Meeting the True Needs of Children Diagnosed as ADHD

Meeting the True Needs of Children Diagnosed as ‘ADHD’

By

Expert Author Dan EdmundsHow should one look upon Attention Deficit Hyperactivity Disorder (ADHD) and what is the effective way to aid those who are given this diagnosis? There has been considerable debate as to whether or not ADHD is a genuine disorder. Psychiatrist and professor Robert Hedaya (1996, pg. 140) mentions that an examination by Hartmann in 1993 felt that ADHD is actually normal variant of human behavior that doesn’t fit into cultural norms.

In addition, there is no objective test for this disorder. Hedaya (1996, pg. 140) mentions that a commonly used test is the TOVA (test of variables of attention), a test where the client must use a computer and hit a target at various points. This test is designed to measure the person’s response time and distractibility. However, Hedaya (1996, pg. 140) notes, this tool cannot be relied upon to make or exclude the diagnosis in and of itself. Hedaya (1996, pg. 268) notes that there has been controversy in the use of stimulants for the treatment of ADHD, he states, medications alone do not provide adequate or full treatment in this disorder.

Hedaya (1996, pg. 269) notes that the most serious risk in the use of methylphenidate (Ritalin) for ADHD is that about 1% of these children will develop tics and or Tourette’s Syndrome. Hedaya asks the question,”One might wonder-, why use methylphenidate at all?” Hedaya argues that the side effects involved in the use of methylphenidate are mild. However, he notes that side effects include nervousness, increased vulnerability to seizures, insomnia, loss of appetite, headache, stomachache, and irritability. Hedaya (1996, pg. 271) argues that the causation of ADHD lies in problems in dopamine regulation in the brain and states that stimulants work by stimulating dopamine in the brain and thus the symptoms of ADHD are lessened.

However, previously Hedaya states that Zametkin (1995) noted that stimulants have the same effect in both those diagnosed as ADHD and those who are not (Hedaya, 1996, pg. 139). Dr. William Carey of the Children’s Hospital of Philadelphia commented at the National Institutes of Mental Health Consensus Conference in 1998 that the behaviors exhibited by those considered ADHD were normal behavioral variations. A Multimodal Treatment Study was conducted by the National Institutes of Mental Health in 1999 in regards to ADHD. Psychiatrist Peter Breggin and the members of the International Center for the Study of Psychiatry and Psychology challenged the outcomes of this study because it was not a placebo controlled double blind study. Breggin also argues that that the analysis conducted of behaviors in the classroom of those children studied showed no significant differences between those children receiving stimulant medications versus those who only were utilizing a behavioral management program (MTA Cooperative Group, 1999a, pg. 1074). Breggin notes that there was no control group in the study of untreated children and that 32% of the children involved in the study were already receiving one or more medications prior to the onset of the study. Of those in the study who were the medication management group, they numbered only 144 of which Breggin finds to be enormously small.

Breggin states that in the ratings of the children themselves that they noted increased anxiety and depression however this was not found to be a significant factor by the investigators. Breggin also believes that the study was flawed in that drug treatment continued for 14 months whereas behavioral management was utilized for a much shorter duration. Breggin argues that the behavioral management strategies, which involved mainly a token economy system, were ineffective as well and did not take into consideration family dynamics but regardless, the study still showed that there was no difference between the populations treated with drugs versus those undergoing behavioral management solely. Breggin notes that many of the children receiving medications had adverse drug reactions, which consisted of depression, irritability, and anxiety. 11.4% reported moderate reactions and 2.9% had severe reactions. However, Breggin also states that those reporting the adverse drug reactions were not properly trained, but were rather only teachers and/or parents.

The study, as Breggin concludes, showed no improvement in the children treated with medications in the areas of academic performance or social skill development. Breggin feels that the study was improper in that all of the investigators were known to be pro-medication advocates prior to and after the study. Breggin states that Ritalin and other amphetamines have almost identical adverse reactions and have the potential for creating behavioral issues as well as psychosis and mania in some individuals. Breggin argues that these medications often cause the very behaviors they are intended to treat. He notes that children treated with these medications often become robotic and lethargic and that permanent neurological tics can result.

In his textbook, Attention Deficit Hyperactivity Disorder, Russell Barkley, an advocate for the use of methylphenidate in the treatment of ADHD, notes that there is little improvement in academic performance with the short-term use of psychostimulant medication. Barkley also acknowledges that the stimulant medications can affect growth hormone but at present there is not any knowledge of the long-term effects on the hypothalamic-pituitary growth hormones. Barkley (1995, pg. 122) also states, at present there are no lab tests or measures that are of value in making a diagnosis of ADHD.

Dr. Sidney Walker, III, (1998, pg. 25) a late board-certified neuropsychiatrist comments that a large number of children do not respond to Ritalin treatment, or they respond by becoming sick, depressed, or worse. Some children actually become psychotic – the fact that many hyperactive children respond to Ritalin by becoming calmer doesn’t mean that the drug is treating a disease. Most people respond to cocaine by becoming more alert and focused, but that doesn’t mean they are suffering from a disease treated by cocaine. It is interesting to note Walker’s analogy of Ritalin to cocaine. Volkow and his colleagues (1997) observed in their study, EMP (methylphenidate, like cocaine, increases synaptic dopamine by inhibiting dopamine reuptake, it has equivalent reinforcing effects to those of cocaine, and its intravenous administration produces a high similar to that of cocaine.   Walker (1998, pg. 14-15) that in addition to emotional struggles of children leading to ADHD-like behavior, that high lead levels, high mercury levels, anemia, manganese toxicity, B-vitamin deficiencies, hyperthyroidism, Tourette’s syndrome, temporal lobe seizures, fluctuating blood sugar levels, cardiac conditions, and illicit drug use would all produce behaviors that could appear as what would be considered ADHDEhowever Walker feels that these issues are most often overlooked and the person is considered to be ADHD.

