Attn. Evocationer #3 (I think)

This is long overdue, but it is with respect to my middle child (my third and final child for whom you have consulted). Thank you for your input. Also posting update on my oldest on her thread.

Describe each complaint/associated set of symptoms in detail. Please include the following when doing this:

Appearance
2. Sensation or pain
3. Situations/events/triggers for making it worse
4. Situations/events/triggers for making it better
5. Event that seemed to start the complaint
6. Other sensory features – smell, sound, taste, tactile etc

Complaint: When she gets pushed to her limit, she becomes explosive.

Sometimes her resentments build up over time and there is a straw that breaks the camel’s back so to speak, other times she is preemptively reactive to how she assumes the other will act based on past experience. In any case, her reaction may seem very disproportionate to the trigger but is reflective of the festering upset. This happens mostly with her family and not outside of the home.

Triggers-her sister being cruel to her/acting out/getting special attention; her brother annoying her; feeling that there is not “fairness” in treatment of her relative to others; feeling afraid or overwhelmed by a task or challenge.

Made better-Sometimes physical affection and attempts to calm and/or problem solve can help, but often she just needs time to blow off steam before she calms.

Complaint: Nagging cough, raw scratchy-sounding voice

Triggered by-came on during the transition period of our move (when she was staying with my parents while her dad and I were finishing packing up the old house). Seems exacerbated by the lack of sleep that she has been getting since the move; the cold room in which she now sleeps.

Made better: Warm beverages, throat lozenges. She is highly resistant to any medications/interventions of any kind (And always has been in any time of illness of any sort).

Complaint: Fear of dark/new places/people

Is afraid of the dark. Is also uncomfortable being alone in the room that she is sharing with her sister while we stay at my parents’ house, although she has always been afraid to be in a room alone at night (even as a baby; she cried hysterically as soon as she woke up any time she was alone in her room; she came to join us in our bed every night until age 4 at which time she started sharing a room with her sister). Is shy/slow to warm up by nature. Will hang back and watch for a very long time and will resist attempts to include her. Even with familiar people she is often uncomfortable in new settings (e.g. doesn’t want to attend friends’ birthday parties without a parent).

Made better by being with a trusted adult (generally a parent)

Complaint: Fear for medical practitioners/interventions
Very fearful of the dentist or any interventions aimed at her mouth. Fearful of doctors of any sort. Does not like/resists any interventions when she has a physical problem: she will express a complaint to me (e.g. I hurt my arm”) but will then resist/refuse any attempts to address it (e.g. no to ice, no to heat, won’t take anything, won’t let me rub anything on it, etc.)

Made worse: If she feels like an intervention will be forced upon her, if she is threatened or if the practitioner attempts to scare her into compliance (e.g. if you don’t take this medicine for your fever you could die.”) She had a very bad experience with a dentist when she was around 2-3 years old where they made hold her, laying back on my lap to do an exam and she was gagging, felt trapped, etc. It was horrible and regrettable and it has been 5+ years since and she’s just allowing her teeth to be brushed/a gentle cleaning by a dentist.

Made better: Sometimes if I can talk with her about the reasons behind a suggested intervention/its importance for her health and promise to support her and give her a “stop” signal, etc. she may acquiesce.

Complaint: Shy/Intense avoidance to appearing vulnerable

Not sure which drives this but she does not like to be in situations where she may need help and does not like to ask for help. She will go without rather than communicate a need except to her trusted circle of adults. (e.g. she will forego eating lunch rather than ask an adult to help her open her Thermos if it is sealed too tightly for her to open on her own). That said, even with trusted adults she will make her needs known but will often resist making a request and will voice a complaint/make a demand instead. When talked to about this she will reiterate that she DOES NOT LIKE making requests.

Made better: If the situation is low key and she’s in a good mood, or if she is supported/encouraged by an adult, she may make requests, but it’s relatively rare.

Complaint: Whiney! This child is my most inclined to whine/complain about the state of affairs in her environment. Often times it is less about what she is saying and more about how she is saying it (whiney tone) that is difficult to be with. Better/worse as with above.

Complaint: Crowded teeth. Ever since starting to lose baby teeth and acquiring adult teeth her teeth are very crowded, especially her lower teeth.

Complaint-pigeon-toed/flat footed. Since birth her right foot turns in quite a bit. She also appears to be pretty flat footed. This is noticeable in her gait and when she runs but does not prevent her from anything and is not grossly obvious to the casual observer.

Complaint: “Pot stirrer” When her siblings escalate she finds this distressing but she deals with this distress by making quiet but nasty comments that will only aggravate them more. She doesn’t lose control herself (yell, scream, escalate) when her siblings are out of control, she just calmly makes some hurtful or otherwise nasty comment that she knows will add fuel to their fire.

