#it's ok i am now in therapy and we have weekly appointments set up

[orcelito]

It's a little funny. I spend so much time compartmentalizing that I convince myself I'm totally fine, of course, all the time.

But when I was filling out the questionnaire before my therapy appointment yesterday, it was like

.... OK yea maybe I have some problems

Also this one 😂😂😂

[m2fjourney]

Therapist

I saw a therapist yesterday. Despite my tendency to just launch into long narratives, I think we covered the intake basics. I got a lot of my background off my chest and I think he knows from where we’re starting. He has experience with transgender patients and worked in college counseling for some time. The practice overall has a transgender specialty of which my therapist is a part. Since it was a virtual visit, it was a little less interactive than I think in person would be, but at least I could see someone. 

We talked a lot about my thoughts on transition. I think I jumped on the hormone question before it was out of his mouth. I definitely still want to wait a little to drop some weight and tone a bit. Testosterone might as well well do me some good for once. I am down to 192.6 this morning. I feel much better, but it’s hard to see changes on my own body. We talked about voice a bit. I started to freak out when I first looked into self training my voice because I got overwhelmed by even the simplest instructions online. People instructing seem to be very skilled and aware of their voices and a) I have always hated my voice b) I have zero voice talent or training because of a and c) I really, really want to change my voice. I did finally take a step back (something that was hard for me to do with anything overwhelming in the angry before-times) and remind myself that I have done lots of other things that were difficult at first and frustrated me at first and I eventually figured them out. My therapist did have a good referral for voice training and I emailed them and they emailed back right away. I only asked about needing a referral, but they were nice and said it depends on insurance, but consults were usually covered and to just say you had persistent hoarseness and you could do a consult. He also said that depending on where I was in the process they had training and surgical options. I don’t feel I need to jump on this right now, I will probably go back to some online resources and see where I can get. 

I have weekly appointments now with the therapist. He seemed to appreciate where I was and wants to help me navigate the new me. The initial euphoria of my egg cracking is ebbed, but I am still not angry. I am sleeping OK again, though not over-sleeping any more, I am up early enough to knock out my physical therapy exercises and a growing routine of regular exercise as well before I have to get ready for work. 

I got a new silky pajama set from Target and some nice underwear from Tomboy X, combined those made me feel awesome. I tried tucking with the Tomboy X tucking bikini briefs for the first time. I think it worked ok, but I am not sure I got the nuts as far into their cave as I could have. Needs work. 

I found myself starting to think about when I’m presenting female. I am thankful that I was able to tick off a handful of people and places I love that will absolutely 100% have my back. Whether it’s our “regular” cocktail bar that has a very vocal pride and diversity commitment from owners and staff or friends with kids who are transitioning one way or the other. The sadder part of the exercise is the two buckets that are either people who I will absolutely lose (mostly not close anyhow, thankfully) or people who I don’t know how they will react. We have a favorite bar that has been closed since the pandemic began and although I know staff there are very accepting, I don’t really know how the owner (who we know personally and outside of the bar) will react. He is a little “old white guy” in a lot of ways, but he also hires a bunch of cool and accepting younger staff so it’s a crap shoot. I am bracing for unexpected losses during this process. 

[theselfcaresocialworker]

Note: 

I got frustrated yesterday when I had a regularly occurring phone session scheduled with a client and they were driving in a car with a bunch of other people. I needed to cancel because of HIPPA and they gave me an attitude about it. This keeps happening and it’s really frustrating for me because: the session is a regular weekly appointment at the same time every week (which is difficult for me to swing on my end of things), so I feel like it should be more or less easy to remember; by forgetting the regular session it feels like my time isn’t valued because I have to cancel that session and by then it’s impossible to fill that slot; I get a lot of pressure to see a certain amount of people a day so when that doesn’t happen I can get “in trouble”; when I don’t feel like my time is valued or respected it makes me care a little less. 