F. Xavier Castellanos states at the 1998 Consensus Conference that those children with ADHD had smaller brain size than those of children who were considered to be normal. However, Castellanos reported as well that 93% of those children considered ADHD in the study were being treated long term with psychostimulants and stated that the issue of brain atrophy could be related to the use of psychopharmacological agents. Dr. Henry Nasrallah from Ohio State University (1986) found that atrophy occurred in about half of the 24 young adults diagnosed with ADHD since childhood that participated in his study. All of these individuals had been treated with stimulants as children and Nasrallah and colleagues concludes that cortical atrophy may be a long term adverse effect of this treatment.  Physician Warren Weinberg and colleagues stated, a large number of biologic studies have been undertaken to characterize ADHD as a disease entity, but results have been inconsistent and not reproducible because the symptoms of ADHD are merely the symptoms of a variety of disorders. The Food and Drug Administration has noted (Walker, 1998, pg. 27) that ee acknowledge that as of yet no distinct pathophysiology (for ADHD) has been delineated.

There has been concern as well about the addictive component of psychostimulants. The Drug Enforcement Administration (1995c) reports that it was found that methylphenidate’s pharmacological effects are essentially the same as those of amphetamine and methamphetamine and that it shares the same abuse potential as these Schedule II stimulants.

Breggin states that psychiatrist Arthur Green in the Comprehensive Textbook of Psychiatry published in 1989 reported that all commonly diagnosed disorders of childhood can be linked to abuse and/or neglect. Abuse and neglect produces difficulties in school, such as cognitive impairment, particularly in the areas of speech and development, combined with limited attention span and hyperactivity. (Breggin, 1991, pg. 274)

Being that ADHD is a subjective diagnosis and that stimulant treatment has been shown to have risk as detailed above, what is the effective alternative to aiding those who have been diagnosed ADHD and what actually is underlying the difficulties that these individuals may be manifesting? Psychologist and educator Michael Valentine (1988) suggests that it is necessary to love your children, care about them, do as much as possible to have them grow and develop, teach them social skills, and teach them how to identify and express their feelings and to become uniquely human; but at the same time, care about them and love them enough to give them guidance, structure, limits, and control as they need it.

Valentine advocates a psychosocial approach to aiding children and adolescents who would be considered to be ADHD. Psychiatrist Peter Breggin also advocates this approach and feels that it is necessary for parents to feel empowered and for their to be a compassionate therapeutic adult in the lives of these children. Breggin (1998, pg. 308-310) feels it is necessary to examine the effects of institutionalization and placement on children as well as the effects of psychiatric stigmatization (that is, the effects on esteem of receiving the label of ADHD itself). It is necessary to examine the experience of the child and if they have suffered physical, sexual, or emotional abuse from adults, or have experienced peer abuse. It needs to be examined if they have an appropriate educational setting and if any conflicts exist with instructors or if the educational environment is stressful to them.

Psychiatrist William Glasser (2003, pg. 31-32) comments in this regard, Epediatricians are being called in to diagnose schoolchildren who do not cooperate in school because they don’t like it as having attention deficit disorder or attention deficit hyperactivity disorder. Treating them with a narcotic drug is only confirming what many psychiatrists and pediatricians already believe: that it’s better to use drugs than to try to apply their prestige and clout in the community to the real problem: improving our school s so that students find them enjoyable enough to pay attention and learn in an environment where drugs are not needed. This misguided psychiatric effort has created an epidemic of drug treated mental illnessEin the schools.

Breggin continues that it is also necessary to examine the environment the child lives in and the stressors around them. It is necessary to build relationship and collaboratively design structure and limits with the child or adolescent (Breggin, 1998, pg. 318) Breggin feels it is necessary to train parents in relationship building with their children and in working through situations of conflict. He states, parent management training has consistently proven successful in improving parent self-esteem, in reducing parent stress, and in ameliorating ADHD-like symptoms, especially negative attitudes toward parental authority and aggression.

Dr. David Stein (2001, pg. 236-238) has detailed a drug free approach to aiding children who are diagnosed as ADHD who Stein prefers to call highly misbehaving children. In this program, known as the Caregiver’s Skills program, Stein states it is necessary to treat your child as normal and not diseased. He states that the children should not be taking any medications, as they are risky for the child’s health and merely blunt behaviors. Stein argues, if the behaviors don’t occur, we can’t help (them) learn new habits.

The program encourages social reinforcement rather than material reinforcement, encouraging parents to refrain from excessive prompting and coaxing. The program encourages development of target behaviors and consistent encouragement and social reinforcement as well as consistent consequences for misbehavior. The program encourages the self-assessment and evaluation of the child of their own behaviors.