Complaint: Takes too much ownership over others. This comes up most often with her older sister (who does a lot of things that she shouldn’t do) but my middle child will take it upon herself to correct her sister, tell us (the parents) what is going on etc. It is difficult to advise her how to handle this because we don’t want to advise her to become an accomplice but likewise we don’t want her to be an endless “tattletale” or to be in the role of “parenting” her older sister who seriously resents her younger sister correcting her behavior or telling her what to do.


MENTAL STATE OF THE CHILD (IMPORTANT)

1. When the physical complaint is active, what is his/her emotional state like? What does he/she do? What does she/he want you to do? When she has active physical complaints she tends to be more tearful and whiney. She can also have a shorter trigger and be more prone to angry explosions.

2. Does he/she describe any unusual sensation or pain in the body, especially when they are complaining of something?

She complains of physical aches and pains with some regularity. Sometimes it is her leg or a foot, her throat, etc. I cannot think of a particular, persistent physical complaint at the moment.

3. What fears does he/she have? How does she/he react?

As mentioned, fear of dark, strangers/new places or situations, fear of the dentist, fear of medical interventions, fear of being alone in her room at night, fear of bugs. She is also incredibly resistant to taking baths or showers-she refuses showers completely and fights like mad about baths but is happy as a clam once in one. Not sure what fear drives this exactly.

4. Was there any incident in the past that had a great impact? What happened at the time? Is there any ongoing reaction to this event? How does he/she talk about it?

Several months back my husband and children were spending the night at my parents’ home while my parents were out of town so that I could paint the children’s bedrooms prior to putting our house on the market. I took the kids to my husband’s office at the end of the work day and he was going to drive them to my parents’. My middle daughter got very upset that I was not going to come and spend the night with them. There was much crying and difficulty separating at the parking lot. That night they had tacos for dinner and my husband had a very difficult time getting our older and younger children to bed (my middle daughter went to sleep okay). She woke up an hour or two later vomiting. She threw up a couple times than night, and wanted very much to come home. They came home fairly early the next day and she was fine. She continues to be very distressed by throwing up or the idea of throwing up (herself or anyone else). She also won’t eat tacos anymore unless they have a hard shell (she was eating soft shell tacos the night that she got sick). To add context, it is extremely rare for anyone in our family to vomit and she probably had no conscious memory of anyone throwing up prior to getting sick herself. Last week a student in her class at school threw up in the classroom. This was very distressing to her and she did not want to go back to school the next day.

There have been two instances (one in my parents’ bathtub and one in her other grandparents’ pool) where she felt unsafe in the water (lost her footing or couldn’t get her head up to breathe….not really sure what happened in the bathtub). In any case, she brings the incidents up on occasion and at present she refuses to take a bath in my parents’ bathtub unless someone else is in the bathroom with her the whole time (she’s 8.5 years old and refuses to shower at all or bath without parental supervision)


5. Is there any story (book, fairytale, cartoon, movie etc) that seems to really resonate with her/him? What does he/she say about it?


Frozen-“because she has a mean older sister and I have a mean older sister.”

6. What kind of fantasies does she/he describe to you? How does this translate down into play, games, toys? Does he/she tend to draw particular things over and over? If so what are they? If you point to these images, what does she/he say about them?

Fantasizes about having magic (like a magic wand) and being able to fly. She will climb up on the play equipment at school and talk about being able to fly as she jumps down. She likes to draw pictures of people, mostly girls with long hair and earrings and accessories.

7. Does he/she describe any dreams or nightmares to you, and what are they? How does she/he react on waking from them?

She has dreams about having magic and being able to fly. She doesn’t like to talk much about her bad dreams, but she did relate a recurring nightmare of spiders crawling around her and into her mouth. She may have said that she was unintentionally eating them too. It was clear in her retelling that this was very upsetting to her.

8. How is he/she when interacting with other children? What about sports or games? How about obeying rules or social conventions?

She can be pretty shy around new kids and might even resist their attempts to include her in their play even though she wants to feel comfortable with them (she just doesn’t). When she settles in she can be silly/giggly with her friends. Sometimes she is sassy/disrespectful to adults as a way to be funny/look cool in front of her friends. Sometimes she is sassy/rude to other children she doesn’t know well as an awkward way to engage with them, (e.g., “Eeew that boy over there is in my class at school!)

9. How is she/he when interacting with older people? Is there any difference between family or friends and strangers in terms of reactions and behavior?

