Little Things Add Up To Big Stress

The last few weeks have been stressful.  Actually, based on how I've felt the last few days, they have felt extremely stressful.  There is nothing "big bad" going on, but lots of small stress causers, and they pile up until I feel like I do now.

I think that's the case with a lot of parents like myself.  We live with a base level of stress, most all the time.  When small things get added on, and on and on, it doesn't take much to put us over the top.  The funny thing is, when things are REALLY bad, something kicks in---adrenaline or a hidden reserve or something.  It's still very hard, but more a sadness or anger or worried hard.  Stress, for me anyway, is like the workaday version of those.  It can be just as tough to deal with, or tougher, without being as headline worthy.

What is stressing me, you ask?  Or even if you don't, I'll tell you.  Let's start with the last 10 minutes, after Janey got off the bus but before she started watching a Christmas Madagascar special and kicked me out of the room....

 I sit out in the 95 degree heat, waiting for the afternoon bus home from summer school.  It comes at highly various times, due to highly various Boston traffic, so I wind up often waiting for it a while.  When it does come, Janey gets off the bus and within a minute, turns off both air conditioners.  She hates AC.  It is sticky hot in a way that Boston sometimes gets, an unbearable way.  I suggest she uses the potty instead of the bed.  This displeases her, and she starts screaming.  I take a deep breath and try to calm down, and offer her some chips if she will try the potty.  She calls my bluff by going to where I've hidden the chips, easily finding them and opening both bags.  And then rejecting them.  As I go to clip one bag shut, she somehow hides the other open bag.  As I search for it, she screams hysterically as I have not instantly put on the TV show she asked for at least 10 seconds before.  I stop the hunt, find the show, clip the chips and sit down to write this.

Now an update, 15 minutes later.  After I wrote what comes before this point, Janey changed her mind about a show.  I went over to put on the new show she asked for.  But that was not really the show she wanted.  I was supposed to know that, somehow.  So she screamed a while longer.  I figured out the right show, and she pushed me out of the room again.  I sat down to write and have some of my coffee.  Janey came over to turn off the AC I'd turned back on.  I turned to talk to her, and knocked over all my coffee.  Naturally, it didn't just go on the floor, but instead on Janey's special pillowcase, the one non-human object in the world she cares for, which she obsessively takes off the pillow and puts down various places.  I tried to sneak the pillowcase into the hamper, but she noticed and got extremely upset.  Somehow it having coffee on it made it necessary in her eyes for me to make more coffee.  She pushed me over to the coffeemaker and screamed until I started some.  I started it, and then snuck back over here.

None of this is huge stuff, but in the half hour since she's been home, it's a lot.  And that has been this week.  Getting on the bus in the morning is the worst.  The bus comes to get her any time in a 30 minute range.  Today it was there at the earliest time, yesterday at the latest time.  If we aren't out there when it comes, they do honk, but they have a lot of kids to pick up and can't wait long.  So...we have to go out to wait for it at the earliest time.  Janey tolerates 5 minutes or so of waiting, but then she wants back in the house.  And screams because she can't go back in.  If the boys are available, I have them stay inside with her, but even then, if they look away for a minute, she takes off her shoes, and otherwise makes herself unpresentable for school.  Generally, they aren't available (Freddy works until late and William is currently visiting my parents), so that isn't even an option.  I just have to figure out how to keep Janey from freaking out in the heat while we wait.  Again, not a huge thing, but it's making me a little crazy.

Oh, shut up, Perfect Woman!

Sometimes, I am up to dealing with stress.  Lately, I'm not.  It's the heat, partly, and my health partly.  I don't get into health details much here, not to be mysterious, just not to overshare, but there are currently four different diagnoses I carry, each of which has among the top 2 symptoms "extreme fatigue"  And I am feeling that extreme fatigue lately.  I am feeling every second of my 51 years.  Having a child that needs full time care, who is not capable of self-care and will not ever be, most likely...it's tiring.  And stressful.