REFERENCES:

Barkley, Russell, Taking Charge of ADHD, Boys Town, NE, Boys Town Press, 1995)

Breggin, Peter R., Reclaiming Our Children, Perseus, Cambridge, MA, 2000)

Breggin, Peter R., Talking Back to Ritalin,Common Courage Press, Monroe, ME, 1998)

Breggin, Peter R., Toxic Psychiatry, St. Martins Press, New York, 1991)

DuPaul, Barkley, and Connor, Stimulants (article appearing in text Attention Deficit Hyperactivity Disorder, 1998).

Glasser, William, Psychiatry Can Be Hazardous to Your Mental Health, Harper Collins, New York, 2003)

Hedaya, Robert J., Understanding Biological Psychiatry, W.W. Norton, New York, 1996)

Nasrallah, H.J., Loney, S. Olson, M. McCalley-Whitters, J. Kramer, and C. Jacoby, Cortical Atrophy in Young Adults with a History of Hyperactivity in Childhood, Psychiatry Research, 17:241-246, 1986)

National Institutes of Mental Health Consensus Conference Statement, 1998

Stein, David, Unraveling the ADHD Fiasco, Andrews McMeel, Kansas City, 2001)

Walker, Sidney, The Hyperactivity Hoax, St. Martins Press, New York, 1998)

Weinberg, Warren et al., Attention Deficit Hyperactivity Disorder: A Disease or a Symptom Complex, Journal of Pediatrics, 130, 665-6

Dan L. Edmunds, Ed.D.
http://www.danedmunds.com

Article Source: http://EzineArticles.com/?expert=Dan_Edmunds

via Meeting the True Needs of Children Diagnosed as ADHD.

15 August, 2011 00:55

 

COMMITMENTS :  Cutting the Cord :  Saying goodbye to your therapist can elicit bad feelings–unless it’s handled right. Then the parting can be a chance for growth.

December 04, 1995|LIBBY SLATE | SPECIAL TO THE TIMES
You’ve been in psychotherapyfor a while and feel your therapist just isn’t meeting your needs anymore, so you decide it’s time for a change. Or perhaps it is your therapist who is moving on–leaving town, going on maternity leave, retiring because of age or illness.Whatever the reason for bidding adieu, when the two of you part company, you’re not just breaking off with a mental-health professional. Therapy involves transference, in which you transfer feelings about important figures in your life onto the therapist. So you’re also saying sayonara to your mother, your father, significant others past and present, best friend, maybe a sibling or two–so many people it’s a wonder you can all fit into one office.

That period of wrapping up therapy and saying goodbye is known as “termination,” a word that evokes images of being fired from a job or being stalked by Arnold Schwarzenegger. But mental-health experts consider termination a crucial stage in therapy.

If handled properly, it provides an opportunity to re-examine the issues that led the client to seek help in the first place, to evaluate the therapy itself and to deal with feelings that might bubble up in the face of bidding farewell.

A so-called natural termination, in which the two of you agree to end treatment because your goals have been met, is difficult enough. Who, after all, likes to say goodbye, especially to someone who has helped you so profoundly and so intimately? But a premature termination, where a dissatisfied client leaves without much notice or a therapist departs before the patient is ready, can be downright traumatic.

“It’s always best if people can have time to pay attention to the process of saying goodbye,” says Carl Shubs, a licensed clinical psychologist in private practice in Beverly Hills. “If people leave too abruptly, it interferes with the process–they’re not able to deal with the sadness or anger, the mourning that occurs.”

Adds Sylvia Martin, a licensed marriage, family and child therapist in private practice in Sherman Oaks: “Termination is a time when people start to deal with all their losses. It can trigger feelings about old issues, or issues about the relationship between the therapist and client.

“If there is an old loss they have not grieved, they will tap in and experience the same feelings,” she says. “Maybe they had a feeling of abandonment when they were young and did not understand it. Or maybe they have not had the luxury before now of dealing with a loss–for example, going through a divorce with two kids.”

*

If it is the patient who says so long, a good therapist will try to determine if he or she wants out because the topics being discussed are becoming too painful. In those cases, the therapist will encourage the patient to remain, so as to work through the discomfort and resolve those issues.

Many times, though, the client is willing to slog through the hard stuff, but feels this particular therapist is less than able. Such was the case last year for Laura, 41, who works in the travel industry in Orange County and sought counseling for marital problems.

“I was therapy illiterate,” she recalls. “I had no basis for comparison. But I never felt I was getting help. I would drive home and think, ‘Why did I just go there?’ I didn’t expect a magic cure, but I was just begging my therapist, ‘Give me some tools to help me.’

“All she said was, I had to divorce my husband, which I wasn’t ready to do. I felt her attitude was, ‘You won’t take my advice, so I don’t know what to tell you.’ ”

Laura–who is still married and on better terms with her husband–found another therapist to her liking. But she stuck with her first counselor longer than she preferred to because, she says, “The last thing I wanted was to look for someone new to spill my guts to, to start over again.”

Indeed, for some people, leaving the current therapist is the easy part; it’s finding a new one that poses problems. Says Studio City writer Catherine Johnson, author of the book “When to Say Goodbye to Your Therapist” (Simon and Schuster, 1988), “Finding a new therapist is not like finding a new dentist. It’s extremely difficult to find a match.

“It’s a bit like finding a lover, or best friend, or a parent. You don’t just go out and find a new best friend. You have to find a real emotional fit, on top of basic competence.”

