and actions that cause me to try and please others but I am trying. Recent events over the past year has made me vulnerable to backsliding. 

Our conversation with J the other day helped me to realize how vulnerable I have become. I have found myself fishing for compliments at work, looking for ways to affirm myself, and making sure J’s case worker knows we have been trying to help him. I hesitate looking for a new church for fear of being hurt or falling into the same merry-go-round trap of pleasing others in order to be accepted. I have been more critical of J than I ever have been because I want others to think we are doing a good job handling him. 

J was right. I should not let others dictate who I am. I should not let J’s actions be a reflection of my parenting skills. If others have a problem with how direct I can be or if they are intimidated by me, that is their problem, not mine. As he stated, I should just be myself. I realized that J has never asked me to change who I am. It took this child with all of his struggles and issues to make me realize that I am okay just the way I am.

Beating Our Heads Against the Wall

We are beyond frustrated. So frustrated to the point that we are becoming numb. I no longer want to react to anything he does or says. Whatever steps we take to try and teach J about his behaviors it is to no avail. He continues to misbehave and threaten others around him. He continues with his crying and screaming fits. He continues to argue and push boundaries. His case manager and doctor continue to grasp at straws and repeat the same thing to us over and over. We are exhausted from beating our heads against the wall.

It is getting harder to hang on to the good days that occur. They are becoming few and far between. For every good day, there are 7 bad days. The bad days occur more consistently than the good. We do our best to praise J on the good days in the hopes to incentivize him. If we observe him behaving well, we do our best to praise him in the moment. However, it does not seem to make any difference. 

A couple of weeks ago J was getting his hair cut. I was praising him on his behavior during the haircut. Over the years, getting J's haircut was always an issue. He would scream, squirm, yell, argue, and fight - before, during, and after the hair cut. It has only been within the past year he has been doing better. Whenever we take him to get his hair cut, we do our best to acknowledge his good behavior. It does not stick. When he got his haircut two weeks ago, an hour later he was arguing and accusing me of making statements I did not say and proceeded to call me a liar. All the praise I gave him went right in one ear and out the other. 

We have been doing everything the case managers and his doctor have said to do for over the past 5 years. It is so easy for them to sit on the other side of the desk and tell us what we need to do. It is so easy for others who sit on the sidelines to make suggestions, comments, critiques, and so forth about a situation when they do not have to deal with it every damn day. They do not have to sit and listen to a child scream and cry for hours. They do not get the phone calls from the school telling them to come pick their child up because he threatened to hurt or has hurt another individual. These case managers and doctors do not receive constant text messages that their son is threatening to hurt the teacher and fellow students. We provide the case manager and doctor with all of this information and the response from them remains the same. Their standard response is to adjust J's medication and tell us once again to get him therapy. 

We adjusted J's medication this past month. He has had so many medication adjustments since he was 5 years old. This latest adjustment I am told is the last medication they can try on him. He is now on Thorazine (chlorpromazine) 25 mg twice a day. He also takes propanolol 20 mg twice a day and Intuniv 2 mg once a day. J has been on clonodine, Adderall, Focalin, risperidone, Vyvanse, Depakote, and Haldol. These meds have been adjusted numerous times before he was taken off of them. He has received therapy, been enrolled in therapy day school, admitted to a research psychiatric hospital, and admitted to a behavioral hospital. The behavioral hospital admission was a complete waste of time. The research hospital provided us with some answers but even then they were still unable to help him. His behaviors worsened in the day therapy school. He is under an IEP at his present school which is supposed to have staff members to help him but they are the ones calling or texting us just about every day. All these medication adjustments and other steps we have taken have done very little to help J or us. 

It boils down to the parents. We are getting tired of being made to feel like J's behavior is our fault somehow. As if we are not doing enough to help him or take the various professionals' advice on how to handle him. I have been fighting to get him the proper help. I have requested numerous times for him to be admitted so he can be thoroughly evaluated and his medications properly adjusted. I have made a request to have an MRI done on his head to see if there might be a physiological component as well but that has gone unanswered. Every which way we turn, we hit a brick wall. The only thing that will cause the professionals to increase their services is if J threatens to harm himself. It does not matter if he harms or threatens to harm others. 

Last week, I received a text message from the school that J threatened to stab a teacher with a pencil. He has already choked a teacher twice, punched the bus aid several times in the face, attacked another kid, and eloped from the school. I have asked the school to call the police when he becomes this violent but they refuse to do so citing their policies. Their solution is to send him home every time. Each and every time, it falls to us to do something about it. 

