Chat transcript 1/19/06

It is with great pleasure that I welcome Mr. George Lynn to STARFISH Advocacy Association. From the first time I opened the book Genius! – I felt as if Mr. Lynn was a kindred spirit. Mr. Lynn’s Seven Criteria of the Field of Nurturing are simple steps to ensure that the 4 assumptions of invitational education – Trust, Respect, Optimism, and Intentionality that are the basis of creating and inviting a child to find success. Mr. Lynn is the father of a child with neurological disorder and understands first hand the trials and tribulations that we each live each day. He joins us tonight with his wife and co-author Joanne Barrie Lynn. Without further delay let me please welcome George and Joanne to the STARFISH community and Family! Welcome! Q. Mr. Lynn, what inspired you to write Genius!? How is this book different from your other books about children with A. I was inspired to write the book by the parents who spoke with me during and after my presentations about my work with kids. People wanted to know if there was any hope for their kids, most of whom had serious behavior difficulties at home and school. So many severe diagnoses. So I wrote the book to answer with a strong “Yes!” to this question and described key factors that I see in the parenting approaches of the most successful parents. The book is different in that it starts with the premise that our kids are in the process of becoming whole; there is a developmental lag in basic self-control. But they are not broken. And, in fact, some of their most distressing behaviors may foreshadow the gifts they will give to society, through wild creativity, unbridled energy, and white-hot focus. The trick is to get them to their young adulthoods in one piece. Q. How do I identify my child's genius? My son isn't particularly great at anything, although he gets by in most A. In the book I make clear that when I talk about a child’s genius I am not referring to IQ or eminence, greatness or such. I am referring to core energy in a person that may be expressed in ways humble or exalted. Maybe the adult works as a janitor by day and writes by night and never gets published but enjoys his life and has lots of friends. Maybe he becomes a thundering, charismatic success. There are drawbacks and joys in either place. To find this core energy, or “guiding spirit,” (this the Roman definition of genius), you study what he has always enjoyed doing and what he is good at doing. You look at his fears as a source of his gifts—successful people sometimes derive their intensity from wrestling with their own demons. You study the general patterns of his personality, his “archetype” to use Jung’s term. Is he a Hermit, or Hunter, or Warrior? All these types have powerful positives. So much more can be imagined for a child if you do not see him as hopeless autistic (Hermit), or ADD (Hunter) or “Bipolar,” (Warrior). If he tells you his nighttime dreams you can get a sense of his genius—the part that wants out into the world. Q. If you have a child that is refusing needed medication, is it usually best to have a third party, such as a therapist or medical doctor, address the issue? How much influence can or should a parent be expected to have alone? A. In Genius! I call meds the “scaffolding,” or “lattice,” (as in things flowers grow on in the garden). Needed supports for the development of personality. If one is indicated it is best to, of course, suggest it and discuss it, but not push it. Never, never push medication on a child. In my state (Washington) a child over 13 years old may legally refuse to take medication. So I do ask trusted others, beloved family doctors, hockey coaches, etc., to bridge the topic. Or I suggest to parents that they build an ordinary reward structure around their desire to have their kid take his meds. If he is dx bipolar disorder, he does not drive the family car unless he takes his mood stabilizer every day. Q. Do you feel that your opinions about special needs children have changed over years working with them and if so how is that reflected in your early writings and those of recent years? A. When I first started my specialty with this population in 1991, I did not know what I was getting into. There were no labels or definitions, really: no “ADD,” no “ Tourette Syndrome,” or “Bipolar Disorder,” “Asperger’s Syndrome,” in the common lexicon. My clients taught me about these conditions and how they impact the lives of kids. And I follow the medical literature (as a layman). For a year or two before I began my book on BD in kids, I was hearing about it in anecdotal writing about child psychiatry. My first book is total How To (parent very disturbing kids). My second one on bipolar in kids was written with a huge feeling of responsibility not to misinform people about the seriousness of this condition. My third book, Genius! Is an attempt to get more integrated, perhaps more real about the topic. I value the usefulness of a good diagnosis, but I see more and more so much confusion among all of them, so much experimentation with drugs, that I have pulled back a bit and now start more with trying to see a kid for who he is and not get into an easier route of deciding on his dx. Sometimes the most helpful thing for me to do is suggest to parents that they talk to their doctor about Q. When co-morbid disorders are present which do you A. The most serious one. This would be the bipolar disorder, obsessive-compulsive disorder, or high-functioning autism. These are the major dragons. They are powerful parts of who a kid is and must be the focus for his development of self-control and personal effectiveness. If a child is dx Oppositional Defiance Disorder and dx OCD, it will be the obsessionality