Lisa Moore, 34, a West Los Angeles advertising account executive, discovered that last year when she left the marriage and family counselor she had been seeing for 15 months because she thought the therapist had crossed the professional line and was becoming too friendly. After six weeks with a new therapist recommended by her physician, she decided to return to her former counselor.

http://articles.latimes.com/1995-12-04/news/ls-10124_1_bad-feelings

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14 August, 2011 23:20

When is it time to say
goodbye to a therapist?

By Alexia
Elejalde-Ruiz

Chicago Tribune

Posted: 03/29/2011 01:00:00 AM MDT

Maybe you don’t like your therapist. Maybe you do, but you’ve resolved the
issues that drove you to seek counseling in the first place. Or maybe those
issues remain unresolved, with few signs of progress. Maybe your sessions feel
as if they’ve morphed into very expensive chats with a friend.

For myriad reasons, people come to a point when they wonder if they should
break up with their therapist. And “break up” is the right term for it, because
quitting therapy can spur emotions as painful and complicated as ending a
romantic relationship.

How do you know if you’re ready to stop therapy? And how should you go about
it? First, any therapy that is abusive or destructive should be stopped
immediately, said Dr. Kenneth Settel, clinical instructor in psychiatry at
Harvard Medical School. Examples of abusive therapists are those who are
disrespectful or insensitive to certain issues; those who violate boundaries;
those who reveal too much about their own problems; and those who insist on
focusing on areas the patient didn’t come in for.

But assuming you’re not dealing with that, patients should approach ending
therapy as a chance to grow, Settel said. Rather than cut and run or avoid the
topic altogether — tempting routes for the confrontation-avoidant — it’s
important that patients, well, talk to their therapist about it.

In therapy, the relationship between the patient and the therapist is a
vehicle for understanding the patient’s issues, Settel said. So the way you end
therapy can be a way of examining how you say goodbye to people, and the
feelings involved in leaving and loss.

Ask yourself why you want to move on. When did you start feeling that the
therapy was no longer helpful or productive? What happened that made it
different? Was there a change in you, in the topics being discussed, in the
therapist? Confronting that tension can be a turning point because it forces you
to work through obstacles, Settel said.

“Ending therapy can be very therapeutic,” Settel said.

Though the patient-therapist relationship can have a weird power dynamic —
you’re paying, but the therapist is the expert and knows your every demon —
patients should feel they have control of the process, said Lynn Bufka, a
psychologist and head of the department of practice, research and policy at the
American Psychological Association. Patients should feel empowered to ask
questions, steer the sessions to focus on particular issues and let the
therapist know what’s not working.

The tricky part is making sure you’re not leaving therapy just because it’s
unpleasant or difficult, which oftentimes it has to be, Bufka said. More than
make you feel better, therapy is supposed to help you understand yourself
better.

On the flip side, therapy shouldn’t be some indefinite appointment you keep
as part of your routine. There should be regular discussions about what you’re
trying to accomplish and whether you’re meeting those goals.

“I hope that I’m going to work myself out of a job,” Bufka said.

There is such a thing as staying in therapy for too long. One warning sign is
if a patient has to run all decisions by his or her therapist, which can signal
dependency, Bufka said. Another concern is if the therapist relationship is
taking the place of building other relationships.

Another downside of staying in therapy for too long is that you don’t have
the opportunity to practice the skills you’re developing independently, Settel
said. If the therapy was aiming to help you build internal skills of
self-observation, stopping therapy can encourage growth because it forces you to
internalize the process.

Read more: When is it
time to say goodbye to a therapist? – The Denver Post
http://www.denverpost.com/lifestyles/ci_17720234#ixzz1YuUEWgne

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14 August, 2011 23:16

 

How to Figure Out When Therapy Is Over

Published: October 30, 2007

If you think it’s hard to end a relationship with a lover or spouse, try breaking up with your psychotherapist.

A writer friend of mine recently tried and found it surprisingly difficult. Several months after landing a book contract, she realized she was in trouble.

“I was completely paralyzed and couldn’t write,” she said, as I recall. “I had to do something right away, so I decided to get myself into psychotherapy.”

What began with a simple case of writer’s block  turned into seven years of intensive therapy.

Over all, she found the therapy very helpful. She finished a second novel and felt that her relationship with her husband was stronger. When she broached the topic of ending treatment, her therapist strongly resisted, which upset the patient. “Why do I need therapy,” she wanted to know, “if I’m feeling good?”

Millions of Americans are in psychotherapy, and my friend’s experience brings up two related, perplexing questions. How do you know when you are healthy enough to say goodbye to your therapist? And how should a therapist handle it?

With rare exceptions, the ultimate aim of all good psychotherapists is, well, to make themselves obsolete. After all, whatever drove you to therapy in the first place — depression, anxiety, relationship problems, you name it — the common goal of treatment is to feel and function better independent of your therapist.

To put it bluntly, good therapy is supposed to come to an end.

But when? And how is the patient to know? Is the criterion for termination “cure” or is it just feeling well enough to be able to call it a day and live with the inevitable limitations and problems we all have?

The term “cure,” I think, is illusory — even undesirable — because there will always be problems to repair. Having no problems is an unrealistic goal.  It’s more important for patients to be able to deal with their problems and to handle adversity when it inevitably arises.

Still, even when patients feel that they have accomplished something important in therapy and feel “good enough,” it is not always easy to say goodbye to a therapist.

Not long ago, I evaluated a successful lawyer who had been in psychotherapy for nine years. He had entered therapy, he told me, because he lacked a sense of direction and had no intimate relationships. But for six or seven years, he had felt that he and his therapist were just wasting their time. Therapy had become a routine, like going to the gym.

