Tim’s caseworker emailed today and wants to schedule a time next week when we can have a family therapy session via telephone.  It’s a four hour drive round trip to ODTC, so by phone is easier to schedule, but a family therapy session rarely goes well, by phone or in person.  Tim hates it when people talk about him in front of him. I know, everyone hates that, but he hates it to a violent, paranoid extreme.

She wants to talk about last week and Tim’s freak out at the idea of going to the dentist, and the subsequent psychotic break and his (and our) desire to return to school rather than be home for Thanksgiving.  Rather than have a family therapy session, I think we need to have a conversation about a plan on how we get Tim to doctor’s appointments without his mind convincing him he’s going for a visit to see Dr. Mengele.  He complains weekly about the fact that he broke his glasses, but the last three times he had an appointment with the eye doctor, he couldn’t bring himself to go into the office because the equipment and eye drops would blind him.  Never mind that one of us was with him, and, the first time of the three, Tom had an appointment at the same time, so he could have watched his dad go first.  I fear that this irrational anxiety, which is getting stronger and stronger, will bleed over into a distrust of all people he doesn’t know but has to interact with.  What happens when he has to go to the Social Security office?  Will he turn into TV’s stereotypical whack job, with a tinfoil hat and paper shoes, to keep people from reading his thoughts?  This is the crap that runs through my mind whenever we have one of these episodes.  How in Jeebus’ name will he ever be able to interact with anyone if we’re not there?

When we brought up the idea of residential treatment (we call it “school” for shorthand) with Tim, he articulated to Dr. D, his psychiatrist, without any conversation, that it would be a good idea so he could learn to be independent from  Tom and me.  I thought that was an amazing thought for him to come to all on his own, and showed that not only was he old enough to handle residential treatment, that he had an internal agenda about what he wanted to get out of it.  But some days, it seems like the rest of the synapses in his brain – the ones that cause what happened last week – didn’t get the message.  And that terrifies the shit out of me.