A Great Disservice

  One day, one of the more volatile children at the facility was upset about a limit that I had imposed about his behavior. He had deliberately pushed the limits of his individual treatment plan, and I subsequently removed the privilege I had given him. He became very upset, verbally aggressive and threatening toward me. Nothing I hadn't seen before. I offered him the opportunity to go to his room to cool down, but you can guess he wasn't happy that I would suggest that he do anything, let alone calm himself. In his mind, he was pissed and justifiably so. I did all I could to verbally assuage him, but I knew I had just opened Pandora's Box.
  He was getting more and more upregulated, and with each spittle-laden threat that spewed forth from his angry mouth I saw my window of opportunity to help him find some sort of emotional stability close. It was obvious with his threats and screams that his intention was to get me to restore the privilege I had just rescinded, but that wasn't going to happen, and I think he knew that somewhere deep down in his oft-broken little heart. But, he had begun this cause, and he was in it to win it.
  Well, as he knew his world became more and more restrictive as his threats and words became more and more aggressive, he went for the gold- he got right into my face, millimeters from my nose, and told me to F*** off, and that he was going to punch me in my face. I knew I had lost any chance of getting him to calm or go to his room. I called for security to join me in case we had to go hands-on with the boy, and I gave the boy the direction to go to the Time Out room. At that moment, his demeanor changed. He gained his composure, straightening his body with the utmost defiance and pride, leaned against the brick wall, and smiled. He smiled a challenge. "I will not go to Time Out." That was indicative to me that he knew exactly what he was doing the whole time, and was he behavior was not out of his control (as it is some of the children we treat, sometimes).
  At this point, a security guard had just arrived, so I asked him to assist the boy to the Time Out room. I told him that the boy was a threat to others and that he was not going to calm on his own volition. Now, security guards are not psych techs, they have no authority to counsel, coerce, persuade, or even encourage the patients in any way. They are just hired muscle for protection. But, for some reason this security guard felt the need to act as diplomat between the boy and me. I assured the security guard that the point of negotiations had passed and he simply needed to help the boy get to Time Out. He threw at me a few reasons why he couldn't take the boy to Time Out, but none valid or founded on anything but the man's opinion.
  It was now 5pm. My shift had ended. But, I knew I needed to see this out. Due to the security guard's insistence, the boy was getting away with his act of defiance. Another staff member had joined me at this point, but was vacillating on whether or not to help the situation- taking the security guard's side then mine, then his again.  She told me that I could leave if I wanted, that she would take it from there, but I honestly contemplated staying all night if I had to to ensure that the boy followed through with my direction. His body was calm at that point, but my experience with this child had told me that although his body may be calm, his emotions were still reeling. He was an erratic child, known to explode at any given moment. Time Out was the best place for him at that moment, and all he had to do was walk to TO and simply follow through with my direction.
 I decided to leave. My coworker, though I felt may not push the issue and would allow him to get what he wanted, was capable and I'd have to trust her to do her job. I got a text from her later apologizing for not backing me up more, and assuring me that the boy eventually went to TO.
 The next day I approached my boss with the information regarding the security ground a) not doing his job, and b) attempting to do the job of a tech. I relayed the story of the night before, but instead of dwelling on the problem of the security guard's misconduct, he started scrutinizing my judgment calls. What he proceeded to say shocked me. He said that when dealing with a child it isn't always about follow through. What?, I thought. It isn't about follow through? What is the point of enforcing any sort of limit or boundary on a child if we aren't going to follow through with it? If a child is verbally assaulting me, threatening me and the safety of others, how is it that I am not supposed to follow through with my limit that the child needs to be contained?? I understand the notion of picking your battles, but of all battles that needed to be seen to the end I figured this one did. He continued to tell me that what we need to first be concerned with is the emotional state the child is in. Help them see things rationally, so to speak. "When kids who leave here come back to visit," he started, "I have never once been thanked for all the times I put them in TO. They only ever are grateful for the help and support I gave them."
 Uh, duh! They aren't going to thank you for the harsh discipline! When they are a danger to themselves or another person and it is crucial that they are contained, I will not think twice, and NO I'm not looking to be thanked for it.
 Was I supposed to just give in to this boy's demands? Was I supposed to cower and let him run the show with his threats and verbal abuse? Was it appropriate to teach that child at that moment that if you yell and scream and threaten someone enough you will get your way, or get out of having to deal with the consequences of your actions? Was I supposed to have given him a limit, then backpedal because he intimidated me?
 Sadly, I see that all the time. I see my boss do it all the time. We give in to the kids because the will wear us down. They become the enforcers, the authority, and they call the shots. They are persistent, and unless we are willing to be just as persistent, they will see that they can get anything they want if they just hold out just a little longer than us, or throw a big enough tantrum. We need to be the adults. And outside of this center, had the boy gotten consistency in his parenting- follow through, tough love, and authoritative instruction, positive reinforcement, he wouldn't have been at the center.
 We do children a great disservice when we kowtow to their tantrums and their demands. If they do not learn boundaries in their formative years, they will never learn them, and the parent-child relationship dwindles and becomes ineffective. If we are not the adults, we do not help them.