“It’s not that anything bad has happened,” he said. “It’s that nothing is happening.”

This was no longer psychotherapy, but an expensive form of chatting. So why did he stay with it? In part, I think, because therapy is essentially an unequal relationship. Patients tend to be dependent on their therapists. Even if the therapy is problematic or unsatisfying, that might be preferable to giving it up altogether or starting all over again with an unknown therapist.

Beyond that, patients often become stuck in therapy for the very reason that they started it. For example, a dependent patient cannot leave his therapist; a masochistic patient suffers silently in treatment with a withholding therapist; a narcissistic patient eager to be liked fears challenging his therapist, and so on.

Of course, you may ask why therapists in such cases do not call a timeout and question whether the treatment is stalled or isn’t working. I can think of several reasons.

To start with, therapists are generally an enthusiastic bunch who can always identify new issues for you to work on. Then, of course, there is an unspoken motive: therapists have an inherent financial interest in keeping their patients in treatment.

And therapists have unmet emotional needs just like everyone else, which certain patients satisfy. Therapists may find some patients so interesting, exciting or fun that they have a hard time letting go of them.

So the best way to answer the question, “Am I done with therapy?” is to confront it head on. Periodically take stock of your progress and ask your therapist for direct feedback.

How close are you to reaching your goals? How much better do you feel? Are your relationships and work more satisfying? You can even ask close friends or your partner whether they see any change.

If you think you are better and are contemplating ending treatment but the therapist disagrees, it is time for an independent consultation. Indeed, after a consultation, my writer friend terminated her therapy and has no regrets about it.

The lawyer finally mustered the courage to tell his therapist that although he enjoyed talking with her, he really felt that the time had come to stop. To his surprise, she agreed.

If, unlike those two,  you still cannot decide to stay or leave, consider an experiment. Take a break from therapy for a few months and see what life is like without it.

That way, you’ll have a chance to gauge the effects of therapy without actually being in it (and paying for it). Remember, you can always go back.

Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.

http://www.nytimes.com/2007/10/30/health/views/30beha.html

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Farewell By: Matthew Groff

 

Farewell

Open our eyes and the world can seem a scary place. Open our minds and the choices can overwhelm. Open our hearts, and we may feel a need to lessen the pain. Look to our souls to choose a path. Remember the joy, remember the discovery, Remember all we h…ave learned, Remember the friendship, remember the love… With feeling. Remember the pain, for what it taught us About ourselves, about our world. But, remember with mindfulness, And let the hurt go. In the darkest and coldest of nights, Our fearful or angery expectations will not serve us. But our dreams of a brighter warmer day Will illuminate a path to that dawn. Hope heals, hope sustains, Hope can warm cold hearts and open closed minds. To forgive ourselves, to forgive others, To dream of a better world that yet may be, This is love. To act on love, To be willing to strive and sacrifice For the growth and healing, Of ourselves and others, Is to be responsibly human. With such humans I have fought alongside for what I believes is just and fair, With such humans, I have wept, With such humans I have laughed, With such humans I have even vented and stormed. I have seen more than my fair share of bright warm days. Now, not by choice I must go. Without expectation that I will see days as bright or warm, Or coworkers as responsibly human. But with hope that I may be able to appreciate, How bright those tomorrows may be, And how responsibly human those future coworkers may be, Or, may yet become. When we look to the future, We create paths of energy That draws those futures to us. Always dream of brighter days… Especially in the dark cold nights. See More

By: Matthew Groff

 

Jaycee Dugard Interview with Diane Sawyer; Her Future After Surviving Philip Garrido – ABC News

 

Jaycee Dugard Interview with Diane Sawyer; Her Future After Surviving Philip Garrido – ABC News.

July 10, 2011

 

Jaycee Dugard has powerful memories from the last 20 years, 18 of them spent as a prisoner of kidnappers Phillip and Nancy Garrido.

Yet, some of the most overwhelming memories come from her first two years of freedom which she and her children have spent reunited with her mother.

“Wow. Now I can walk in the next room and see my mom. Wow. I can decide to jump in the car and go to the beach with the girls. Wow. It’s unbelievable. Truly,” Dugard said in an exclusive interview with ABC News’ Diane Sawyer.

Dugard was kidnapped by Phillip and Nancy Garrido when she was just 11 years old in 1991 and held captive in a backyard compound.

She was subjected to rape, manipulation and verbal abuse. She gave birth to two daughters fathered by her abductor in that backyard prison.

Dugard lived in virtual solitary confinement until her first daughter was born three years into captivity and wasn’t allowed to spend time outdoors until after her second daughter was born, more than six years after her abduction.

She writes that the closest thing to freedom she ever felt in the compound was when she was allowed to live in her own tent and plant a small garden.

Now, Dugard is telling all in a new memoir, “A Stolen Life,” and in her exclusive interview with Sawyer.

She’s taking an unflinching look at the horror she’s overcome and giving an unsparing account of the way a predator operates and how she survived.

