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The Counseling Angle

  • Posted on December 13, 2013 at 10:00 AM

I’ve never been much of one for counseling. I’ve tried it for depression. I’ve tried it when Mark and I were working our way through a rough marital patch. I’ve also watched Mark go through counselors until he found one he more or less clicked with. It’s hard finding the right person, and sometimes there just aren’t enough options.

After Willy started having seizures, he struggled to cope with them. The seizures destabilized his moods and made him prone to irritability. When he started taking anti-seizure medication, we expected his moods to stabilize, too. Instead, his moods got worse. In a moody fit, Willy wrote us a very scary letter that expressed suicidal feelings without suicidal ideation.

Mark is diagnosed with bi-polar disorder. I’m diagnosed with depression. We know way too much about emotional imbalances to let something like that slide. I made an appointment with Willy’s pediatrician, showed him the note, and asked for a referral. Actually, I didn’t have to ask for the referral, because the pediatrician offered me a referral before I got the chance to ask. Of course, Willy’s doctor was well-versed on Willy’s autism and epilepsy diagnoses, so he knew we’d need someone with special skills. He had just the person in mind.

When I made the call, I explained the complexities of our situation to the receptionist and asked for an appointment with the person Willy’s pediatrician recommended. It turned out that the person our pediatrician had in mind was a psychiatrist. The receptionist confirmed that she would be the very person she would recommend for a family in our situation, if we needed a psychiatrist. The receptionist recommended, however, that we start with a psychologist. She selected one based on our criteria and we scheduled our initial appointment.

Willy’s counselor turned out to be a great fit. She was easy for me to talk to, which is important because I’m the one who has to explain the complexities of our family dynamics. She’s also easy for Willy to talk to, which is even more important because he’s the one she’s trying to help. She has a solid understanding of autism, a good understanding of epilepsy, and a fabulous understanding of how special needs and adolescence can collide.

During our next neurology appointment, I showed the same letter to the neurologist. I talked about the counseling and I also talked about my discovery that mood instability and depression were a side effect of the prescribed medicine. After discussing our options, the neurologist recommended that we try a supplement called B6 before we considered changing Willy’s prescription. We were very lucky to find a medicine that eliminates Willy’s seizures with such a low dose and there’s no guarantee that another medicine will have the same results. In his experience as a neurologist, B6 had helped several patients with such side effects, though there wasn’t a documented medical explanation for it.

I can’t tell you how much of the transformation is due to the B6 and how much is due to the counseling. All I can tell you is that Willy is doing much, much better. It’s going a bit far to say Willy’s mood is stable, because he is, after all, a teenager. But he’s not depressed and his mood instability is not abnormal in its frequency or its severity. While we’re not ready to stop the counseling sessions quite yet, we’re focusing more on skill-building than on damage control. The hope is that, when we’re done, Willy will be better able to cope with life without the safety net of counseling, though we’ll continue the supplement.

Aggression: Understanding Willy

  • Posted on April 10, 2013 at 10:00 AM

Kathleen and Kim wrote a post for The Autism Channel about aggression. This is my third response.

I’ve already discussed Ben’s aggression and Alex’s aggression. Now, I’d like to turn to Willy, because Willy’s experiences with aggression are both markedly different and even more heartbreaking than those of his brothers.

Willy has had a few minor phases with overt aggression. Early on, when we were just learning about autism, Willy would throw tantrums and he’d throw toys. His initial “social” attempts involved hitting, kicking, biting, and pinching to try to get his way. Then, he developed the language and social skills he needed to be more successful. So, basically, he developed in a fairly “typical” way, but on a different timeline than his “normal” peers. For many years Willy exhibited few aggressive behaviors, even fewer than his older brother, who is a typically developing child. Willy is compassionate and passionate about justice, which has sometimes gotten him in trouble when he’s argued with teachers or parents who use their authority in a way that Willy disagreed with, but it also made him conscious of how aggressive acts were acts of harm.

Then, this summer he “developed” or “manifested” epilepsy. (Honestly, I don’t know how much epilepsy is always there, like autism, or if it is developed, but that’s neither here nor there.) Ever since, he’s had a rough time of it. Even though the seizures are under control, we’re still dealing with the emotional fall-out from that experience. Added to that, Willy started the school year as the victim of bullies, which may or may not be on-going in a way that’s too subtle for Willy to understand but not too subtle for him to feel (at least, this is a theory shared by his counselor). So, it’s easy to understand why he’s having problems. And, yes, under these stressful circumstances, he is acting out more, including some aggressive behaviors.

Unfortunately, acting out is really the least of it. Willy has become somewhat more aggressive, and that’s unfortunate. The bigger problem is his self-destructive emotional state. He’s “acting out,” but it’s more on an emotional level than actual aggression (though he did hit a teacher after he saw the teacher (playfully) hit another teacher, because he didn’t understand the interaction). He’s experiencing bursts of anger that he doesn’t really understand and can’t control, which results in some aggression, too. What worries me so much more is that he’s also experiencing bouts of sadness and anxiety. He’s had suicidal thoughts.

This is aggression turned inward. He doesn’t really want to hurt other people, so he turns it on himself, which in turn makes him feel worse. Neither the help at home nor school is sufficient, so we’ve started taking Willy to a counselor. It’s early in the process and we’re still in the “it’s going to get worse before it gets better” stage of things.

Now, on the surface, it may seem that Willy’s story has little to do with aggression. Yet, from watching all three of my boys, actually all four of them, it seems rather clear to me that this self-destruction is aggression turned inward, which also involves lashing out when whatever that’s going on inside becomes too much for Willy to bear. I don’t know what to make of that observation, but it seems significant. Regardless, understanding and support are the keys to helping us cope with all of this as a family and provide each of our children with what they need. Right now we’re finding both rather lacking.