I read a note from a friend today about her 10 year old who seems to push situations to the limit in their home, to the point where she is becoming dangerous either to herself or them…then once they restrain or contain her for safety, it enables her to calm down.

I see this cycle with LuLu as well. I’ve been carefully observing how the hospital staff handles this, trying to figure out how I’m going to handle it when she returns. One of LuLu’s major problems is her total lack of impulse control. Another is her inability to connect her logical thought with her emotional brain and actually stop herself from negative behaviors or force herself into positive behaviors, if any emotion at all is surfacing (happy, sad or angry). It’s like there’s no regulator on her at all.

At the hospital, the staff has higher expectations for her to have (as they put it) some “coping skills”. Apparently they have discovered she has very little. She can correctly debrief and process after each episode. But she has no stopping power once she starts to ramp up.

For years the regulatory system we’ve used for LuLu was mine. I would stop her (physically and emotionally). I would restrain when dangerous, snuggle when sad or calm enough not to hurt one of us. Calmly wait as she processed what happened. The problem is that all the processing of what the right thing is to do hasn’t enabled her to actually DO it.

I sense in my friend’s situation that her daughter is similar. So you get into this awkward place of being your child’s regulatory system. You’re no longer just Mom, or even just therapy Mom, but you’re the therapist, the hospital aide and actually the child’s frontal cortex…all rolled up into one.

When LuLu was smaller, I believed that she would eventually make this connection, gain the impulse control and be able to turn away from the impulse and to a positive action. Now, frankly, I’m not so sure.

The hospital staff’s expectation that she know how to do this is much higher than mine. I had hopes that by raising the bar, she would work toward their expectations and have more ability to control herself than she’d shown me. I see little evidence this is the case though. And I get mixed report from the hospital staff. Some tell me she has had great days, is funny and sweet. Others tell me she had to make several trips to the quiet room and did and said some very offensive things. And knowing my daughter, all of this report is likely true.


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