PHOTO: ABC News' Diane Sawyer sits down for an exclusive interview with Jaycee Dugard Sunday night, July 10th on ABC.
/ABC News
ABC News’ Diane Sawyer sat down for an… View Full Size
Jaycee Dugard Dependent on Her Abductor Watch Video
Introducing Jaycee Dugard to Nancy Garrido Watch Video
Jaycee Dugard Pregnant at Age 14Watch Video

“Why not look at it? You know, stare it down until it can’t scare you anymore,” she told Sawyer. “I didn’t want there to be any more secrets…I hadn’t done anything wrong. It wasn’t something I did that caused this to happen. And I feel that by putting it all out there, it’s very freeing,” Dugard said.

Dugard, 31, remembers the first night after she and her daughters were rescued in 2009.

They spent the night in a motel room just down the hall from Dugard’s mother, Terry Probyn.

Both Probyn and Dugard had held out hope throughout their nearly two decade separation that they’d find one another.

They had no idea that they’d been only 120 miles from one another the whole time.

“That night, I woke the girls [my daughters] up and I just said, “I’m so happy. I’m so happy!” Dugard said. “I ran down the hall…the girls are following me and knocking on the door…I walked in, ‘I’m so happy! I’m so happy!”

Click Here to Watch the Full Episode of Diane Sawyer’s Exclusive Interview with Jaycee Dugard

Simple firsts have brought healing to Dugard and her family: learning how to drive from the sister who was just a baby when Dugard was kidnapped, eating family dinners around a table instead of the fast food that Phillip Garrido fed her for 18 years, and even just saying her name which was forbidden by her captors.

Still, the sounds of her imprisonment haunt her.

“That lock. Hearing the lock…for some reason that and the bed squeal. It was a squeaky bed…I guess the noise, the sound. Weird what sticks in your head,” Dugard said.

Dugard remembers trying not to cry when she was first abducted because it was too hard to wipe tears away with her hands cuffed behind her back.

“I didn’t really want to, because then you can’t wipe them away, you know? Then you get all sticky and …then they get itchy,” Dugard said.

She says she had no choice but to endure.

“There’s a switch that I had to shut off,” she said. “I mean, I can’t imagine being beaten to death, you know? And you can’t imagine being kidnapped and raped, you know? So, it’s just, you just do what you have to do to survive.”

Page 2 of 4
July 10, 2011

 

Two of the most challenging moments for Dugard were giving birth to her two daughters in 1994 and 1997.

“I knew there was no hospital,” she said. “I knew there was no leaving.”

At just 13 years old, Dugard noticed she was putting on weight but didn’t know why.

On a Sunday in 1994, the Garridos told her she was pregnant.

Before her abduction, the little girl who sold Girl Scout cookies and wrote stories, knew nothing about sex.

Dugard writes that giving birth was the most painful experience in her life.

“And then I saw her. She was beautiful. I felt like I wasn’t alone anymore. [I] had somebody else who was mine…and I know I could never let anything happen to her. I didn’t know how I was going to do that, but I did,” she said.

 

The Kidnapping

Dugard remembers the last time she left her family’s Tahoe, Calif., home to walk to her fifth grade classroom on June 10, 1991.

She’d packed her peanut butter and jelly lunch, worn her favorite kitty shirt and a butterfly ring given to her by her mother.

In all pink, she started on her walk.

“And [I] walked up the side of the hill…that was the safe way to go against traffic. And halfway up, my world changed in an instant,” Dugard said. “I heard a car behind me.”

Creeping behind Dugard were Phillip and Nancy Garrido. Phillip Garrido rolled down his car window.

Jaycee Dugard Dependent on Her Abductor Watch Video
Introducing Jaycee Dugard to Nancy Garrido Watch Video
Jaycee Dugard Pregnant at Age 14Watch Video

“His hand shoots out and I just feel numb. My whole body is tingly…I fall back in the bushes,” Dugard said.

Garrido had shocked her with a stun gun. Panicked, Dugard scooted back towards the woods. She remembers grasping a sticky pinecone, the last thing she touched while free.

Now, she wears a pinecone charm around her neck to symbolize her freedom.

“It’s a symbol of hope and new beginnings and that there is life after something tragic.”

After shocking her, the Garridos stuffed her into their car, hid her under a blanket in the backseat.

Nancy Garrido sat on her while Phillip Garrido drove to the couple’s Antioch, Calif., home.

“It was so hot,” she said. “I remember my throat felt very dry and scratchy and like I had been screaming, but I don’t remember screaming,” she said.

Dugard remembers hearing Phillip Garrido laugh and say, “I can’t believe we got away with it.”

“It was like the most horrible moment of your life times ten,” she said.

When they arrived at their home, Dugard was stripped of her backpack, her pink clothes and her name. Garrido took her to the bathroom and told her she had to be quiet.

“I guess he wanted me to be clean…very scary. I was scared,” Dugard said.

Dugard was forced to wear nothing but a towel at first and was locked in a semi-soundproof room that had only one window.

Somehow, Phillip Garrido missed the pinky ring her mother had given her. She’d hold onto that ring throughout her captivity. She’d also hold onto the hope that she’d see her mom again.

 

Clinging to the Memory of Her Mother

“I wondered if she found out what had happened to me, if she was looking for me,” Dugard said.

Dugard worried that she’d forget what her mother looked like. She’d keep journals referring to her mother as just “her” because to write “mom” was just too painful.

Her mom, Terry Probyn, carried out a frantic search for her daughter, making tearful pleas on television.

She’d continue to hold vigils for her daughter when public interest in the family’s plight waned.

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“I feel like I spent my lifetime looking for her and dreaming about her and talking to you and you were always there. You never left me,” Probyn told Dugard during the interview.

