My psych eval (25 years later) part 1

Alissa was referred for psychological evaluation at this time by her therapist…Alissa has a long history of outpatient treatment including an inpatient hospitalization at the end of December of 1992. Alissa has utilized a variety of medications including: Prozac, Pamelor, Anafranil, and is currently taking Wellbutrin. Alissa was referred for this evaluation due to concerns about her OCD and possible ADD.

The family system includes an autistic brother who has proved challenging for all family members. For a time period Alissa functioned as the caretaker for the brother…Alissa has had a difficult relationship with her father. The father reportedly has several indicators of a possible psychiatric disorder. Alissa’s mother will spend many hours a week working.

Alissa has had depressive and suicidal symptoms starting in the fourth grade…Throughout the meeting with Alissa it became apparent that she has had serious psychiatric symptoms for many years. Her condition is quite serious and of a chronic nature…At the time of this evaluation, she had reddened hands which she attributed to dry skin. Due to the OCD, this examiner speculates that the hand condition does reflect excessive hand washing. She stated that as a younger child she would wash her hands frequently, including before and after eating, and before and after using the bathroom.

Symptoms that Alissa currently endorsed include checking to make sure that she has turned off the lights on her car. Due to the distance involved it is a major inconvenience for her to go to the classroom building at college to the parking lot to check on her car. She did go to this extreme measure and when she got to the car realized that she had turned the lights off even though she was not consciously aware of doing so. At other times she will have to check numerous times to ascertain the exact location of her purse. At home she counts a short flight of steps constantly whether she is ascending or descending the steps. This seems to be a strongly ingrained ritual. This examiner believes that there are other examples of obsessive/compulsive thoughts and behaviors that Alissa is not acknowledging at this time…She does describe the checking behavior in terms of feeling she “has to” check.

Yes, it is true that I was very depressed at a young age. I remember people telling my mother that they have never seen such a young child so depressed before and that I needed help. But there weren’t many programs available to special needs siblings. I felt incredibly alone and disconnected from my peers. I started seeing a therapist in my late teens.

It was especially hard in grade school because my autistic brother was in the same school as me. They had a special ed room that was shared with the library. I don’t know whose dumb ass idea that was. It was never quiet in the library, although we were told to be. That probably made my brother’s behavior all the more shocking.

When I would go in for library, my brother was oftentimes flailing around as if he was possessed inside of the big ‘naughty’ box they put him in that was located between the classrooms. This caused my classmates to point, snicker, and laugh. It made me feel angry, sorrowful, and ashamed. He was MY brother. It was very painful.

I think I developed rituals to help me cope, to feel like I had an iota of control over my life. The hand washing ritual started when I was in middle school after I was almost attacked in the parking lot while I waited in the car for my mom to finish up with her support group for parents of special needs children. The support group was held in the library and sometimes the library closed before the meeting was done and I would meet my mom in the car. That hot summer night I felt like I was suffocating in the locked car while those guys tried desperately to get in. It was so hot, but I didn’t dare open a window. The car handles were dirty. I felt dirty. Hand washing made me feel clean and cleansed.

You would think that I would have issues with libraries or books. Sheesh!

I like to have clean hands, but I haven’t obsessively washed them in decades. I like things clean and I like to feel like I have control even if I don’t. My parents are hoarders. Our house was always chaotic and messy.

It’s strange how I can be obsessive without being addictive since they seem so similar. But I don’t want anything external to control me, yet sometimes the internal things still do. Sometimes I still have to check things..

To be continued…

 

Journal 5, part 1

12-10-1990

Tonight is my choir concert. For awhile my mom wasn’t going to go because Matt was reacting. But she is going to go.

Events were always difficult for my family. My mom always wanted Matt to be included in all of the family activities. We never really wanted him to attend our special days. We were afraid that if he hurt someone that would mar the day forever in our memory. Plus we wanted some time when we could be the focus.

How would we feel if a special day was ruined by Matt attacking someone? It would make for an unforgettable choir concert, graduation, or wedding day.

My parents typically took turns attending events if Matt was unable to go. My dad would often times stay home with Matt because he hated social events.

But if Matt was ‘reacting’ bad enough, my mom would stay behind. She didn’t trust anyone else to take care of Matt. If Matt hurt someone, he could sometimes be hurt in the process of restraining him.

For example, if Matt was at the roller rink and attacked a small girl…what do you think her father would do? My mother said that no one could love Matt like she did.

Usually there were early warning signs of reacting that we became hyper vigilant for.. His ears would turn red, his fists and teeth would clench, and his pupils would constrict giving him wild eyes. Sometimes these reactions would last for a short time and sometimes for several days. Sometimes it would happen unexpectedly and sometimes we just knew..

The longest it usually lasted was 2 days until it slowly faded away. For 2 days, Matt would scream and be agitated in general. He would often hurt himself or those around him. He would keep our younger brothers, that he shared a room with, awake at night by rocking his body side to side in his bed violently. During the day, he would run in place flapping his hands together sometimes violently enough to make his chin bleed after his hands rubbed against it repetitively.

He had to be watched constantly because sometimes he would run away. Or he would do deviant things like overflow the sinks. Most of the time he muttered to himself. He would laugh after hurting someone or doing something wrong.

After the reaction was over, Matt would sleep all day and all night.

My mom went to great lengths to try to explain Matt’s strange behavior by saying that he was reacting, or allergic to things.

Matt attacked the stranger in the roller rink because the music was too loud.

Matt attacked the girl because she was wearing perfume. The perfume triggered it. We were no longer allowed to wear or have anything with a fragrance in it. No hair spray, no nail polish, unscented soaps…we even had to dip our toothbrushes in peroxide and baking soda to brush them. I found this to be very restrictive when most girls my age used a bottle of hairspray a week.

Sometimes it was auto exhaust. My mom no longer allowed the cars to be parked in the garage. They had to be parked at the bottom of the driveway. If the wind was blowing in a certain direction, we had to shut all of the windows. My mom would panic if we had to follow another vehicle closely on the road, the exhaust could seep in and set Matt off.

Maybe it was gluten, dairy, and artificial colors. My mom started buying Matt organic food. She went to great lengths to make separate meals for Matt that no one was allowed to eat.

Maybe it was the wood stove. That furnace was removed.

Maybe it was the formaldehyde in the curtains. They were removed and old blankets were put up.

I could probably list at least 50 or more things that at one time my mom thought were triggers. We had to painstakingly follow rituals to try to stop the triggers from eliciting a response in Matt, but it never worked.

My mom took Matt to almost every doctor in the state and to several doctors in other states. She had faith that he could be healed from this affliction. As a child, I believed that he could be healed too. We hung on to every hope that he would be completely healed.

My mom took Matt to physicians, homeopathic healers, allergists, and even a lady that read auras. But nothing worked.

I fear that what I am telling you makes my mother sound like she was completely crazy. But I want to assure you that my mother was the sanest person in the house. In her natural state she is an easy going…go with the flow kind of person…She is very compassionate, sensitive, and loving…But with Matt, my mother was fierce and determined to do anything she needed to do to protect him…to feel like she had an iota of control over something that no one had any control over… and to seek answers while holding on to this irrational dream that some day she would wake up and he would be normal.