that will get my immediate attention. The ODD is an anxiety reaction, the OCD is a driving, destructive, dragon that may or may not be the engine that will power his success as an adult. But first it needs to be tamed. The Genie (aka Genius) needs to Q. You say to see what scares our children.Is this really a A. Oh yes. Of course you want to help your child master his fears so he can transcend them and be successful. But you also want to follow them to find out more about him and his genius. As I noted above I believe that what we fear often contains gifts for us by way of inspiring our resourcefulness. It’s gotta scare the heck out of us to really be good for us (sometimes). This fits with observer perspective, once you know what you fear and accept the fear, you are less encumbered by it. In the process of gaining this knowing you get stronger. This process starts with acceptance. Occasionally I will have a mother son couple sitting across from me on the couch. He is 12 and still has “separation anxiety.” Such a heavy word. At these times I like to point out to the boy that his desire not to leave the love of his mom to find his own way into the world is understandable. Heaven, really, who wants to leave. At these times, with this fear accepted, it will often quickly diminish. Not pushing or drugging it away. Just understanding it. Q. Suggestions for positive activities to help with weight loss? Ds’s appetite takes a drastic increase when in depression. Meds have contributed to being obese. A. You need to review his meds to see if you can change them or adjunct them for weight gain problems. Some of the new generation antipsychotics are to be avoided for this reason even if they work well for mood control. Your doctor might suggest adding a bit of Topiramate to the mix which does decrease Q. Any unique/new ideas for waking ds in morning --- and then how to get him to move faster so I’m not late for work? A. Best thing if he is groggy from meds is to adjust the time or dosage he gets them. If that has all been taken care of then a later start in the a.m. is advised along with write in to the IEP around that. Less intense classes when he is cognitively down Q. My son is very unhappy about going to an out of district school - it is a two hour commute. Every morning he pleads to stay home. He goes to school and does well, but it is tough getting him out the door. We praise him when he goes without screaming. Any other suggestions? A. Jeez. What an ordeal. Two hours in the car. Yeeech. OK. If he can read while the car is going (some can and some cannot), how about a sack of goodies and a good book that he gets paid to read and would not ordinarily read? How about getting the school to agree to mental health days or do a bit more schoolwork from the home computer? How about more project work that he can do and turn in when he comes for other academics or social activities—sort of a home school/building combo? Little things for him to look forward to. You can see why people fight to have district-paid private school for their kids when this kind of abusing commute is involved. Q. How can parents help a teen realize his genius when he resists pretty much everything we say? What is our role? A. Resistance is best dealt with by good listening. Do not take it on directly. Look for the genius and affirm it. Accept that he may be oppositional for years. In my book I talk about several different ways to identify genius including sorting out a kids fears, early interests, and current talents. Affirm these. Q. My son doesn't like going to therapy. It is so bad that I start to feel ill when it's time to go. He screams, breaks things, cries and storms around. When we get there, rarely will he sit with the counselor. We stopped taking him because we didn't feel anything beneficial was coming of it. I believe he needs therapy still. Do you think a different counselor could encourage him to A. Yes to different type of counselor. One who does not do anything until he gets rapport. It gives me a headache to read this. I do not work with kids unless they want to come in on their own every time. I try to be useful. Sometimes that involves just hanging out and following the child around my office commenting on his skill at investigating all the little science knick knacks and things (I work with a lot of “Aspies.”) Kids seem to value this experience. And it will feed a sense of stability between sessions. Sometimes the work, especially with teens, is extreeeemley intense. But a kid has to say, “Yeah. The guy’s not a total waste of air. I guess I’ll go back for one more and we’ll see.” There are also very invasive counselors—people who still do “squeeze therapy” with our kids “Yeah. He’s getting better. You can tell by the look of shear terror in his face.” This people are to be avoided. Q. The more I enforce the rules or consequences, the more my 8 yr. old son rages and threatens me with destructive or aggressive behavior. (He has hit us while driving). By "negotiating" with his demands to calm the situation down, he has effectively gained control and I feel used and manipulated. What can I do to enforce the situation without the rages? A. I do not know if he is dx bipolar disorder. If he is, medication is the first order of business. He could kill everyone in the car if he kicks the driver in the back. This has happened to me. It is an experience I would like to forget. I would go on only short trips with him until I knew that it was safe to do so. Usually medication will be effective against rage. It does give most kids more control. If meltdown is happening (he has some control), natural and immediate consequences may get his attention. Do not engage him. Stop the car. Park the