The two women, clinching hands and with their bodies turned toward one another, share a remarkable bond.

“Being a mom now, you know, I know that she never forgot about me because I could never forget about my kids. But…when you’re a kid and you think you’re easily forgettable and you’re not important. But she kept…her hope. I don’t know how she did that. You know? How did I keep my hope? How did she keep her hope,” Dugard said.

Dugard still fights feelings of anger towards her captors, but tries not to dwell on them.

“I don’t feel like I have this rage inside of me that’s building,” Dugard said. “I refuse to let him have that. He can’t have me.”

Dugard’s mother can’t forget what the Garridos stole from her daughter and her.

“I think I have enough hate in my heart for the both of us. I hate that he took her life away and that makes me sad…I hate that he stole her from me. He ripped out a piece of my heart and he stole my baby,” Probyn said.

The two women look at one another. Probyn tells her, “I’m sorry, baby.”

She goes on, “He stole your adolescence. He stole high school proms and had pictures and memories…”

Dugard smiles and tells her mom, “But he didn’t get all of me.”

Jaycee Dugard Dependent on Her Abductor Watch Video
Introducing Jaycee Dugard to Nancy Garrido Watch Video
Jaycee Dugard Pregnant at Age 14Watch Video

 

The Manipulation

The Garridos mercilessly manipulated Dugard.

When she was first kidnapped, Phillip Garrido kept a stun gun present whenever he raped her, a way to remind her of his power.

After abusing Dugard, sometimes for hours in drug fueled sex binges called “runs,” he would sob and apologize.

He’d tell her that he had a sex problem and she was saving him from hurting other little girls.

While Philip Garrido was her main tormentor, his wife Nancy was equally adept at playing with Dugard’s emotions. She would bring Dugard things like a purple bear, a Barbie, chocolate milk, a Nintendo.

But she never stopped her husband from abusing Dugard.

She’d even keep Dugard locked in the compound when Phillip Garrido was away serving time for a parole violation.

“In some way, she’s just as manipulative, because she would cry and say, ‘I can’t believe that he did this. I wish he would have got a headache that morning he took you,'” Dugard recalled.

“In some ways, she’s…just as evil as Phillip,” Dugard said.

The Garridos manipulated Dugard until the presence of a stun gun and the use of handcuffs were no longer needed to keep her from fleeing.

It was classic manipulation, Dugard’s therapist, Dr. Rebecca Bailey, said.

Bailey is a family unification therapist.

Phillip Garrido’s power over Dugard grew by being “responsible for everything from time to food to human companionship to your clothes to your identity,” Bailey said.

When Dugard had her daughters, she didn’t flee because Phillip Garrido had convinced her the world outside their compound was unsafe, ironically full of pedophiles and rapists.

Even now, it’s still hard for Dugard to fully understand why she didn’t leave.

“I’ve asked myself that question many times. I know there was no leaving. The mind manipulation plus the physical abuse I suffered in the beginning, there was no leaving…. I don’t know what it would have took. Maybe if one of the girls were being hurt,” Dugard said.

 

Coping With Captivity

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Dugard coped with the manipulation by keeping journals, writing stories and dreams that allowed her to imagine herself in a life outside of the compound.

While the Garridos stripped her of her innocence, they could not strip her of her imagination.

She would come up with stories about the tree outside the window, she named the spider in her room, she wrote in her journals about falling in love one day, riding in a hot air balloon, being a veterinarian.

Throughout her captivity, she would take care of several cats and other animals.

When she became a mother, she turned a corner of the compound into a school for part of the day.

She remembered how she used to play school as a little girl, but now she was responsible for actually educating two little girls.

She made a regimen of classes during the day with worksheets and lessons she found online.

She mothered her girls even though the Garridos forbid the children from calling Dugard “mom.”

Nancy Garrido, jealous of Dugard, required that the children call her “mom.”

Even with access to the computer, Dugard said she never searched for her mother or for news accounts of her kidnapping.

She was scared to because of the Garridos’ manipulation.

Jaycee Dugard Dependent on Her Abductor Watch Video
Introducing Jaycee Dugard to Nancy Garrido Watch Video
Jaycee Dugard Pregnant at Age 14Watch Video

 

The Rescue and the Future

Dugard and her daughters would be rescued in August 2009 after an increasingly paranoid and delusional Phillip Garrido alarmed two campus police officers, Ally Jacobs and Lisa Campbell.

He’d shown up on the University of California, Berkeley, campus with the two daughters he’d fathered with Dugard.

The campus officers, both moms, did something nobody else had done.

They saw a man haranguing and they talked to him, engaged him and then acted on their suspicion.

A background check revealed he was a convicted sex offender.

When they called his parole officer to ask about his two daughters, the parole officer didn’t even know that Phillip Garrido had children.

Over the 18 years Jaycee Dugard was in captivity, parole officers had visited the home at least 60 times and never reported anything amiss.

Phillip Garrido was called to a meeting with his parole officer on Aug. 26, 2009. He brought his wife, Dugard and the two girls.

At first, Dugard lied for Garrido, still under the spell. She eventually confessed who she was by writing her real name down.

In her memoir, she says that writing her name was like an extinguished flame reigniting.

“The light came back…it was very dark for so long…but that light finally came back on,” she said.

Dugard is savoring her freedom and planning for the future.