NOW. None of this is the clients issue. THIS IS ALL MINE. I in no way put this on the client (except the part of remembering sessions, that is part of the deal as client and therapist). It is still ok and good to express and validate this frustration because THERAPISTS ARE PEOPLE TOO! We don’t have to just swallow things and magically “not be upset about things” because we are professionals. I feel like this is a common misconception about mental health professionals, that we are somehow less human than the client, which is so not true. We feel the same feelings, have struggles, make mistakes, get upset, stuck, frustrated. Our job is not to be perfect or to be unfeeling therapy robots.  

It is our job to express our side of things to clients when necessary and set boundaries in a calm collected objective way. It is our job to be a neutral and objective third party, a sounding board, a support. Not a boundary-less, punching bag who mops up a bunch of word vomit from out shirts every 50 minutes. 

SELF-CARE TIP: set clear expectations with the client about session times, confirm that the time you set will be free from distractions and will be private; when frustrated express it somehow in an appropriate setting, with appropriate people; breathe; shake it off; drink some water; use self-validating statements like “It is ok that I am upset by this, that makes sense”; write a blog post about it a day later because you still can’t move through the frustration enough somehow lol 

Take care!

Sara

[simplicityredesigned]

Disclaimer: I have read, heard, and cried at the many many many stories about ABAs, Behavioral Therapy, and the abuse that occurs within the autism world. I have had friends that left Behavioral Therapy because of the treatment of their children by the therapists. At no point was punishment a part of Reine’s therapy. I was never asked to sit in a different room while she was in her sessions. There was never a hand laid on her by myself or the therapist at ANY time nor was it suggested. Nothing was withheld from Reine as a form of discipline or punishment.

Before you blast me with hate emails, negative comments, etc I hope you take the time and read about OUR experience. I have no doubt that we were “lucky” with our therapist. Not all Behavioral Therapists are the same. Ours happened to be extraordinary! I was given permission to post the pics of our incredible therapist with Reine.

The hardest part about therapy is when it ends. You are left on your own, hopefully, with all the tools, you need to be able to navigate the world around you better than when you went in. It is scary when you leave the therapist’s office for the last time.

In January of 2017, Reine began Behavioral Therapy for Oppositional Defiance Disorder (ODD) tendencies.  She was not officially diagnosed with ODD because I stopped almost all contact with the outside world not allowing her to hurt non-family members. I was too afraid of having the police/Child Protective Services called on us or being sued if Reine hurt another child.

Behind closed doors, we were living in a nightmare that seemed to be endless. We were unable to open windows because of the constant screams of anger that erupted out of nowhere or the intense meltdowns that sounded like I was physically hurting Reine to anyone passing by our home. There are holes in many of the doors and walls, door jams splintered, paint scraped off down to the drywall, and so many smashed toys. What seemed like endless bottles and tubes of shampoos, conditioners, dish soap, hand soap, lotions, deodorants, body washes, toilet paper, wipes, and spices to name a few, were being replaced weekly because Reine would hide and empty the contents. Bedroom doors had to be locked at all times. Dinner was started at around 7-8 pm because I could not keep an eye on Reine and cook food at the same time. I refused to accept that this was our lives but in reality, it was.

The Developmental Pediatrician and I went head to head twice in the battle of Momma vs Doc (who sees my child once a year for roughly 10 minutes) when I refused to put Reine on medications, instead, begging for a behavioral therapy referral. The Doc thought that meds were the answer instead. Needless to say, I won this round. We were placed on a 9+ month waitlist twice thanks to issues beyond our control.  I knew in my soul that medications would not solve Reine’s issues, they would only mask it. I wanted to know what the disconnect was that was happening between her and us that was causing the behavior. I wanted the tools and strategies that we needed to correct it.

The day I got a phone call telling me we finally were given an appointment to see someone in behavioral for an evaluation, I cried. I had so many expectations riding on this one appointment and this one therapist. During the evaluation, I laid everything out on the table for the therapist. I do mean everything. If this woman was going to help me, I felt she needed to know it all. I had no one left to turn to for help with the nightmare we living in at that moment, except for her.

After I told her everything, I heard the words that completely and utterly changed my life… “We can do this.” I left that evaluation in tears. I had no idea what to expect beyond this meeting but again, my gut and soul were telling me that this was one of the many missing pieces between Reine’s world and ours. I knew I would give it everything both Reine and I had and then some to help both of us escape the hell that was our lives.