The woman in the picture is how I feel like I'm supposed to be.  It's my ideal, one that reality doesn't modify much.  I should be calm always, working on solutions instead of complaining, feeling grateful Janey goes to summer school instead of wishing it was for longer, cheerfully doing the housework while she is there instead of grudgingly doing it and wishing I was just sleeping instead...yeah.  I should be making up a nice chocolate cake instead of writing right now.

This is mainly just a rant. There aren't solutions.  And I'm certainly not alone.  I know you, out there in the wider autism nation, are right here with me in Stress Village.  And most importantly, I know Janey is stressed too.  And like me, she is doing the best she can.  So, we'll keep on keeping on.  55 minutes until Tony gets home.  Not that I'm counting.

"William lives here too"

We've had a lot of success over the past year with new approaches to Janey's behavior and our responses to it, which I've written about a good deal.  In a nutshell, we've realized if we let her follow routines, and we focus on behavior outcomes more than on how we get to those outcomes, life is a lot easier for all of us.  However, there are limits to this approach, and we've been running up against them lately.

Janey and her big brother William

The difference in the last month is that Janey's brothers are home from college.  It's great having them home, for Tony and me.  Janey adores her brothers, and was very excited at first having them here.  But they don't always fit in with the routines she's set up for herself over the school year.  Often, they don't obey the rules she's made---rules like "Nobody can be in the living room with me while I watch TV", or "No music can be played in the house except as approved by me" or "Daddy and Mama give all their attention to me when I ask for it".

When I have read books about parenting kids with autism, especially the extreme "I cured my child" books, one thing I noticed often is that siblings are pushed to the background.  Either there are no siblings, or you get lines like "Of course, the other children often wound up missing out on our attention, but in return they learned so much compassion and love!"  I swore I'd never have that attitude.  Luckily, Janey's autism came to the forefront right around when the boys were reaching the age that less attention from Mama and Daddy was not a bad thing.  I have guilt that will last forever at events I missed and times I was too tired to listen well, but overall, I think Janey being seven years younger than Freddy, and ten years younger than William, was a lucky thing.

However, as anyone with adult or young adult children living at home knows, they still need you at times.  And I don't ever, ever want them to feel like Janey is more important than they are.  But what do you do when a force like Janey's will meets a force like her brothers?

The answer is---I often just don't know.  For Tony and me, the peace and calm that comes from letting Janey control the things she can control is so worth it.  But what do we do when Janey quite literally pushes William out of the room he wants to be in?  What do we do when she screams because Freddy is trying to show me something on the computer?

Generally, I stand firm.  I say things like "William lives here too.  William has a right to be in the room.  Freddy can watch a video on YouTube just like you can"  But, as I've written about, just being firm doesn't work with Janey.  Her routines, her need to control her environment---these things are not something she can change easily based on rewards or deterrents or our attitudes or words.

Over the last week, I've seen the return of some disturbing behaviors I haven't seen Janey show in a long while.  Last night, when I told her that she couldn't use the big TV right when she wanted to, she lunged and tried hard to bite me.  Only a quick reaction on my part stopped her.  This morning, when I was putting on her shoes, she wanted me to use the shoehorn, as Tony usually does.  When I didn't immediately comply, she tried her hardest to break the shoehorn she'd brought me, and almost succeeded.

So---what do I do?  It's one of those cases without a right answer.  All my kids are important to me.  The boys certainly have modified their lives and behaviors a huge amount over the years, but I am not willing to tell them they can't even be around, which is what Janey quite plainly wants at times.

All this is making me think of how extremely difficult it must be for those of you with children close in age to your child with autism.  It's something I have never had to deal with.  Like with so many ideas for dealing with autism that might work for one family but not another, many of the approaches we've had success with would quite literally be impossible if Janey had a close age sibling, or if not impossible, extremely unfair to that sibling.

We'll see how the summer plays out.  I'm glad Janey is still in school for now, and will be in summer school for a good chunk of the summer.  But I'm worried about the changes in behavior, worried with the fear of someone who has seen just how tough things can get.  I hope they don't.

