how can a teen be made to confront faulty thinking if its never addressed- vent

[Anonymous]

OP, what kind of therapy has she been doing? I just learned in DBT family therapy today that we are supposed to enforce serious consequences if DC threatens to self-harm. That is manipulative and dangerous behavior that shouldn’t be reinforced. True urges to self-harm should be brought to parents in advance of DC taking action so we can help them use their self-regulation skills before it escalates. Have you looked into DBT? It might be a good time to transition to it now that you’re between therapists.

[Anonymous]

Anonymous wrote:OP, what kind of therapy has she been doing? I just learned in DBT family therapy today that we are supposed to enforce serious consequences if DC threatens to self-harm. That is manipulative and dangerous behavior that shouldn’t be reinforced. True urges to self-harm should be brought to parents in advance of DC taking action so we can help them use their self-regulation skills before it escalates. Have you looked into DBT? It might be a good time to transition to it now that you’re between therapists.

OP here, well that's the tricky part. On paper it sounds like she was threatening. But as she explained later she was in fact just trying to let me know why she was taking some time to calm down, because she correctly remembered I had already told her a long time ago that if she has such feelings she needs to tell me in advance. And so she did The feeling passed. She calmed down. It only took about 20 minutes.

She later comes to me completely calmed down and tells me a slew of very specific self reflective things. I asked her if she considered a problem that after doing so well for so long that a perceived slight would cause her to feel so bad. She explained some specifics and said she was working on them.

I had already given her very serious consequences for meltdowns and expressions of wanting to self harm. I let her know if she cant pull it in she will end up in the ER and I have no control over what happens once she is in the system. It seemed to make her understand that simply saying she feels one way or another is not sufficient. Of course all this was before I understood the full scope of her feelings. All that is now very different thanks to treatment and many many many conversations.


To answer your question: the "type" of therapy she received was straight talk therapy. It seemed to at least get her used to talking to someone.

[Anonymous]

Oh, and yes, I have considered DBT for her but its not been easy to find anyone with that focus.

[Anonymous]

OP again, I just found this: https://dialecticalbehaviortherapy.com/

Looks interesting!

[Anonymous]

Op, can you get her on a list for an in network neuropsych or look into high functioning autism? Or talk to dr about treatments/therapies for undiagnosed autism? This sounds like my daughter and she needs constant therapy for IDing emotions, handling emotions, responding well to others.

Good luck

[Anonymous]

DBT PP here. You cannot expect her to knock out every issue one by one with a therapist. DBT requires a change in mindset that allows you to accept that two truths can exist at the same time. Also, you said she blows up at a perceived slight, and blames everyone (namely you) for making her upset. But think of it as if she has lots of issues piling up and she is getting more emotionally dysregulated until finally, one small thing marks everything spill over the edge. It wasn’t that big a thing but she was already close to spilling over, and then bam! The goal should be to not reach that point, but to give her skills to lower her response to all the small slights that pile up so they don’t overflow. It’s great that she’s reflective and insightful and willing to do the work. Definitely read more about DBT.

[Anonymous]

+ 1 to DBT for her.

It sounds like she could stand to work on her distress tolerance skills.

[Anonymous]

DBT family here. Based on our experience it helped DD and us as parents. I hope you can find therapist with that training.

[Anonymous]

Anonymous wrote:Op, can you get her on a list for an in network neuropsych or look into high functioning autism? Or talk to dr about treatments/therapies for undiagnosed autism? This sounds like my daughter and she needs constant therapy for IDing emotions, handling emotions, responding well to others.

Good luck

OP here, thanks everyone. No, definitely not autism in any form. Her untreated ADHD creates a lot of emotional dysreguylation, either directly or indirectly. Im still trying to wrap my head around how to get her help for her ADHD in terms of medication, because she is so all over the place its hard to get any plan going. I cant be riding her constantly to stay focused or stay on task when that is exactly what she cant do.

[Anonymous]

Anonymous wrote:DBT PP here. You cannot expect her to knock out every issue one by one with a therapist. DBT requires a change in mindset that allows you to accept that two truths can exist at the same time. Also, you said she blows up at a perceived slight, and blames everyone (namely you) for making her upset. But think of it as if she has lots of issues piling up and she is getting more emotionally dysregulated until finally, one small thing marks everything spill over the edge. It wasn’t that big a thing but she was already close to spilling over, and then bam! The goal should be to not reach that point, but to give her skills to lower her response to all the small slights that pile up so they don’t overflow. It’s great that she’s reflective and insightful and willing to do the work. Definitely read more about DBT.

OP again. My frustration has been that exactly all of this is stuff I have always known. I didn't even know it was a "thing" as a therapy approach, but more just strategies I developed independently over time.

What happened to DD was trauma, puberty, and untreated ADHD all came together at once. THen depression and anxiety got hold of her.

So we HAD to peel away the layers of issues before we could get to the intractable nugget of depression and then we got treatment for that and NOW there is everything that remains to me done.

It was just frustrating that no therapist ever bothered to notice her patterns, but then of course she was resisting, so they can't be mind readers! And she also got frustrated no one was giving her things to do. They were, they just didn't make sense to her.

Another search on DBT therapists in Frederick County doesn't look promising, but I will expand my search since we are doing telehealth anyway.

THanks again everyone!!

[Anonymous]

Anonymous wrote:OP, what kind of therapy has she been doing? I just learned in DBT family therapy today that we are supposed to enforce serious consequences if DC threatens to self-harm. That is manipulative and dangerous behavior that shouldn’t be reinforced. True urges to self-harm should be brought to parents in advance of DC taking action so we can help them use their self-regulation skills before it escalates. Have you looked into DBT? It might be a good time to transition to it now that you’re between therapists.

NP. By consequences, does your therapist mean that you should take the kid to the ER?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, what kind of therapy has she been doing? I just learned in DBT family therapy today that we are supposed to enforce serious consequences if DC threatens to self-harm. That is manipulative and dangerous behavior that shouldn’t be reinforced. True urges to self-harm should be brought to parents in advance of DC taking action so we can help them use their self-regulation skills before it escalates. Have you looked into DBT? It might be a good time to transition to it now that you’re between therapists.

NP. By consequences, does your therapist mean that you should take the kid to the ER?

Quite the opposite. Consequences like taking away electronics, losing privileges for using self-harm or suicide as a threat. Self-harm threat in this example is crying wolf. You shouldn’t reinforce that behavior by taking directly to ER. Should get DC to use distress tolerance skills before or call DBT therapist if skills don’t work.