This latest time, I decided to do nothing. I decided not to talk to or engage with J. My husband talked to him this time but said very little. I did not want to have another evening or day that ended with him screaming or yelling, "that's not fair," and us getting worked up and losing our cool. I did not want another evening having the same discussion with J that we have had numerous times. Needless to say, we did not want another evening beating our heads against the wall. Our heads can't take much more. 

Who is Being Punished Anyway?

Last week we ground J to his room for his actions. In the past when he attacked a teacher or another adult, we took some things away and grounded him for a few days. This time, we stripped his room of practically everything, leaving only his bed and clothes and he was grounded for a week in his room. He was not allowed to come out except to go to the bathroom and to eat dinner. Otherwise, he remained in his room. However, I am not sure if this time will make a difference. 

Each time we gave J a punishment for his actions it has resulted in a battle between him and me and my husband. J pushes and pushes throughout his punishment. He uses any manipulation tactic to think of such as "you are the reason I can't have anything in my room," "nobody loves me," "you must hate me," "I will never get to go outside again," "I will never get to eat again," and on and on. He will scream in his room and wail knowing I am next door trying to work. He kicks at his door and pounds on the wall periodically. And, he will throw items in his room breaking his own toys. He will sit at his bedroom door and scream or constantly talk through it. I will hear his bedroom door open and shut multiple times. We will have told him multiple times to be quiet, stop screaming, stop wailing, shut his door, and just about anything else you can think of. It is futile. In a couple of minutes to an hour later he will start back up again. 

In the past we have made him write sentences as a form of punishment. He fought with us then and what started out as 25 sentences would grow to 200 and last for days. This form of punishment never worked. In fact any consequences we gave him never really worked. He would be okay for a few days and then he will do the exact same thing again he was previously punished for. We have taken away privileges, grounded him to his room, taken away TV, forbid him from playing with his friends, restricted him to the house, and so on. We have even tried positive reinforcement for good behavior in the hopes it will make a difference. No matter what consequences or positive reinforcement tactics we used, none of it seems to make a difference. 

We grounded him for a week in his room for punching the bus aid in the face multiple times. Over the course of the week he would cry, wail, scream, argue, open his door often, pound on the walls, and took every opportunity to disrupt the household. I work from home. My office is next to his bedroom and all week long I had to put up with his behavior. I have had case managers tell me to ignore him and not let him get under my skin. You try ignoring it for a week and see how you feel at the end? At one point I ended up putting my headphones on and play music to drown him out. Needless to say, I began to wonder who was really being punished here? 

We have tried to punish J in the hopes he will learn from his behavior and choices. Each time we have punished him, we have discussed reasons why and the consequences of his actions. He will repeat back to us our conversation and express understanding. However, we have had this same conversation over and over. We feel like a broken record that never gets off of the turntable. The lyrics and beat remain the same. It is grating on my ears. 

I have gotten to the point where I dread having to punish him for the wrong choices and wrongful actions he has made. Every time it has resulted into a battle with him. My husband and I have had to change our plans numerous times because of a punishment we have given J. We cannot go out because someone has to be home with J who is grounded to his room. If we go out, we have to take J and it gets him out of his punishment. There is a part of me that just wants to ignore the entire incident and not do anything to him. It would simply let J get away with whatever he has done. And yet, I cannot seem to do that. So I do the thing I dread and place a punishment upon him. I then have to brace myself for his responses to come. It has resulted in an indirect punishment upon myself and my husband. It is a vicious cycle. 

A therapist recommended I read a book titled The Boy Who Was Raised as a Dog by Bruce D. Perry. She indicated how this book could help us in understanding J and how to best approach him. I downloaded it to my Audible account but have not been able to bring myself to listen to it. Over the past 5 years I have heard numerous things about how to react to J. I have read numerous articles and other books and found them not to be very useful. It is just something else I need to make time to do but right now I am not in the mindset to listen to it. I am still trying to get over this past week. 

Needless to say, every time we place a punishment on J, we end up paying the cost whether we want to or not. It is a merry-go-round we cannot seem to get off.  Just when we think we can, J does something that starts it in motion again. It is nauseating. In the end I feel we end up punishing ourselves in an attempt to make J behave and teach him a lesson. Punishments nor rewards do not seem to stick with him and it ends up becoming a fruitless endeavor. I still hope that someday it will stick and J will be better all the more for it. I guess that is why I remain on the merry-go-round. 

Exhaustion

 For the last 7 years, I have searched and searched for ways to help J. Since he was 5 there has been so many medication adjustments I can't quite remember all of them. He has been in some sort of therapy since he was 5. I have read books, reviewed articles, looked up diagnoses, and listened to all of the therapists and doctors. Tried everything I could think of to help J. I am exhausted. 