groceries and go home without them. Offer him his choices and tell him you will be glad to talk to him as soon as he gets control of his body. That is important sentence syntax because it does not blame him as much for what he is doing. It gives him something to do. I advise parents not to negotiate if you are being threatened. If you get to that point, you need to have a plan in mind, a way of dealing with it—maybe he goes to the ER for a psych eval, maybe you simply pull back, clear the area of destructibles and let him blow through it. Waiting 8 hrs in the ER for the eval punishes both of you but it also reminds him that you repulsed by his threats and will not give in. You have the strength and will to meet him and to put that genie back into the bottle until it is old enough to be more Q. How do we help our children to really see that they have a bright future ahead even with their illnesses? How do we help our children comprehend their own self-worth as individuals; regardless of their disabilities? A. Most importantly, you address their suffering, not their diagnosis, and you normalize having the pattern of challenges and gifts that come with it. You might say to a child, “You know you have some of that bipolar energy and it just makes you a tiny bit impulsive,” or “That’s the way we ADD’rs are—more honesty than tact sometimes. Sorry. You come by that trait honestly.” I’ve learned this from kids with Tourette syndrome—they tell other kids “It’s OK. Its just movements I have to make. Its not contagious.” Or (more typically). “I have Turrets. Get used to it!” And you help kids see the success patterns that come with the dx. As we point out in Genius! It is difficult to find too many people in history who made significant contributions to culture who would have been on heavy meds if they had lived in our time. Perhaps not happy people, but getting the job done—fulfilling their particular Q. Our 10 year old has been diagnosed with Asperger Syndrome, ADHD, dyslexia and is also gifted. He takes 150 mg of Zoloft a day for anxiety. He uses an irritated tone of voice often and gets angry very easily since he is competitive, perfectionist and doesn't always understand social cues. What is the best way to handle this? What do you recommend to improve communication, the art of conversation and social skills - is there a book or training method that is most effective (there are so many)? Any tips on how to decrease his distractibility other than medication? Is the Fast ForWard program effective? Are enzymes or fish oil advisable? A. Wow! I’m breathless for you! Lots of questions. Ok. First thing to say is that his social presentation is who he is. Sooner or later people will just get used to it. As they do with people who have Temporal Lobe Epilepsy and are chronically crabby and depressed. I know this is enormously inconvenient for him socially, but how many doctors would you describe who have Btw, I think Zoloft is a good med for him, because of its positive impact on anxiety, but I would be very careful about the suicide factor, which is most associated with this SSRI. He is on a hearty dose of the med. If that does not calm his personality, get used to it. Let him know how he is coming across in a very matter of fact manner but do it from a place of acceptance. At some point, his need for friends will motivate him to take a breath. That is what I see in kids with AS. Oftentimes they really start hurting when they get into their early twenties and try to turn things around, to get more friends in their lives or start their careers. This is the time when many of them actually begin to develop more social skills. Right now, give him feedback and help him develop more social capability if he comes to you with the question. So many good books on AS out there. Of course there is Tony Attwood’s Asperger’s Syndrome, chuck full of ideas. For younger kids, there is Olga Holland’s, the Dragons of Autism. What a wise person she is! It would seem like the Starfish metaphor is very applicable to autistic children. You have to have the patience to wait, you have to understand their world, and you have to have a couple of good techniques up your AS distractibility is a complex issue because it may result from any number of different factors—he may be obsessing, he may be in hyperfocus, he may be inattentive in the ADD sense. You don’t know. So the first step is talking with him from this place of not knowing and going from there to find out how to help Naturopathically, magnesium, zinc, and b6 supplementation are often suggested for kids on the autistic-AS spectrum. In fact many parents endorse naturopathy because it has helped much more than pharmacology. There is really no med for autism because as such, it is not a disorder but just a different way of thinking. Einstein showed features of both autism or AS in his personality. Go tell him he belongs in the DSM-IV! Finishing. Fish oil may help. Omega 3 with a high EPA to DHA ratio has been shown in studies by the NIMH to stabilize mood in some children with an early onset BD dx. You would not want to give the kind of Omega 3 you see in Safeway to your child with bd because it is stronger in DHA and DHA is very energizing (and seems to improve focus in some ADD kids). So if there is a mood disorder you need to order a product with a five to one or seven to one ratio of EPA to DHA. Q. Can you give me some examples of affirmations that I could use with my middle school age child? This seems like such a A. Affirmations for a middle school age child should emphasize his ability to deal with anxiety and affirm what a great teenager he is going to be. See my book for format for the affirmation. How you put it is very important. This is