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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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I have an 18 year old girl that seems to seeking constant attention

Customer Question

I have an 18 year old girl that seems to seeking constant attention all the time it does not matter if its good or bad as long as the attention is on her. Icannot get her to mix outside now that she is on her holidays,she stays in all the time and all of a sudden she says she gets panick attacks. every time we have an outing she says she cant go right as we about leave makes an excuse about some illness then all attention is on her and the outing is ruined. there has been a lot of friction in the house lately and i am at last nerve. She seems to a bit of a hyprochondriac as well. Can you help in any way please.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 3 years ago.

Doctor Blake :

Good morning and welcome to JA.

Doctor Blake :

Please understand that it is both unethical and unprofessional to diagnose 3rd party over the internet. However... you mention that your daughter may be suffering from PANIC ATTACKS.

Doctor Blake :

This, coupled with her other behaviors, suggests some profound problems with anxiety.

Doctor Blake :

The degree, nature, and duration of her condition suggests that it is more than could typically be handled by having a talk with her - or even by speaking with her general doctor.

Doctor Blake :

I would strongly recommend that you consider exploring the treatment protocol used to address anxiety disorders in general. In terms of medication, many psychiatrists recommend the use of a Selective Serotonin Reuptake Inhibitor (SSRI). This has been found to helpful with a number of people who suffer from panic attacks and other forms of anxiety.

Doctor Blake :

But over 30 years of research has demonstrated that medication PLUS a very specific form of treatment (called Cognitive Behavioral Therapy (CBT) provided by a trained Mental Health Professional (MHP)) is the most effective. In some cases, CBT has been found to be *more* effective than medication alone <or> medication plus treatment.

Doctor Blake :

CBT seeks to change the thoughts (cognitions) and action (behaviors) of individuals who have learned a false set of relationships between certain behaviors and certain perceived outcomes. For those suffering from anxiety problems, including panic attacks, people believe that they must behave in a particular fashion in order to avoid feeling badly or even dying. Providing CBT will help to "unlearn" those kinds of false beliefs, and provide a series of specific/focused strategies to employ when the individual begins to feel anxious again.

Doctor Blake :

The treatment is not like the old-fashioned "talk therapy" with which you might be familiar. In fact, research has shown that this kind of therapy tends to keep the client/patient stuck "ruminating" on old problems or issues or false beliefs that "keep them stuck." CBT is very focused and targeted at alleviating the false beliefs and actions that keep people stuck. That's why it will be very important to ask your future MHP if s/he has training in CBT and has used it with clients in the past.

Doctor Blake :

Given the nature of your daughter's unhealthy over-attachment to the family right now, you would all likely benefit from family-based CBT. This will help the family as a whole support your daughter as she begins to make changes in her thinking and acting... and provide you all with strategies to help support one another as you make this change. Remember that - although your daughter is identified as the patient in this case - the family as a whole has likely been behaving in a particular way that supports your daughter's behavior for some time. Helping the family change and communicate will help your daughter to change!

Doctor Blake :

I would strongly urge you to speak with your doctor/her doctor about a referral to a MHP who can implement CBT. In the event that your daughter also needs medication, your general doctor can prescribe an SSRI - but referring to a psychiatrist might be warranted. In terms of MHPs to provide CBT, most often a doctoral level psychologist is best - but anyone with proper training can administer the treatment(s). If you're having difficulty locating a CBT in Ireland (and you shouldn't), you might check with your local college or university (ask the Psychology Department) for local practitioners. You could also check:

Doctor Blake :

http://www.icbt.ie/

Doctor Blake :

I hope that this has been helpful information for you and your daughter. Please understand - although things seem pretty "scary" right now, anxiety disorders are among the most treatable forms of mental health problems an individual can face. With the proper treatment (and possibly medication), this can be overcome!

Doctor Blake :

I hope this has been helpful. I wish you and your entire family the best of luck. Please click <ACCEPT.>

Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience: Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
Doctor Blake and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
what can i do with my daughter she refuses to attend a doctor for help and is verbally abusive to me . what can i do. she has said that i have neverd cared for all her life and never to speak to her agian i was very upset, which she seems to enjoy seeing me in that state. According to her i am making idiotic theorys up about her.I know she is 18 so what can i do to help her.
Expert:  Doctor Blake replied 3 years ago.
Thanks for writing back to JA.

This is, as you well know, the hardest part of working with someone who is suffering. You can try everything within your power to get them the help they need... but if they refuse to get it, then you have to make certain that you're taking care of yourself.

With regard to getting her into treatment, because she is no longer a minor, she can legally make her own decisions about treatment. Now, it is possible for you to "strongarm" her... this could include threatening to remove her from the house, calling an ambulance to have her evaluated and taken into treatment, or staging an "intervention." Unless she is deemed incompetent or in immediate danger to herself and/or others, legally there is nothing you can do.

HOWEVER, you need to answer some difficult questions for yourself:

---> How much verbal and emotional abuse are you willing to tolerate? What is your "breaking point?" What will be the consequences if your daughter continues to be verbally or emotionally abusive to you - or if she crosses that breaking point? Are you (and is your family) willing to abide by the consequences you lay down?

----> How are you handling the stress of having a daughter in your house who is saying things that disturb you? You indicate that you are "very upset" and that your daughter "seems to enjoy seeing you in that state." Is this state dangerous to you? How is it impacting other members of the family? What are you doing to keep yourself safe and other members of your family (besides your daughter) safe?

These may not seem like important questions, but they are. Right now, your daughter's illness has gotten you tangled up in her emotional state. Therapists might say that you have become "enmeshed" in your daughter's problems - and aren't able to think or feel "straight" right now. (Don't worry - you're not crazy... this is part of living with family members who are going through a difficult time.)

Seeing a family therapist FOR YOURSELF might be very very very helpful. It will allow you to address the questions I listed above (--->) and begin to sort out what needs to happen with your daughter. It will also model for your daughter the route to healthiness. Yes, I'm sure she wants nothing to do with you right now... but going to sort this out with a professional will help you and (in the long run) help her.

Once you are disentangled from your daughter's emotional upset, you'll be able to think and feel more clearly - and establish clear boundaries that will allow YOU to function better and YOUR DAUGHTER to function better.

The other last reason I'm recommending that you consider therapy is (again, not because you're crazy...) because right now, you can't get your daughter into therapy. She said so herself. Well, you still have to deal with her - and your own emotions. You can't do anything to help her - but you can help yourself. And you deserve to.

When you take off in an airplane, the flight attendants always tell you, "in the event of an emergency" to put the oxygen mask on YOURSELF before helping out the kids around you. Same thing applies here. You're officially in "an emergency." Take care of yourself FIRST (because it's all you can take care of) and then, if she'll let you, take care of her.

I do wish you the best of luck. I know that there will be some painful days ahead. I strongly urge you to consider what I've suggested.

Please click <ACCEPT>.

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Doctor Blake
Doctor Blake
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Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure