Postings from June 1 - 30, 2005

Dear Happy Shrink,

My name is T*****.  I have an 11 year old daughter that is very difficult to deal with.  My daughter (J*****) is 1 of 4 children and has a twin brother.  I don't know exactly how to explain my daughter personality, but here it goes.  She regularly creates drama in our house.  She picks fights with her siblings as-well-as with my husband and myself.  I have tried taking special time just with her so that she doesn't feel like the middle child, even though her and her brother our the last.  She will start an argument and be relentless by yelling for a while then stomping off, only to come back minutes later and repeat the same behavior.  She will do this until you loose your tempter and yell at her or punish her.  Then she gets this little grin like she gets her kicks by getting a rise out of you.  I have tried positive response, no response, and negative response.  We are at a loss other than counseling.

My sister, who is bipolar-manic depressive, is currently going through dialectical behavior classes and is really getting valuable information from it.  She suggested getting the book and workbook to work with my daughter.  Do you think this would help?  If so, where can I get the book?  I have looked on the Internet, but have been unsuccessful. Any information you can provide would be great.

Thanks

T*****

Dear T*****,

The fact that your sister is bipolar may or may not relate to your daughter's problems. It does seem to me that she could benefit from some counseling. Clearly she is seeking attention and is determined to acquire it one way or another. In a family that has four children, sometimes there may be a lot of competition for attention. An eleven year old that can push your buttons to the point of making you and your family angry at her is a very powerful little girl. Perhaps some therapy can give her the tools to be powerful in more productive ways. 

Usually, when a pre-adolescent is in therapy or counseling, there is a component of family therapy that goes with it. I would encourage that you find a therapist that will not only work with your daughter, but work with you, your husband and the other kids. No doubt all six of you have a stake in how things work out.

As far as the DBT that your sister is doing, that can be helpful to many people but I would suggest your daughter get a full psychiatric evaluation before you consider that as well as other therapeutic options. I urge you to act now because these behaviors can get worse if not dealt with. Good luck and let me know what happens.

happy(cravingforlessattentionthesedays)shrink

Dear Happy Shrink,

I'm wondering about the ebb and flow of life that causes one to always be looking at the greener grass on the other side of wherever, when often, the greener grass is only a mystical glow from the fires of hell separating us all from a perfect life.  So Judi is unhappy being alone. I guess I have a similar problem in that I might like to have a soul mate but instead I have a husband I can't decide what to do with.  So, as you know, I moved half way around the world -- well, perhaps one third of the way around the world is more accurate -- but distance has not solved my problem with what to do with the husband.  I remember the very first time I wrote you several years ago when I stated that I hated my job (that was three jobs ago -- five if you count each school separately) and wanted to run away and become a drug user. You quite rationally noted that running away wasn't a workable plan.  The drug thing wasn't the smartest of ideas either. I really did hate my job, but obviously that was only one aspect of what I hated in my life. What I don't hate is my husband. And I think this might all be easier if I did hate him.

Another analogy that has worked for me was the one this smart guy out west suggested: that when someone is standing on your head because they are drowning and don't realize that they are drowning you too when you are offering to save them, you don't have to worry about hurting their feelings by asking them to get off!  In fact, it would be OK to pull them under in order to break the peril you are suddenly in.

That worked well enough to get me on a plane.  And his dallying threats to separate spurred me to take him up on the offer - I hope you noticed the glorious metaphor used there... -- but now I can't actually make that happen.  It is a technical issue, not a motivational one. The issue is one of national & state jurisdictions. So he has to take care of the separation stuff. Since I'm not suicidal, I won't hold my breath waiting on that. But I dislike inaction, stasis, being in someone else's control.  So this is making me a little crazy. And he doesn't seem to be drowning any more.  But I think that's just because the flood has subsided, not because he has learned to swim all that well.

Here's another analogy that I think works for me.  When the pup follows you home and you want to keep it.. It's OK to give it up when you know someone else is going to take care of it.  Give it a good home, love it the way it deserves, train it to be a good companion, allow it the dignity its life deserves. It is rare to find someone willing to make that kind of commitment. So I feel like I am leaving the stray on the side of the road and I can't bear to drive away. I guess I feel guilty.  And I haven't done any thing wrong. I thought pitching a few stones at the pup would drive him off.

The smart guy I met here tells me it is a sad thing.  No doubt he's right about that. The feelings of sadness are seriously real.  Deep, so hard to accept. Combined with other losses the effect is profoundly exhausting. How am I suppose to just shrug on a new load and keep trudging toward the greener side when hell is scorching me? The smart guy west of you tells me I'm remarkable.  I guess that's suppose to inspire me to not let myself down, or boost my self-esteem or something.  One thing it does do is make me feel like I have failed miserably at something because a remarkable person wouldn't feel like I do.

I probably shouldn't write at night when I am tired.  But some instinct or habit drives me to write and on paper things look pretty ugly.  Ha!  There's an oxymoron. Things always seem to look a little better in the morning. Perhaps the shadows of your wisdom will drop into my dreams.  So, good night.

Regards,

Grass hopper/pond hopper but can't walk on water

Dear Happy,

I've been having dreams.. about random white objects becoming skulls, or ghostly faces.. with hollow black eyes.... The first Time I saw such an image was when I was eleven, in the rear window of my old house. My siblings were pushing me towards the back of that room, and I had had a feeling, when I came to look up at the window, a ghastly white face with hollow black eyes cast its image in the window. I shot through that house to the exact opposite end in a matter of a couple of seconds. It's hard, I wake up, and hear myself screaming but I'm not. I haven't slept for more that a matter of 20 minutes since i was 12.

 And wit with all that's going on in my life now, I feel so hopeless, because nothing is happening the way it was planned,  and I cant stand to stay where I am any longer than I already have to.

 I've been contemplating a lot of things....  and I've been hurting a lot of people with the way I get so down... please help...

Hopeless In Ohio

Dear Hopeless In Ohio,

This thing that happened to you when you were eleven; was it real? Was it a practical joke? Do your siblings remember what happened? It sounds to me like you are suffering from Post Traumatic Stress Disorder (PTSD). These dreams or more aptly put, nightmares sound awful and your sleep pattern of only getting 20 minutes at one time has had to have taken a toll. 

I would urge you to see a mental health professional who specializes in PTSD. There is help for someone with your condition, but you need to seek it out. Please try and find someone who can help you to understand what happened to you when you were eleven. Please let me know what you find out. Good luck.

happy(andhopefulforHopeless)shrink

 

Dear Happy,

Edna is pissed off at me again. I took fifty bucks from the cookie jar and she thinks I went out and bought beer. I actually got this swell tattoo. Wadya think?

Bubba

 

Dear Bubba,

Isn't that a picture of your son Andy and isn't that MY lawnmower?

happy(ThankstoCornfed)shrink

Dear Happyshrink,

Every couple years or so is hardly too often to say thank you for your website. Even though you are taking more time off, you are still freely giving your compassionate wisdom. And humor!  (God bless Jewitch too!!!!!!)

Thank you.

r.

Dear Happyshrink,

Thanks so much for your reply!!!  Here is some more info about her family dynamics and caregivers.

She went to cosmetology school at night while in high school and as soon as she graduated high school - she moved out on her own. ( she told me to get out of that HOUSE w/ her parents)  Initially she rented an efficiency apt w/ no kitchen. Eventually - had various roommates.  She did not have chronic illnesses while growing up or any hospitalizations. She worked as a hairdresser & other part-time jobs at night to try &  make ends meet. Endometriosis diagnosed shortly after this & had her first laparoscopy. Never was able to work totally fulltime as a hairdresser because was out sick and couldn't build up her clientele.  I think she suffered from this off & on for a few yrs and maybe had another laparoscopy & then would get better for a while. Always, had to work 2-3 jobs.  

Met her first husband and dated about 7 yrs off & on. Not a wonderful relationship. Where she was very very sweet & wanted approval and affection - he walked all over her & belittled her to make himself feel better. She got very very close to his mother & sister & his sister was actually her roommate for many yrs. She DID EVERYTHING for that family & I feel they took advantage of that. I know they loved her, but they had strong confident (arrogant) personalities and she was more timid and giving.  They broke up (he broke up with her while at college) & stayed that way about 2 yrs & she dated a really nice guy & became engaged. She had one laparoscopy during this time of the engagement.  During those 2 yrs, her ex called her about 7 times and once even begged her to get back with him, but she didn't. We were so proud of her & started seeing another side of her then. After that point, she wasn't as quick to let someone walk on her. That engagement with the 2nd man  fell through, but was a mutual decision and she was ok with that. They both felt they were more friends than potential husband and wife. Enter first husband again - he came calling & well... they got back and married within 7 mos.

Stayed married 9 yrs - he was there during the multiple endometriosis surgeries, fertility treatments and ultimately. the hysterectomy without them having children. He was openly resentful of her illnesses and bills. He is very materialistic & loves to look good to other people.  I know he was saddened and resented that he couldn't father a biological child, but somehow he never spoke that openly to her. He would often talk about she just had a H.S. diploma & he had a BBA, yada yada yada. They were always always behind on bills. Never went on a honeymoon, vacation, etc because of lack of money. He was very good at finding her weak spot (self esteem). He lost a couple of jobs during all of this time, too because of half-a.. work ethic/attitude. He's the kind that wants money coming to him and not working for it. I remember one time, she got a part-time job at a local drug store. She loved it & they loved her. She started as cashier and then was promoted over a dept, etc. She got about 3 raises in 9 months and never was sick or missed work. Her last raise was announced to her husband, me and my husband at dinner - her husband commented - "that's great honey for a job like that". He didn't even say it sarcastic. That's just the way he thought and spoke to her.  Next day, she was sick for about 2 weeks & had to quit that job. They did go to marriage counseling with their pastor for about 4 months, but it didn't change things. My husband & I started to see a pattern of fighting, then illness. Fight w/ mother, illness. Someone criticized her or took it wrong, illness.

Husband would  say he was sick of her laying around all of the time. He never missed much work though due to her illnesses. He would get off early, etc to take her to Dr's appts. and sometimes she could drive herself. If she had a surgical procedure ( except for the hysterectomy), he usually would only have to be off one day. Most of the time, I or her mom or my husband would go to. She would just lay on the couch Through all of this and he would cook or sometimes, she would still do that. Yes they adopted a baby during all of this chaos.  Relationship of course was still the same as when they dated and they were broke.  The baby brought a lot of joy to them & brought her FAMILY very close. It did help in that kind of way, but of course as anyone knows - the basic problems are there & only exacerbates with the birth of a child. She stayed home fulltime to be a mom & she is a great one. Made her own baby food! Wonderful mom. Not much illnesses during this time except for some bladder/kidney infections, ear infections, etc. My husband & I started noticing if her & her spouse were fighting (she told us everything) or said something derogatory, she would get a little sick. Never to the point, she had to go to a hospital or couldn't take care of her child, but it just seemed to go hand in hand with depressive episodes and illness. When the child was about 2 - she & my husband's father was diagnosed w/ leukemia. Since she wasn't working, she took care of him; took him to chemo, radiation, all of his doctor appts.  and they became very close. Her mom had to still be the worker. She did this for 6 months and she was never ever sick. She was a real trooper. He died about 6 months after diagnosis, but I've always been glad they had that time. I don't think they ever talked about anything too touchy/feely, but it was still a loving relationship & he ABSOLUTELY adored that grandchild.

Got a job when the child was about 3 1/2  and placed her in preschool. Actually got a job at her husband's work in the office. (yeah, we know.. bad idea). Anyway, her spouse was a sales rep & out of the office most days. Another job she loved & they loved her. Since she was on the "inside" she found out what a truly lazy individual he was and how he wasn't a good provider. No one at that company liked his arrogance & couldn't believe she married him. He had always left the house about 7 or 7:30 and got home at 2. What sales rep do you know can do those hours & bring home good money? My husband had been telling her that for awhile & now she was seeing for herself. The other sales reps made twice what he did, but worked long hours. He talked to his co-workers (the ones in the warehouse or office that didn't have a DEGREE in the same way he treated her). This coupled with the fact that she realized how short life was after her dad died - made her determined to get a divorce. 

They Divorced when child was 4 1/2yrs old. She initiated. He did not want it and begged her not to do it. She  moved in with us for about 2 months and then moved to the city where her/their job was. He still worked there, but was never ever in the office. He took it hard & I had never seen that side of him. It was civil and they agreed on everything. She received primary custody of the child w/ w/end visitation for him. He pays her child support. He stayed in this area. Not long after,  she started dating a guy in the warehouse while her ex was still working there. He is 14 yrs younger than her. We discouraged her, but who listens. She's never felt this way before & he did treat her like no other, but he was young. He had a daughter that was 2 that he shared custody with an ex girlfriend. I have to say, we were impressed with his parenting skills & that he had the daughter most of the time at his own apt. Relationship went went way way too fast. Everyone was trying to encourage them to slow down. Dated about 6mos and got married. He moved in to her & daughter's apt w/ his child visiting frequently. Shortly after, she got sick again (gallbladder disease for one) &  with something else - ended up getting fired from that job from absences.  Husband and ex still worked there.  Got better & got another office job. Ex started dating and got married. He eventually got fired from that company for not producing.  His relationship with his child changed after that & remains there today. Sees her twice a month for about 1 day and pays the child support, but has gotten totally into his new wife's children. This hurts my niece & sister-in-law desperately. 

New brother-in-law pretty mature in some ways for his age (he grew up hard and with no guidance), but has a wonderful wonderful work ethic and very well thought of at his job. Quickly moved to supervisor of the warehouse, then the plant & at present.... inside sales rep. He's great with the kids. He is very quiet and shy, but very nice. However, shortly after wedding...... I called them one night & I could tell she had been crying. She did not talk much. Later she confessed that he was holding her "hostage" and accusing her of running around on him, etc. He was violent, but didn't hit her. He stole her car keys and tore the phone out of the wall.  I told her to get out & she could stay with us. After more conversation, I found out that these signs were there during dating, but she never told us. One time when they were dating, they got in an argument & when she came home, he had slit his wrists & she had to take him to dr. He went to counseling for awhile & got on meds for depression/anxiety d/o, but of course quit both shortly after. According to her, he was completely changed. We tried & tried to talk to her and encourage her to live with us, but HE WOULD never do that again and he would never ever touch those children she said. She got sick again with interstitial cystitis, elevated blood pressure, irregular heartbeat, etc; etc. Started having numerous numerous medical bills. They had to move out of their apt & move back to another town where her mother lives. All 4 moved in with mother in a tiny house. My sister-in-law didn't work. Cleaned some houses for extra money. My brother-in-law continued to do well at his job. All was well for awhile... my brother-in-law did alot of work for my widowed mother-in-law and they all got along well. But, then old routines in the mother/daughter relationship resurfaced & caused problems. 

They stayed there about 1 yr before it came to a head; they  moved out and went back to other town to another apt. Same cycle, when kids weren't there... he would start a fight with her and then he started hitting her. She didn't tell us this until later of course & there were never any physical signs. One day my husband called & found out that it had just happened. He went & got her. The kids were at their dad's and mother's that week. We set her up an appt with a battered women's shelter, etc etc and she actually went. My husband called my brother-in-law and talked to him. It was terrible. Of course... she went back. He went to counseling/anger mgmt and takes an anti-depressant. This was all in August of 2004 and to our knowledge, it hasn't happened since, but who knows. We ask her & him, too and they deny it. Say things have changed.  The kids never knew anything. ( we hope) I feel very uneasy about this relationship, but so far, he seems to do ok. If these hospitalizations haven't thrown him over the edge, then maybe he's on the way to recovery. 

My husband & I have openly talked to him about abuse, etc and I know it's rare people change. He seemed to sincerely want to change his life and voluntarily went to all of this to save his marriage. In fact, it was hard for his counselor to find an opening in an anger mgmt course as a volunteer vs court appointed. Anyway... he is continuing to work while she is in hospital & we and other family members have been keeping the children. If they are with us, they have to go to my daughter's daycare while we work, but this week - they are staying with an aunt that doesn't work while my brother-in-law can still work. He gets off work & goes straight to hospital and spends the night. Gets up & takes shower & goes to work to repeat the process. I've seen no open resentment from him as in my other brother-in-law, but I know it's a huge stress. She hasn't been out of the hospital long enough to see how it has really effected them. She is presently in hospital again for pancreatitis. She was discharged this past Friday & readmitted on Saturday am for another attack. She had another ERCP last week with a stent placed. They did not see any type of obstruction and said this should solve the problem. She was able to tolerate small bites of food a day before she went home, so they discharged her on a low fat/bland diet. She went back home on TPN because she wasn't able to take in enough calories yet. Supposedly on Friday, she had one piece of bread, a few bites of grilled chicken only and woke up on Saturday am with an attack. Her amylase/lipase are very high & she is back. in hospital.  The doctors don't know what to do. Everything comes back ok. I don't know what's going to happen, but this is the 8th admission total for this problem in about a 2 1/2-3 month time span.  

It's just a sad complicated story with a wonderful woman at the center of it & we want to help her. I'm very sorry this is so long, but I was trying to give you her history in the most concise way possible. Thanks for your input.

KF

Dear Happy,

My husband & I have been wondering for years about his sister's extensive medical history. I've known her for 15 years. Here are some of the FREQUENT illnesses/diseases she has had:  endometriosis requiring several laparoscopies and eventually a hysterectomy at 24 (never having given birth), depression ( 2 INPT admissions for major depression), multiple multiple trials of antidepressants that never seem to work. chronic asthma frequent bladder & kidney infections, colds chronic ear infections and swelling of her ears, interstitial cystitis requiring catheterizations and cystoscopy surgeries (problem for about 6 months, then was fine; then again for about 3months and haven't heard it mentioned in about 3 yrs), Rheumatoid Arthritis (major bout and office visits w/ trial of various meds - haven't heard any problem about exacerbations in about 2 yrs; do not think she still takes meds or sees that MD; not sure if labs were ever conclusive) ,possibly lupus (hasn't mentioned this in a while), gallbladder attack, but diagnostic w/u was not conclusive, but eventually resulted in removal of gall bladder, TMJ resulting in purchasing a very expensive mouth piece (*approx 10years ago, that she wore about 1 yr and hasn't mentioned since), lactation d/o w/ pituitary gland - had to take very expensive medicine for about 8 mos. ( has not had problem since; remember.. has never given birth), tick fever - about 3 yrs ago and was sick for a few months, frequent migraines, anemia - no transfusions needed, chest pain & irregular heart rates * (wore Holter monitor about 2 times and went to various docs and cardiologist for about 6 months and haven't heard about problem since), elevated BP - on and off again on bp meds *hasn't had this problem in about 1 yr. bouts of insomnia off & on for about 8 yrs - has been on sleeping pills, but only for about  3mos NOW w/ CHRONIC PANCREATITIS - has been on home TPN and is in hospital now. 3rd hospitalization in 2 months with initial Dx, then bladder infection & now w/ possible line infection * however preliminary cult has been negative.

 Long history and MEGA medical bills of various doctors and hospitals over these past few years. She does suffer from severe self esteem and has had some issues w/ her family and growing up ( who hasn't, right?)

 I could go on and on and on, but some of these illnesses obviously have positive lab tests - so I don't know if that can be fake or not or can it be self induced. Anyway.. to my knowledge - no one has ever mentioned this to her & I certainly haven't. 

Maybe we're reading too much and watching too much TV. It just seems strange because no physician has ever been able to find a definite cause of any of this & sometimes it's just a working dx and never really been resolved. She has had about 18 jobs in 15 yrs because she gets fired for missing so much work. She is an excellent worker and great person, but could all of this on one little person be for real?????????????????????????????????????????????????? she is about 4' 9'' and weighs about 100lbs. For about 1 yr, she was very swollen and gained a lot of weight when her bp was elevated?????

 OH YEAH. Every medicine makes her sleepy & knocks her out including Tylenol?? She is only on an anti-depressant and inhaler at this time. doesn't seem to be a drug seeker/pain meds.

Thanks

kf

Dear kf,

While you have given me an extensive history of your sister-in-law's illnesses over the past 15 years, and perhaps her mental state has contributed to some of these conditions, there is no way of know from what you have told me how much of it is psycho-somatic, self induced or non-existent. I do have some thoughts that I would like you and your husband to think about.

Very often, the severe dysfunction of a family member is born out of a family dysfunction. In these cases, the family member remains sick and in need of care so that other family members don't have to deal with their own conflicts, failures, fears and depression. I wonder which family members take care of your sister-in-law and how they may benefit from her being ill. Benefit is a very subjective word and I don't necessary consider their benefit to be a good thing.

I had a patient once who had a wife who suffered from depression and was constantly sick and in need of his attention. He initially presented to me his resentment of how his wife's condition held him back from his career aspirations. Over time, we began to do family therapy and what emerged was his own fears about success and taking risks. His wife who was very dependent and wanting to please him sacrificed herself and became a "professional patient." 

I wonder if there is a family dynamic that may be a part of your sister-in law's illnesses. Please let me know what you think and give me more information about who are the caregivers.

happy(cargiverandcaretaker)shrink