For 10 1/2 months, I drove an hour (sometimes more depending on traffic) one way, almost weekly, for Reine and me to meet with Christine. This petite, beautiful soul of a woman. As I write this, I am in tears. I know that Christine has no idea of the full impact that she has had on my family. I don’t even know how to repay her for everything.

We began with the small stuff that we could easily navigate through first and make solid, quick changes that would be easier to piggyback other more difficult behavioral changes onto. Every session meant homework for us. I took every single thing Christine gave us and implemented it in our daily lives immediately. Some of the things, I am not going to lie, I thought they would never work. But I still did it. I customized what I needed to for Reine to adjust and adapt to make it easier (always with Christine’s knowledge and OK) making it a part of our daily lives. Each day got a little bit easier. Each week got a little bit easier.

Some of the things we did with Reine…

Timeout Bench This was a dedicated bench for Reine to use for timeouts only. When she did something that was not acceptable she was placed or told to go to her time out bench where a timer for 2 minutes was set. This was for her to take a breath as well as us. There was no berating, freaking out, lectures etc. We told her in one to two sentences that her behavior was not acceptable and why. When the timer went off, she came out of the timeout and it was not mentioned again.

My Way, Your Way Cards These cards are used with a timer so that not only did Reine learn that there was more than one way to use something or do something, but to also take turns.

Wait Timer This is a timer we use for her to see a visual countdown so she can wait patiently for someone’s immediate attention. We set it for no more than 3-5 minutes. When the timer goes off, we stop immediately and listen or do whatever Reine needs.

Charts I created several charts for Reine to use that helped her to see things visually but also as a way for her to see the information she was asking me about over and over again.

How Long Until Chart and Calander This set is used to help Reine see a visual countdown until someone comes home, visits, we go on vacation, or for an event.

Ask Mom Chart This chart was amazing because it allowed me to set a number of times Reine was allowed to ask me the same question over and over and over again. It showed her visually how many times I would answer the question before I stopped answering it.

Expressing Wants and Needs Chart This is a reward chart. Each time she expresses her wants and needs to us in a positive way, a circle gets filled in. If she doesn’t then a circle gets unfilled in. When the chart is completely filled in, she gets a reward. The reward is something she really wants. She strives to fill it out and is so proud of the reward that SHE earned.

Following Directions Just like the Expressing Wants and Needs Chart, this chart uses rewards to help her understand the concept of following directions.

Reducing Anxiety This chart is another reward based chart. It is used to help her calm down, taking deep breathes, and telling me or others how she feels and to work through her anxiety. Unlike the other charts, she doesn’t lose circles if she can’t do something on the chart. We repeat the steps over and over until she can.

Who Is Home Today This chart is used to show Reine who is going to be home and who isn’t for the day.

Homeschooling Charts These charts allow Reine to see the progress of the day and how many more things we have to do before she is done with school that day.

Let’s Play Chart This chart allows Reine to pick things to play/do with us in particular. Many times Reine wants to go from one thing to another to another to another without cleaning up and gets frustrated when we do not know these wants.

Now, Next, Later Chart This chart allows Reine to see the big things we are doing in order.

How do you say “THANK YOU” to someone that helped you in ways you can’t begin to describe…You can’t. You can only continue to do the things she helped you to learn and to make her proud of the progress you have continued to make.

As part of Kennedy Krieger Institutes rules, Reine is not allowed to see Christine anymore. It has been a LONG and HARD transition for her. She adored Christine and was so confused by this process. She retaliated and backslid in hopes of seeing her again. She still asks about her and begs to see her on a regular basis. It breaks my heart every.single.time. I have to tell her she is not allowed.

Christine, if you ever come across this post and read it, know that you are so very much loved and missed. I can not begin to tell you what you mean to me personally. I owe more than you know and I can ever repay you for. You are damn good at what you do. Never forget that. Thank you so much!

This slideshow requires JavaScript.

Bittersweet Goodbyes Disclaimer: I have read, heard, and cried at the many many many stories about ABAs, Behavioral Therapy, and the abuse that occurs within the autism world.