PSYCH: ugly truth

We had more disturbing cases today than I truely want to admit. I mean the majority of the troubled teens or the ADHD kids aren't that much of a psych problem as much of an environmental or behavoral problem. Things that need to be fixed with therapy rather than drugs. But they aren't evil. They are kids who have crappy parents or never learned right. Usually when they discover they can't push the doctor around they shape up. That's why the jail system works so good I am told, they get consistancy. My doc was telling me the other day that consistancy is required to deal with people in general so they know they can't walk all over you. And its proved over and over in his sessions. He has certain rules everyone must follow: 

• no meds until you've been sober (drugs or illicit drugs) for 6 weeks no exceptions
• no cussing, threats or raising your voice or you get kicked out and still have to pay for the session
• no video games or books in his office (for the kids) because we're talking about you and you need to know what we're saying (appts are only 15 minutes)
• the doc is under no obligation whatsoever to see you, and at any point he can kick you out of his office or refuse to see you. End of story.
• if you are late, you will not be seen that day and will be charged $50. You won't be able to schedule another appointment until you pay that money.

His rules apply to his staff (including us) as well. Can't be late and he doesn't have to put up with your crap. Its intimidating but nobody's been late yet. The doc was also telling us that some people are just evil and there was nothing their parents could do about it. These people realize at a young age that if they manipulate or are cruel they can get the things they want. Honestly, some don't recognize the line they cross and others do but cross it anyway. Today, we saw some of those cases.

One little girl came in with parents who wanted therapy, drugs and were willing to work on whatever. You could see their desperation. They only had two kids and the little boy was very well behaved. His sister however, was said to say or do things simply out of spite. Her father gave examples of how she at age 9 was screaming "i will kill myself if you don't..." blah blah. I guess she also steals things from other kids and doesn't respond to spanking.  The parents regale us with stories of manipulation that I would chalk up to teenage level and the whole time the little girl is sitting quietly in the chair in between her parents... GRINNING.  When the doc asks her why she does it, she shrugs and smiles bigger. It was probably one of the most disturbing things I've ever seen. I keep have this recurring thought that one day I'm going to be in my room in the dark and i'll turn around and see that little girl with a knife standing behind me with that little grin.  SERIOUSLY freaks me out.

There was also a little 7 year old boy who was brought in in a straight jacket. He had been brought from the hospital several days ago (who lent the straight jacket to the mom).  Apparently he stabbed someone in an attempt to kill them. The attempt was unsuccessful but the boy screams he's not sorry. He said he doesn't think they should live. He seemed a somewhat normal kid talking about toys and TV. He wouldn't talk to us about the incident and kept wanting to be let out of the straight jacket.  His mom was hysterical and begged us to do anything to fix him. I think she was afraid of him. It was hard for us to tell her there is no pill that would fix that, her little boy was just a bad person.

it wasn't all bad, though. There was a little girl,8, who told me I was pretty and wanted to sit on my lap the entire appointment, which is definately a first. It was cute. Until I realized she was totally playing me and actually stole the $20 I had in my pocket. I didn't notice until the girl had left. I felt incredibly embarrassed when I realized what had happened and how I hadn't noticed. The doc laughed at me and bought me lunch.