Shelly

This girl, to whom I refer as Shelly, was abused to the point of almost complete dissociation from life. I call her Shelly due to the fact that when I met her she was just a shell of a child, unable to form original thoughts or think for herself or understand how she fit into the world in healthy, meaningful way. The following story illuminates how this 9-year-old thought- no clue about the world or herself in it.

One evening I went to Shelly's room to have her line up to go down for dinner. Something was odd about her face. What was it? Was it the lighting? Her face looked grey and strange. It took me a few seconds, but then I realized that she had put scotch tape over her mouth. I was so taken aback by her distorted face, it was so strange! I asked her to take off the tape and get into line. She smiled and said, "I was just pretending I was murdered!" What?

In line, as we were about to walk down the stairs, I saw her mimic to another kid the gesture of being choked- complete with the eyes-rolling-into-the-back-of-the-head bit. I asked her what she was doing.
"I'm just pretending to be murdered. I was once, ya know!"

"You were murdered?"
"Oh yeah, I was."
"I don't think that word means what you think it means." She looked at me, puzzled, and then got back into line with a clueless smile plastered on her little face.

This girl was repeatedly raped throughout her childhood. Was she re-enacting something horrible in her room? Was she forced to act out scenarios of death or murder while enduring things worse than death? This poor little girl. She will never be normal. She will never know what a healthy relationship is like, how normal human beings interact. Her therapist once told me that he no therapies worked with her and all he could do was play therapy just to see what would come out of her mouth and if he could treat it in some round-about way.

Sometimes I have to remind myself that a life sentence in prison is not the best way to spend the remainder of my life...and that helps me (just a little, mind you) not go on a murder spree of my own, taking out the parents of some of the children I treat. Makes me sick to know what some innocent little ones have gone through, and I want so badly to give their tormentors a dose of their own medicine. Maybe Dexter has the right view of the world.

Holiday HooHah

   Before I left town last week, I worked Christmas Eve day and Christmas morning. What a breeze it was, overall. Because of the holiday, most of the kids went home for the day, and we only had 3 kids on the unit. Of those that didn't leave, however, was one boy we will call T.
   T is a chubby boy with aggression issues at home, but here at the facility he is gentle and polite. He is a little socially awkward, being unaware of the needs of others, but mostly he gets along well with the other (socially inept) children. On Christmas, however, I saw the source of his weirdness.
  I answered the doorbell to a short, balding man, with camo cargo pants, an open-collared denim shirt, and a gold chain around his neck. Greasy-looking. His humor was condescending, and his gaze sticky. Regardless, we untie him with his kid, then off they went to a conference room to visit.
  After what I thought was the end of the visit, they come back to the common area and just sat...and stared at me. I suggested many activities they could do, but no. T's dad made a conscious effort to make me feel uncomfortable. He said as much. He said a lot of things. "T, you are really fat", "You could afford to go to the gym now and then," "Well, you can't even see your toes". His condescension extended to us staff members. My boss patted the boy on his shoulder and T's father said, "You hitting my kid? You'll have to talk to my lawyer!" He was joking, but it wasn't funny. He kept making comments about how he hoped T didn't turn out like a retard, and how the way he was standing was going to make him look stupid. On and on he went, making rude, sarcastic, patronizing remarks about his son, about staff, etc., making the situation perpetually awkward.
  Finally, I told him that the rest of the children would be returning from the gym in a few moments, and if he would like to continue visiting with his son he would need to return to the conference room or go to T's bedroom. 
 "Oh, you're trying to get rid of me, are you?"
 "Not at all, but this is a confidentiality issue and your visit needs to be exclusive to just T."
 "Confidentiality? I'm not prodding the kids for information."
 "No, but you are not authorized to be around them."
 "No, you're just kicking me out. You don't want me here."
 "Actually, you are welcome to stay, but your visit just needs to move."
 "Fine, fine. Kick me out. I see how it is."
 Then, he decided to actually leave. On the way toward the front door, he continued. "Well, thanks for ending my visit early.
 "Sir, you are welcome to stay and visit with your son, but you have to simply choose somewhere else to do so than the main room."
 "It's fine. You are just kicking me out."
 "You know that isn't true, so please stop saying this. Staying or leaving is your choice."
 He had the gaul to smile at me. Who does that? This is a VERY VERY condensed version of the things he said to me and T. Did he think he was flirting with me? It was so awkward and weird. Reading it doesn't portray the mood of the moment. Some sort of narcissistic, manipulative, greasy, sarcasm that somehow got a woman to marry him, sleep with him, and produce a child with him. eeeeeeew...
 I've thought and thought about this encounter, and it sheds some light on why his son is the way he is. Perhaps his son is so mean and violent toward his mother because his dad is such a prick. Is he displacing his animosity toward his father unto his mother? This child is product of a jerk.