Therapists, books, and others say that I need to take care of myself. Get some rest. Do something to get my mind off of the situation. Take a break. It's easy for these therapists, case managers, and even family members to say. After all they do not have to sit and listen to a child scream and wail for hours. They do not receive the countless phone calls from school requesting us to come to school and/or pick him up from school because J has done something. They do not have to put up with a child constantly mouthing off to you, arguing with you, or refusing to do what he is told. How can one get some rest or time for themselves when they are exhausted from taking care of a child like J? 

This past Friday, we had to pick J up from school because he punched the bus aid several times in the face. He has been suspended from school 3 times in the past year for punching staff members and even choking one staff member twice. J even bragged about punching teachers and others simply because he does not like them. He did not even think choking someone was hurtful. Each and every incident we have tried to explain to J how wrong it is to punch and choke someone and what the consequences could be. Our teaching and explanations do not seem to make it pass his ears. The forms of punishment we have applied do not seem to work. J continues to harm people on a whim. 

This latest incident, I stripped his room of all toys, games, and books. He has been grounded to his room for a week. The moment he learned of his punishment he preceded to scream and wail for hours. I am trying to work while listening to him scream and scream in his room. I had hoped he would calm down if we just left him alone to get it out of his system but no luck. He screamed and wailed off and on from 9:30 in the morning until 3:30 pm. The case manager just tells me to ignore him and not let him get "under my skin." I have several voice recordings of him screaming and wailing this day. This does not include him talking back and arguing with my husband. I finally reached out to a family member to stay with him for a couple of hours so we could get away. 

The 2 1/2 hours of away time from J, I still could not relax. My head was pounding and I suddenly realized how exhausted I was. I was physically and emotionally exhausted. I worried the entire time we were gone, wondering what J was doing. Plus, if he was continuing to scream and wail, I knew I could not leave my family member there with him for very long. My husband and I were so distracted and exhausted from dealing with J, my husband lost his wallet that night. We finally found it Sunday morning.

When J would not calm down after an hour of being home from school, I contacted his case manager and then mobile crisis. I have had to call mobile crisis several times on J throughout the year. Each and every time I call, I am told he is not a danger to himself or others and therefore there is nothing they can do for him. I convey to them that J continues to harm people and has been known to even create a list of those he wants to harm. But I guess since he is only 10 years old it is just a behavior issue and nothing to be too concerned about. I conveyed to the mobile crisis how concerned I was that he showed no remorse for his actions. I even asked at what point will someone listen to us that he needs help; when he seriously harms someone? She got me in touch with another case manager. 

This case manager was at least familiar with J's case. He has taken us seriously and the last time we spoke, he was instrumental in finding an inpatient behavioral place for him. The last time we spoke with this case manager, J had threatened to burn the school down and had a list of those he wanted to harm and in what order. The case manager suggested finding another inpatient for him but felt it would be of no use and J would benefit better from residential treatment. The catch with residential treatment is that I have to initiate it. Not only am I exhausted from dealing with J's behavior and calling countless people, I now have to find the energy and time to call his insurance and psychiatric residential facilities to see what I need to do to help J. I have made a few calls to some residential places and still have not heard back. This means I am going to have to make more time and energy to keep calling these places. In the meantime, the only thing the case manager can do is recommend more intense therapy 3 times a week in the home. J has gone through this before. 

The past 2 years we have been told J's issues are mostly behavioral. He has gotten progressively worse and it is wearing us out. His school work is even starting to suffer as a result of his behaviors. I have spoken to anyone who would listen, readjusted his IEP at  school, tried different tactics and nothing seems to make a difference. I have spent many times praying for a solution, praying for more patience with him and praying for forgiveness that I feel like I am going in circles. My hope for J is waning. 

I am exhausted. I am tired of calling one person after another to try and get J help. I am asked with every call I make what I want for him. My response every time is for J to go some place to receive a full evaluation, medication wash and an a more accurate diagnosis. Each time I am told they just can't do that. In fact the only time anyone seems to step in to provide help for people like J is when the person commits an atrocious act. I am exhausting my efforts to keep J from getting to that point. 

When someone like J commits a terrible atrocity there is public outcry. Why did not anyone see the signs? Why did not anyone try to help this person before they murdered someone? Where were their parents? How could they have done something so terrible? Was the person getting help for their mental illness? What would make them do such a terrible thing? I have to admit, before J, I would wonder these same things. Now, I understand the frustration more on a personal level rather than an outsider. 