a time of identity crisis and a child should get a lot of hope that he has Q. My husband and I are both so frustrated with how long it seems to take before our 15 1/2 year old "gets it." He has been dx with bp, anxiety, and adhd 2 1/2 years ago. It seems like his therapist, in collaboration with us, his parents, keep reiterating the same things over and over from keeping his hands off his younger brother of 3 years-whom he loves to tease and play with, to coping mechanisms/calming techniques, for when he feels overwhelmed and frustrated, etc, yet he still has trouble "getting it." We work carefully on being consistent and having appropriate consequences, etc. Sooooo having said all that my question is, "How much does maturity play a role in his heightened awareness of self and ability? A. First thing aggressive kids need to learn is that violence is not tolerated. You and your husband need to do the hard planning to determine how to back this up. if you say the same things over and over again and he does not hear you need to determine if his neurology or just attention getting is the issue. Some kids I work with who have the challenges you describe are OCD about sibling persecution. Consider that therapy should not be the place where people nag him to stop. That does not work. If that is happening, your therapist needs to get to the bottom of your son's resistance to change. Q. When you have a child who has a history of severe aggression, how can you nurture his gifts while at the same time, keeping him and society safe? Is there a way we can use his talents (gifted in expressing himself through poetry) to help A. Again, do not be afraid to implement fairly severe consequences for aggressive behavior or violence. This needs to be managed before educating his genius. His genius at this point needs to be contained. Give him the model of family as community. You put in. you take out. If he takes out your piece of mind, cut back on something nice you do for him. Some little thing. If he pushes to violence do not be afraid to call the crisis center, 911, or local psychiatric hospital to intervene. Sometimes it takes a police officer to get through to a strong, Q. How do you keep a child from becoming overly dependent on a parent.especially if one parent is cold but one is A. Parents must work this out with a therapist who calls it like it is. The therapist should realize that parents are doing their best with the situation. If one is cold, then the child should know he is not the target and the family should accept this feature of personality. If coalitions are formed, these should be interrupted with good listening, and expression of feelings and fears between parents before working with the entire family. Q. "Do you think it is worthwhile to try a behavior modification program (positive incentives) with a very unstable child? My 5-yo son is currently hospitalized due to uncontrollable rages and homicidal ideations. His tdoc wants to begin a behavior mod program upon his discharge saying part of the problem is I have been too lenient with him. If you don't think behavior mod is appropriate now, is there any type of psychotherapy worth pursuing for an unstable 5-yo? What is the best therapy approach for a 5-yo once stabilized? Thank A. I do not buy behavior mod as a solution here. Of course you should not reinforce bad behavior. You may want to actually implement a level system in your household starting with a pull back of all privileges if a child is deliberately using his rage to get things from you. If he is more early onset bd straight across, you look first to meds, then to your strategies for protecting yourself and others, then to ways to stabilize your household. You look for respite. You make sure you have admitting privileges at a psychiatric hospital. There are stages to this but parental leniency is rarely the problem. Q. My son's school district was not able to educate him and in fact, because of his bipolar disorder, ultimately harassed and abused him. His psychiatrist and the neuropsychologist that worked with us said the school was compromising his stability and we had to take him out of his public school. Now he commutes to a private school almost 2 hours away. He's doing wonderfully academically but is so sad to be segregated and has lost a means to socialize with nondisabled peers - which he so desperately needs and desires. It's starting to make him angry and depressed. He even hides on the bus because the children in the neighborhood mock him for riding the "little bus." I've pleaded with the school to keep us. A. Well, I have empathy for you. We had something of this experience with Gregory growing up with the high functioning autism dx. The devil is in the details when it comes to getting services from the district. First thing to do is study what they are doing right at his new school. If his placement is being paid by the school district they will have a motivation to look at how the private folks are making it work. You may want to talk about his return to the public school if these accommodations are made and after building staff are trained about his condition Q. I am the mother of an almost 10 year old boy with Bipolar Disorder and ADHD, and the wife of a non-supportive husband. My husband is very gruff with our son and often taunts him to a point of rage. He thinks this will toughen him up. As a result, our son is very disrespectful to his father, frequently tells him to shut up, and has begged me on more than one occasion to divorce him. My husband has refused to attend any counseling, nor read any books which I have offered to explain our son’s disorder to him. Any other suggestion? A. What we have here is triangulation. And