“I would like to study writing, you know? Really, because I love words and I love mythology…the way metaphors work and how [you] can see things differently with words,” she said. “It helped me get through a lot of days, my imagination.”

Dugard wants her book, her story to help people realize there is a way to triumph over tragedy and survive. And for her captors, both locked away in prison, she has a message.

“[You] can’t steal anything else,” she said.

 

Radical Acceptance

 

Radical Acceptance has always been a very hard concept forme to grasp and maybe not even grasp but implement and accept for myself. As I am able for the most part to help others in understanding it somehwat but not really implementing it.

According to The Dialectical Behavior Therapy Skills Workbook by McKay,Wood, and Brantley “The word dialectic (in dialectical behavior therapy)means to balance and caompare two things that appear very different or even contradictory. In dialectical behavior therapy, the balance is between change and acceptance (Linehan, 1993a). You need to change the behaviors in your life that are creating more suffering for yourself and others while simultaneously also accepting yourself the way you are.

Radical Acceptance is one of the hardest skills to master because it will require you to look at yourself and the world in a different way. However, it’s also one of the most important skills in dialectical behavior therapy (linehan, 1993a). Radical acceptance means that you accept something completely, without judging it. for example, radically accepting the presant moment means that you dont fight it, get angry at it, or try to change it into something that it’s not. To radically accept the present moment means that you acknowledge that the presant moment is what it is due to a long chain of events and decisions made by you and other people in the past. The presant moment never spontaneously leaps into existancewithout being causedby events that have already taken place.”

Radically accepting it does not mean that you like it or approve of it. It just means you accept it as it is. It means it is what it is and you have realized their is nothing that you can do to change it. You accept it for what it is no more no less.

 

DT Handout 5

DT Handout 5: “RADICAL ACCEPTANCE
Freedom from suffering requires ACCEPTANCE FROM DEEP WITHIN.
It is allowing yourself to go completely with whatever the situation is. Let go of fighting reality.
ACCEPTANCE IS THE ONLY WAY OUT OF HELL WHICH MUST NOT BE INTERPRETED AS APPROVAL OF THE DISTRESSFUL SITUATION
Pain creates suffering only when you refuse to ACCEPT the pain.
Deciding to tolerate the moment is ACCEPTANCE.
ACCEPTANCE is acknowledging what is.
To accept something is not the same as judging it to be good.
By stopping your self from fighting, the rage or anger you feel will dissipate as long as you continue to accept your condition or your faulty perceptions to events or interpersonal communications difficulties. You will be amazed at how much better you will feel when you are able to accept.”

Missed group today

Well I missed Dbt group today due to my medicaid transportation issue for today but i was aware of it friday afternoon and had informed my therapist who is the group leader of the issue. My son has been here since Friday and I am beginning to be angry with my brother and his wife for doing what they do and treating my son as if he is not important and does not matter. They put him on the back burner and treat him as a live in babysitter but yet do not give him a damn thing except negativity and put downs. I am tryin to use my skills like turn the mind and GIVE/FAST from interpesonal effectiveness module but it is difficult when I am not completely in my wise mind. My son is the only child I have left in this world that I can see and my brother does not communicate with me regarding him at all. I try to communicate on my end but is difficult when there is no communication from the other parties and my brothers wife treats him wrong and also believes that my mother who has raised my son since birth until last summer and I should have no say and they do not need to discuss what is happening with my child with me or my mother when she can not even deal with her own children effectively.

Dbt Group

Well today I had DBT group. It went alright. I have a hard time in that group because we have male sin it. Today there was only one male in it but it makes it uncomfortable for me to be there and he is very egotistic. All and all I had not been to group in like 3 weeks since I got into it kinda with him. I wanted to quit group. I sorta when in group act wired and unfocused to avoid having to talk about anything that is going on with me and exposing myself to others. I do not like to make myself vulnerable to others. When in the past I have allowed myself to be vulnerable and show people the real me alls that has happened is it got thrown back in my face and it has been used against me and used to hurt me. Especially when it comes to making myself vulnerable with and around men. I talked with my therapist about this over the past 2 weeks and she asked me to finish this module out and then she wants me to transfer to the after-care DBT group. Although I agreed I really do not want to go on to the next group I would rather just quit going at all since every group I end up in is difficult for me to open up and even when I do I do not open up about anything real that is important and needs working on. My therapist runs the group and it often frustrates her when I am wired and unable to sit still and unfocused because she klnows I am only doing it to avoid dealing with real stuff and exposing myself and making myself vulnerable. She at times like today lets me know that I need to stop that I am frustrating her and then that makes me angry but not sure why.

Well anyways group went fairly well today as we are in the ending of the Emotion Regulation Module. We are discussing the skills and sometimes I find it difficult and frustrating to be in that group because I do know the skills and how to use them persay but have a hard time applying them when I should be using them. DBT is a practice and needs to be consciously practiced and applied or it will not help. I use the skills at times but also have difficulties using them in positive ways as it seems I can fit the skills to use as my advantage to help me justify escaping and avoiding my emotions and certain things in life when in actuality the distress tolerance skills are only to be used when something is too difficult to deal with in that moment not to help avoid the situation or emotion forever not to hide from dealing with things that need to be dealt with. The rest of the skills teaches you how to deal with the emotions and situations when u can deal with them and it is not causing crisis or putting you or anyone else in danger.

This is where I instead of using the distress tolerance skills only when in crisis or in danger I use them to avoid dealing with whatever rather than everything i should face.