After the second time J assaulted a teacher, I had asked the school to put in his IEP to call the police. Not to press charges or take him to jail but for the police to talk to him, maybe even convince him of the consequences of assaulting someone. However, the school administration refuses to do that citing J's age and their policy. My husband and I have grounded him to his room, had him committed to inpatient facility, and taken away privileges due to this behavior. None of it has worked. J has been reminded to use his coping techniques and many times he chooses not to use them. We have tried praising him for his good behaviors to reinforce him to continue to make good decisions. In fact last week we were praising him for his behaviors. The school even called to say he was doing well. This week has been a total 180 degrees. Needless to say, we have tried everything and the only thing left to think of is for the police to step in to help and even then I cannot get any support for that idea. 

We are running out of ideas and tactics to help J with his behaviors. We are running out of energy and stamina. My only hope now is to garner enough energy and time to see if I can get him residential care. The case manager even stated to me I would need to be a squeaky wheel in order to make this happen because J is not going to get any better. In the meantime I have to again rely on therapy treatments 3 times a week and hope that his latest punishment sinks in somehow. My greatest hope is that some how, some way, I can find enough energy to get the help J needs before something truly awful happens. 

Triggers

So much has happened since I last wrote anything. I know it has been quite some time and although I had good intentions, sometimes life gets in the way. Over the past year a lot has gone on with J; not to mention within my family. It has been a hard year all around. J certainly has not made things any easier. I constantly have to remind myself that it has been difficult for him but what he does not realize is that he did not help things either. 

Over the past year we have received multiple phone calls, text messages, and emails regarding J. We have had multiple medication adjustments this past year. He has been hospitalized, suspended from school, transferred from one school to another because of his behaviors, and made multiple threats toward others. Mobile Crisis has been called multiple times. In the course of all of this, I have been trying to get him the help he needs and it simply has not been enough. 

The biggest challenge has been determining J's triggers. There is no one trigger that will set him off. It could be anything.  He can go from 0 to 90 at the drop of a hat. Just when we think we have nailed down a trigger, something else happens that blows it out of the water. When we think it is a particular time of day, he flips that on its ear as well. We have tried working with the school to determine his triggers but to no avail. It makes it very challenging to develop a plan to avoid or lessen the triggers when we simply do not have a handle on what they are. 

J was hospitalized late this summer because he choked a teacher at school and threatened to burn the school down. We were unsure what set his behavior off that day and why he would attack a teacher. When asked about his actions, he did not realize the ramifications of his actions. In his mind the teacher was fine despite trying to choke her. When asking him what happened, he would not tell us what made him upset. All we knew was he had made a lost of all the schools he wanted to burn down and the people he wanted to hurt. We had no choice but to find an inpatient behavioral hospital to take him. We found one but he was only there for 2 weeks. It did him no good. His behavior went unchanged. 

J was suspended a few weeks ago for the very same action. He attempted to choke a teacher again. This time his behavior escalated due to another kid getting a larger yoga mat than him. The following week his behavior was related to not getting the colored marker he wanted. Triggers. Triggers? 

The one thing I can say that all his escalated behaviors and moods have in common is when something interferes with what he wants. This could be anything. If it interferes with watching TV, he throws a fit. If another child received something he wanted, he goes off. If he has to wait in line for lunch, his behaviors escalate. If a teacher does not call on him or calls on him, he can get upset. When he feels others are talking bad about him, he goes off. When the school bus is too early or too late he gets upset. He had an altercation on the bus because a girl was singing a song he didn't like. He fights and argues with us because we have told him repeatedly to pick up his toys or clean his rooms. Triggers. 

There is no one trigger we can avoid with J, except for writing. It is the only trigger we know for certain that sets him off. He struggles with writing and whenever he is asked to write, he does go off. Other than that, we have been unable to determine any other triggers. Since he goes from 0 to 90 in no time flat, it is difficult to intervene before he goes off. J has been sent to the "refocus" room at school so many times that the teachers and assistance can't keep up with what set him off. However, we are all in agreement that whatever it was, it interferes with what he wants. In essence, a trigger can be anything he perceives to be a threat in the moment. 

How does one handle a child like this? Honestly, I have no suggestions. His behaviors this year have made it difficult to focus on my job. I have had to quit my job in the hopes to find a job with better hours and flexibility because of J. My husband and I are at our wits end with him. His case manager and provider keep telling us to hang on. That is easier said than done - they don't live with him or receive the constant phone calls. I have tried everything I could think of to help J; to recognize triggers to avoid. The teachers and aides at the school constantly ask me what to look for but I am at a lost as to what to tell them. I am tapped out. Triggers? 

In the midst of all of this I continue to seek help for him, for us. I continue to look for triggers in the hope that we can find some answers and better treatment for him. I continue to speak to anyone I can to get him the help he needs. I just hope that one day someone will actually listen and help identify triggers.