sadism. Sadism, perhaps with good intent, but it is sadistic to hurt someone and enjoy the hurting. Triangulation in that it is you and your son against your husband. This gives you no husband and your son no father. I think that counseling would help but to be palatable to your husband it really, genuinely cannot be pedantic—it has to simply be problem-solving; what works and what does not work. Sooner or later ignoring the problem will bite parents in the butt. It will. Every time! It does not toughen someone up to tease them—just makes them go away. Sometimes fathers begin getting the idea when their sons no longer come to them with problems but go to someone else when they need advice—the football coach or family friend. Sorry to say, men generally don’t read books. So you may have to read it to him when the time is right “Honey, is says here that there is a point in adolescence when a son gets big enough to beat the tar out of his mean old dad!” No father wants this to happen. There are good reasons to understand and improve ineffective parenting Q. Do "most" people that have Bipolar also have at least one other illness as well? eg. Bipolar & Fetal Alcohol Spectrum A. FAS can look a lot like BD but you do not see the mood shift in that condition as you do in BD. You may see the pitiless depression or impulsivity or hyperactivity but the feel of the condition is different. I do not see a lot of FAS or FAE in my pvt practice population. I do see a lot of classic ADHD or ADD along with the BD. I see a lot of psychosis and obsessional behavior with it. Of course ADHD, BD, FAS, are frequently reported as co-existing conditions in many families. Thus leading Drs. Comings, Blum and others to believe that there is a “dysinhibition gene” that is carried down generation to generation. The most distressing cases I work with are kids dx BD plus autism. Here you have rebel without a clue. A lot of impulsivity and very little common sense or ability to figure ones way out of tight spots. These kids are usually on a lot of medication and the challenge may be to find out if all the meds Q. My son uses foul language when he is angry. I have three younger children and this is a BIG problem - the younger three admire him so. I send him to his room for time to calm down and remember the rules when he uses this language but, the damage has already been done with the younger ones. HELP!!! A. Tough problem, once they get used to cussing, it’s hard to stop ‘em. They use it to control us and when they are genuinely beside themselves with anger. No easy solution for this one but a good place to start is by teaching your son the concept of community. Do this from the side, “Oh like the football team is really a community, people giving and getting from a common work,” or something like that. Get a bit of buy-in to this basic give and take idea. The next time you get an earful of vulgarity, tell him that the family is a community and he is taking something out, namely your piece of mind. You get to live free of noise pollution. So maybe the give back is a fine for the polluters. Maybe it’s an hour of labor at the local food bank before he can use the car on Saturday night. Little give backs should be planned that involve the things that you do for him; that he depends on you for. Remind of this connection with Q. How do you help your child move on mentally.from a situation in which they feel something was done wrong to them, but the situation has been rectified and is over? A. Check out my book on Bipolar Disorder for more on this method. What I do once I have had a chance to let a kid vent for a long, long time is ask him if he wants to put the issue behind him. Then I ask him to visualize the situation in his mind and see himself dragging the picture like an icon down left or down right wherever he feels relief from his hyper focus on it. Believe it or not, time usually heals these kinds of problems as does a lot of contact with the other kids or adults Q. My son 13(8th grade) is Bipolar and PDD-NOS is having a very difficult time in school (in an alternative school for severely EI kids) and the school has recently petitioned the courts for incorrigibility. He has done nothing criminally wrong. My opinion is they just want to get rid of him. They have told me that Juvenal detention or a strong Boot Camp might help him. They want him in some sort of residential program and they are using the courts to get it done so they won't have to pay. We don't agree and neither does his pdoc. I have begun the search for new placement. I do not know the body of law that is regulating the process you describe. Typically school districts avoid putting kids in residential placements because they are so expensive. I have never heard of a school district being able to use the courts to force a family to send their kid to a boot camp type of school. These typically come in in the $4K to 7K a month range. I would advise you to hire an attorney who specializes in educational law (fee scale tends to be less than other types) or get the help of a paraprofessional group who would represent you and your son in this matter. You might check out Pam and Pete Wrights site (wrightslaw.org or .com) and see if they have a pamphlet on this topic. Btw, my advice to any parent who is considering sending a child to a residential school is to Google or check in person the court records of the district court to which complaints against school staff would be referred. Probably in the county seat for the county. Unfortunately people who abuse kids get to their prey by getting jobs in these establishments, which may or may not be regulated by state Q. How can I help my 13 yr. old son calm himself when he is getting overly excited (but