Arranging

Setting up the scene---Janey is home from school in the afternoon.  She has asked me to put on a show---let's say Kipper.  As the show starts, she starts her routine.  She takes the remote from me and places it in the middle of the right couch cushion.  She observes it, and then re-places it several times to make sure it's right in the middle.  She then surveys the room, and looks for laundry baskets.  I have four of them, and I tend to leave them in the room after folding laundry.  Janey goes to any she sees and moves them carefully to the place she sees as correct.  Then, if there are any shoes in the room, they need to be lined up, left on the left and right on the right, next to each other.  If it's a light arranging day, the next step is the last---she looks in the trash and makes sure nothing in there is out of place.  Certain things don't belong there---magazines, wet pull-ups, most any form of crumpled paper.  Those items get taken out and put next to the can.  Then, and only then, does Janey settle down to watch her video.

Although it sounds hard to believe, I first noticed Janey arranging things literally as soon as she could purposely use her hands.  She would make sure toys she could reach were symmetrically positioned.  Her arranging habits well pre-date her autism diagnosis.  Over the years, the habit has ebbed and flowed, sometimes almost disappearing for long periods, sometimes being out in force.  Lately, it's at a huge peak.  The arranging rituals can take a very long time.  They are almost always done before she does something she enjoys or something relaxing---before a video or before going to sleep at night.

Unlike many of Janey's behaviors, I relate very much to the organizing and arranging.  Not that I am much of an arranger.  But I know how it is to feel I need to do something that to an outsider doesn't seem to make much sense.  I'm completely sure Janey has OCD (Obsessive-Compulsive Disorder).  I am sure because I also have it.

My OCD never took the form of arranging.  It's funny (in a strange, not ha-ha way)---OCD has a lot of forms, and most people specialize in one of them.  I was a checker.  I checked things.  On my worse days, I could check my pocketbook to make sure my credit cards and keys were in it thirty times in a row.  I could re-open a bill envelope over and over to make sure I put the check in it.  I could go down to the cellar enough to get a great workout to make sure I'd actually started the dryer.

OCD doesn't bother me much any more.  Mine has been very well under control, with medication, for a long time now.  Even before that, like with Janey, sometimes years and years would go by without the checking urges.  It's a strange disorder.  Like Janey also, I think I had OCD pretty much from birth.  I can remember as far back as my memory goes needing to check things, feeling like if I didn't check them, sometimes horrible, something unacceptable, would happen.  Unlike Janey, though, I usually knew that my checking made no sense.  Most people with OCD have that knowledge.  We know our obsessions and compulsions are generated by our minds, but that doesn't make them any easier to not do.  I don't think Janey understands that.  I don't think she has the kind of perspective that allows her to see that.

Sometimes, when the arranging gets out of hand, almost anyone would feel like saying, with some degree of impatience, "Just stop that!  Stop moving the baskets!  Stop taking things out of the trash!  Stop uncrossing people's crossed legs (another big one)!"  But I don't usually feel that way.  I know how it feels.  I know how, despite in my case knowing full well I didn't need to check my pocketbook again, I still couldn't help doing it, no matter how hard to tried to fight it.

When we next see Janey's psychiatrist, I'm going to do my level best to explain more effectively than I have in the past what is going on, and ask him about medication specifically for OCD.  I have resisted, partially because I hate the thought of her being on another medication and also because, interestingly, I think the lack of perspective in her situation makes the OCD less distressing.  It's a bit of a problem for us, but for her, I think it isn't, mostly.  I think it just feels like something that needs to be done, or it did in the past, until this latest escalation.  Now, occasionally, she is getting upset, because part of her arranging now involves my placement.  I am supposed to be in the bedroom while she watches her shows.  I can't always be there, partly because I need to check on her quite often and partly because I don't always want to just stay in there for long periods.  So far, she has mostly accepted it when I've explained I have to be elsewhere---at least for a few minutes, until she tries again to push me to the bedroom.

In a strange, small way, it feels good to be able to relate to one of Janey's behaviors as I do with this one.  I'm not autistic, which is why I often get some very good insight from those adults I know who are autistic on Janey's behavior.  With the OCD, I have the perspective. I've talked before about having OCD, but not quite in this detail, and it's a little hard to do, but also---very fair.  I write about Janey, hoping I am representing her in a way she'd approve of if she could read what I wrote, and so I should also be willing to be open about myself.

Now, to have a few minutes to myself before the bus arrives home and we start this afternoon's session of arranging.....

Autism and OCD?

Janey comes to me with the remote, wanting me to put on a Netflix show.  I do, and she takes the remote back.  It gets placed on a closed laptop, precisely in the middle.  She watched a few minutes of the show, and then goes over to the remote to adjust it, to make sure it's in exactly the right place.  A few more minutes of watching, and she goes to where her shoes are.  She's previously arranged them as they always must be, left on the left and right on the right, lined up exactly next to each other.  She looks at them and does a little adjusting.  Then she touches the corner of the coffee table, then the wall in a certain place.  She looks at me.  I've broken a rule.  My legs are crossed.  She patiently takes my feet and moves my legs to the right, non-crossed position.  Then she watches a bit of her show, and then it all starts again.

Janey has never been formally diagnosed with OCD, Obsessive Compulsive Disorder, but I am quite sure she has it.  I have more than a passing knowledge of the signs.  

I've had OCD as long as my mind goes back.  It's been well under control for many years now.  It never goes away, but it affects my life very, very little.  Still, I well remember what it was like.  There are several types of OCD.  Mine was a checking one.  I needed to check that things were where they should be---my keys in my pocketbook, my pocketbook hung up.  When I was little, it was bookbags, or stuffed animals, or even little rocks I'd collected.  Checking once was no assurance.  I'd have to check over and over and over---sometimes hundreds of times.  

Janey's OCD seems to fall into the arranging/symmetry category.  She needs things to be in the right place.  Not all things---she's as much of a slob as the rest of us with most things---but certain things, like her shoes, must be just right.

If you are even interested in learning more about OCD, I recently read a fantastic book about it---The Man Who Couldn't Stop, by David Adam.  It's a personal account combined with the science and psychology of the disorder, and it was one of those books which gave me about 20 "That's exactly how it is!  Now I get it!" moments.  It was terrific.

Thinking about Janey, I am quite sure I first saw the signs of OCD in her long before the autism.  As soon as she could use her hands, maybe at 7 months or so, she would move my hands to the place she wanted them to be, to hold things symmetrically.  Even that young, crossed arms or legs bothered her.

OCD is strange in that it ebbs and flows.  Years can go by with it barely showing its face, and then it pops back up badly.  Lately, it seems to be at a high level with Janey.  It's interesting---it doesn't seem to distress her a lot.  When she does the arranging, it's with a huge amount of patience.  It's like a job that must be done, hundreds of times if necessary, but with good will.  Much of what is usually distressing about OCD is that you understand what you are doing would be considered crazy by most.  When I was checking something for the 100th time, I was telling myself "STOP IT!  You KNOW it's there!  What is wrong with you?"  Maybe Janey doesn't have that inner voice telling her anything like that.  Sometimes, the OCD rituals seem to calm her.

There are times, though, that it must be awful to need something done a certain way and not be able to communicate that.  Lately, after a shower, I am not drying Janey's hair the way she feels it should be dried.  From what I could figure, I used to dry her hair some specific way, while saying "Let's dry-za-la-high-za!"  I say a lot of little things like that, as I think most people do when talking to someoen who doesn't often talk back.  We tend to want to fill the silence.  But lately, I'm somehow not saying it right or drying in the right sequence.  Janey gets very upset.  She grabs my hands and pulls then with the towel onto her head, and screams "DRY-ZA-LA-HIGH-ZA!" over and over.  