Sometimes she is extremely polite and conscientious with adults. People unknown to her are intimidating. If it is an adult very well known to her, she will be playful and social.

10. What kind of activities does he/she enjoy doing? Which of these do she/he spend the most time at?

Likes to draw and sing and dance and act. She sings a lot of the time just going through her day and she dances quite a bit too. She has an absolutely beautiful and gifted singing voice, far beyond her years, but she is exceptionally shy about singing in front of other people. She gets upset when people complement her sister’s singing (she too has a lovely singing voice, although very different from her sister’s), and will say that it’s not fair that she doesn’t get complemented on her singing and then we have to point out that this is because she never lets anyone hear her sing. Once recently we were shopping at a store and she was walking through the aisles singing to herself. Another shopper walking by noticed and commented on her beautiful voice. My daughter immediately stopped singing and would not continue.

11. What qualities seem to make your child different from other children?

Very considerate and thoughtful of others. She always thinks about her brother or sister and shares whenever she gets anything, even though she knows that they would not do the same for her. She is attuned to the needs of others and tries to take care of them (e.g. if her brother is pestering me and pushing me to my limits, she will step in and try to engage him in a positive way to give me a break). She holds things in/internalizes more than most children I think. She wants very much to be good, do well, and please others/meet expectations. As her teacher recently put it, “she is so hard on herself!” She is also exceptionally talented vocally. Her singing voice and sense of music is exceptional (although she won’t sing in front of others).

12. How does your child cope with school, school work, study, deadlines, speaking in front of others, following directions etc?

She is very responsible and conscientious overall although she will sometimes feel overwhelmed by her schoolwork and resist doing it because she thinks that she won’t be successful with it. She follows directions well. She is anxious about speaking in front of others, but when given tasks like memorizing and reciting passages, she always does very well.

13. What kind of questions does he/she tend to ask you or other adults?

If we can get rid of her sister….She invites adults to play with her, she asks for time and attention.

14. What makes her/him laugh? What makes him/her cry?

Cry-when she feels like she is not being thought of/that she or her needs are not important; when she feels overwhelmed or incapable of success; when she is scared (generally about doing something that pushed her beyond her comfort zone); when she gets fed up/frustrated; when she is overtired, hungry, or dehydrated.

Laugh- general silliness and kid stuff.


15. What makes him/her angry or irritable?

hunger, thirst, overtired; not feeling important or attended to; feeling hopeless; the potential for failure/embarrassment

16. What does your child do when alone?

Draws, reads, listens to music, sings, watches TV

17. Is there a particular person or type of person that he/she reacts to, and what kind of reaction?
Her sister really pushes her buttons, eliciting a negative reaction; she is very nurturing and sensitive to younger children.


GENERAL STATE OF YOUR CHILD

1. What position does he/she sleep in? Likes to sleep on one side or the other. Generally starts on her right side and then rolls over to her left to go to sleep. Draws up her knees at her side to about waist level.
2. Is there any position he/she seems unable to sleep in? On her back
3. Any unusual behavior during sleep? Not that I’m aware of.
4. Any problems with sleep? Does not like to be alone in the room/scared of the dark. Very resistant to going to sleep alone in a room.
5. What foods are craved (cravings are strong desires) What foods are hated? Craves potatoes, meat, and candy and sometimes root beer. Sometimes craves “gluten-full and dairy-full stuff because I can’t have it.” Hates macaroni and cheese or things with excessive cheese in general (this would be dairy-free cheese,) or things that are excessively sweet.
6. What drinks are craved? What drinks are hated? Craves root beer with ice, lemonade, juice, iced tea, tea, chocolate milk, and soda water mixed with juices or flavored simple syrups (although she generally is just given water to drink). Can’t think of any drinks that she hates.
7. How does he/she react when hungry, or hunger is prolonged? She gets irritable, crabby, whiney when hungry; asks and pesters for food.
8. How does the weather affect?
No significant impact that I (or she) have noticed.
9. How does the temperature affect?
No significant impact that I (or she) have noticed, other than if she is really hot in bed she has trouble sleeping (she has always been a bit of a furnace when she sleeps.
10. Are there any other environmental influences negative or positive (season, noise, music, moon, light, dark, day, night, time, smells etc.) Loves the smells of her favorite foods (e.g., cake baking, bacon cooking). It puts her in a good mood because she thinks of eating them. Likes to cozy up in warm snuggly blankets and watch tv.
11. Problems with stool or bowel habit? No
Problems with urine or bladder habit? No
12. Where does he/she sweat most? Does it stain or smell unusual? Her forehead, back, armpits, and behind her knees. No particular odor. Not staining.