not necessarily angry)? A. I would teach him how to take a breath down to his diaphragm so that his belly comes out with the in breath. he can practice this every day lying on the floor with a book on his gut. And he can learn to count back from 5 slowly while giving himself a mind picture of something that feels good or calming. If he is technically hypomanic, you would want to consult your doctor to determine if a mood stabilizer or naturopathic remedy would help. Q. Do you recommend and alternative therapies for young Bipolar children? I have heard some things on craniosacral therapy and Reiki therapy as well as different herbal A. Alternative approaches can be very calming. The problem is that you do not have your medical provider right there when a child destabilizes. I have not found that either of the above methods you note to be particularly effective with this population. Your best chance of alt approach working is to Q. How does comorbidity of schizo-affective disorder impact an adolescent also dx with EOBD and PDD-NOS in being able A. Greatly. Greatly. This is a very explosive combination. First you get things under control with meds. That may take up to five tries. Then you put together the right mix of services at school. That will probably be with private resources. And you insure everyone's safety with a home safety plan. And you learn how to communicate with a person with autism. He may actually do better with written than spoken communication. Then you watch and affirm all of his strengths and there may be many for this type. The good news is that some kids with the EOBD presentation resolve their issues toward the end of either adolescence or their twenties. The brain keeps growing if you can keep things stable you are ahead of the game. Q. In Genius!, you talk about how the best environments are ones for Attention Different kids are ones in which family members have strong positive connections and practice good communication skills. This is especially challenging in blended, or step family situations. Do you have any hints or A. Yes. Family counseling is very important. And good relationships between exes is essential. There needs to be something of a shared value around positive regard even if one family is more strict than another. There needs to be a lot of coordination between households and acceptance. I like it when I can get both sets of parents into the consulting room Q. Our son refuses to "own" that he has any issue. He believes the problem is all with us. Any suggestions? A. First you listen, then you listen. Then you get others to reinforce what you are saying such as his friends who may be surprisingly helpful. Kids will point out how rude their friends are to parent sometimes. It does not help to try to get him to figure it out logically. The key to this kind of observer perspective is rapport and noticing the little things and building on them. Sometimes a kid just has more growing to do and you have to be very behavioral in your approach. ADD is an explanation not an excuse, etc. Who cares why you're doing it. If you do it again as night follow day, this will happen. Q. In Genius!, when you talk about caregivers coping with stress and finding a way to stay centered even in the midst of a crisis or the ongoing stress living with a challenging child you mention 3 things as being important - purpose, freedom and A. This means that parents need to have a life and these three things are the essential features of hardiness for parents under this kind of stress. You have to have something other than dealing with crisis in your own mind to pull you out of bed. You have to have things in your life or people whom you love. This could also be an art form. And you have to love your own body and take care of yourself. All these three things are established in research as keystones to ones mental health Q. Consequences for behaviors are a part of life. Many times removal to ds's "safe place" is a consequence, but there are other times I feel he needs to understand the severity of his actions/words. What types of consequences are effective for A. Consequences should relate directly to the offense. They should be short in duration and permit restitution and reconciliation. If he punches a hole in the wall, he fixes it. If he trashes everyone's peace of mind in the family (takes out of the family community) he does a couple hrs in the food bank. I suggest also that parents spend some private time doing an inventory of all the nice things they do for their kid. Put em all on a list as negotiable. He needs to know that they have strong boundaries. This is the essence of BD. A powerful genius (aka Genie) pushing outward that needs to be appropriately Q. How can you tell when the behavior is manipulative and when it is out of control BP behavior? And can you explain to yourself as well as other people why he can hold it together under certain circumstances but not another? A. If a behavior is done to manipulate, there will be a pattern of threats and joviality that accompanies it. Most behavior that is directly a result of BD is very impulsive and clearly occurs in a manic or depressed state. Very little precedent. He can hold it together at school because there is a little bit of choice in his psyche and because the sanctions for letting it out there, mainly becoming an untouchable with the other kids, are so severe. This is the end of STARFISH Advocacy’s first Special Chat – We thank you for joining us, if your question was not answered please feel free to post on our follow up board! Please consider making a contribution to help support future chats!

Source: http://starfishadvocacy.org/files/starfishchattranscripts/georgelynntranscript1-06.pdf