The other night, after a long round with the towel, I told Janey about OCD.  Like with so many things, I have no idea how much she understood, but I told her that I know how it feels, that I've felt the same thing.  I talked to her about the shoe arranging, the remotes, the crossed legs, the drying.  I said her mind might tell her that bad things will happen if she doesn't make sure everything is in the right place, but that's her mind playing tricks on her, silly mean tricks.  I told her I understood.  She looked at me for a long time, one of those uncommon looks of connection.  I don't know what she took in, but I hope it helped, a little.

It doesn't seem fair.  If Janey does have OCD, why must she deal with that in addition to everything else?  But of course, as the classic saying goes, life isn't fair.  And in a small, strange way, it's a connection with Janey, a part of her I share, sometimes I can maybe help her with.  I'll keep trying.

Car Trouble

The half hour car drive to and from Janey's school has usually been a good time for us.  We listen to music,  I talk, Janey sometimes talks, we just relax.  However, the last few days have been awful.

It started after school on Monday.  Janey wanted her shoes off, and took them off, which was fine.  But then she said "I want to snuggle on Mama's bed", one of her most common requests, but one she doesn't usually make in the car, in the middle of traffic.  I said "We will when we get home.  We can't snuggle in the car"  From what I can figure, Janey took that to mean we should get out of the car that second, so we could have our snuggle.  This was at the worst point in my drive, where I am in the middle of 4 lanes, two going the other way and one to the right of me going my way, about to turn into a very complicated intersection of 5 major roads, at which I have to get to the left and then across 4 lanes to get to the far right.  It's taken years to get to the point where I'm not panicked every day about it.  So at this point, Janey wanted her shoes back on.  They are shoes which take two hands to get on.  I was stopped at the light, but I still couldn't do it.  Janey was getting hugely upset, screaming and tossing the shoes.  I made a dumb move and tossed the shoes onto the floor of the passenger's front side, where she couldn't get them.  So she did the obvious counter-move, and took off her seatbelt to try to get them.  I screamed at her to put it back on, knowing she couldn't do that.  I had no way on earth of pulling over where I was, or for a bit.  This is city driving.  Luckily, she listened when I said to sit back in her seat---I had visions of her trying to take control of the wheel.  I pulled over as soon as I could, put her shoes on and her seatbelt on, and thankfully, made it home alive.

Fine.  But yesterday, both going to school and coming home, Janey once again took off her seatbelt.  Yesterday morning, it was because I'd committed the crime of not replaying the song she liked for the 5th time, so she decided to come up front and take care of that herself.  Again, me screaming at her to sit back, waiting until I got to a safe place to pull over, putting back on the seatbelt, blah, blah, blah.  I spent the rest of the ride talking to her dramatically about not taking off our seat belts, with lots of talk of "TERRIBLE car accidents" and "Janey getting EXTRA hurt", which was probably not useful for her but I was in a state.  Coming home, I had her go over with me over and over what we NEVER do in the car, and she faithfully repeated we NEVER take off our seatbelts, and that is TOO DANGEROUS, and all.  And about 5 minutes into the drive, she took it off.  She had the courtesy to be startled and try to put it back on when I yelled, but the damage was done.  Again, look for a safe pulling over spot (of which there are extremely few on our drive), pull over, put it back on, lecture, etc.

Lots of issues come up here.  I have no idea how to deal with this.  Janey doesn't truly care if I yell, she doesn't get punishments, she doesn't care about rewards.  She has next to no impulse control.  She wants what she wants, when she wants it.  And she is getting bigger.  I can see a day coming, hopefully not for a few more years, when it will be too dangerous for me to drive her alone, or anyone to drive her alone, and that will put even more limits on our life.  I am probably projecting too much, but it is scary.  I have no idea how I will deal with a Janey as big as I am.  And in the near term, I have to figure out a way to keep the seat belt on.  I will see if there are locks, although I admit it scares and bothers me a little to think of her locked in a restraint in the car.  Is that safe?  I will continue my ineffective lecturing and taking away of treats and videos, both of which I did the last few nights although I am quite certain Janey made no real connection to the car, although she could recite when I asked what she had done that was naughty.  She can recite anything.   That doesn't mean she gets it, or it will come into any play when she is again faced with the situation.  I'm dreading today's drives.