Saturday, September 08, 2007

Diagnosis Smorgasbord

I spoke with Frankie's counselor about all the diagnoses that Frankie has had over the years. We agreed that with the exception of ADHD none of them seem particularly accurate and that it is clear that ADHD does not explain all of Frankie's ... well, just Frankie.

I suggested that FASD (not full-blown) would explain everything, but maybe that was because it is poorly understood and the list of characteristics is so long.

His response was incredibly sensible. He said that we could get any diagnosis we suspected confirmed depending upon which physician we decided to send him to, and right now the diagnosis doesn't matter. Frankie is getting the treatment and care he needs. And there is no way of knowing yet what about him is the result of trauma and will go away when that is addressed.

I like this counselor. I really, really like that someone is resistant to the very idea of slapping a diagnosis on a child who has not been fully treated for trauma.

There is so much about Frankie that is puzzling. I hope I don't sound anxious and worried, because I am not. It is just a puzzle.

He does not seem to be repressing pain and anger over his past, it just doesn't seem to be there. There is an odd lack of attachment anxiety in our relationship with him. Is this connected to his childlikeness? Is there some organic reason that he seems like a child and is that causing the living-in-the-moment-ness about him? Or is he trying to avoid dealing with negative emotions and is doing that by being a child?

And what about this thing where he is so very, very boyish and yet wants to be a girl? Is that just the strange and wonderful way that he is? Will he grow up to be a woman who collects swords? Or is there something else going on?

I don't know, but I think it is going to be very interesting to watch this kid grow up.


  1. I can't help remembering how recently you were puzzling about his gender identity. He presented as so male, and he hadn't said anything to make you question that, and (it seemed like) you were wondering whether that was really an issue for him at all or whether someone in his past had overreacted to an innocent comment. And then suddenly - *bang*, and he was totally focused on becoming a woman.

    Maybe that will happen with his past as well - it won't even show up on his radar screen until suddenly it takes over, either because he feels comfortable enough to let it out or because something triggers it.

    Or maybe they are totally different issues, but I can't help wondering if this could just be his pattern.

  2. sarsmile,

    THAT is a very interesting thought which really hadn't occured to me.


  3. I think there is also a tendency with foster kids to never really know what the issues are. One of our kids spend 80% of the time living on another planet, completely unaware of what is going on here on earth, the other 20% so deep it's scary. Is this avoidance, trauma, one knows (and honestly no one seems to care!). Perhaps if this child didn't have a "history" I would just see it as her personality or quirkiness, not as something wrong.

    Some people are just not "normal". Does that mean there is something wrong? I don't know.

    I have to give you huge kudos. I broke out in hives at the thought of a 15 year old boy sitting at my computer with bra straps showing cheering about killing people!

  4. I like what you're counselor said. Slugger's previous doctor (a behavioral pediatrician -- whatever that is) slapped him with every diagnosis under the sun. If the label doesn't change the parenting method or change anything about therapy/necessary meds, then is the label even necessary?


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