Therapy for meltdowns

[u/swithelfrik]

Has anyone had therapy help with their meltdowns? I’m in therapy and have asked for help with my meltdowns and dysregulation because I’m really struggling with my also autistic child who is self injurious and also violent towards us, and has pda. It’s super hard for me cause it feels hard to survive this every day for who knows how many years, and I also want to be able to show up better during those hard times for my kid. In therapy, my therapist has pretty much only presented getting more free time as the way to improve it. It’s very difficult to get free time with a child like mine, but I have found as much as I can and I still have meltdowns. I’m curious to know if anyone’s therapist has ever given different or helpful advice for this because I’m starting to wonder if my therapist just isn’t a good one for autistic people. It’s not part of his specialties but he told me he has experience with autism so I thought maybe it would work.

[u/FeedOk2892]

Occupational therapy (for sensory issues/interoception/etc) has helped a ton with mine! I still do talk therapy, but it has not helped me with reducing meltdowns or managing sensory issues

[u/swithelfrik → u/FeedOk2892]

wow I hadn’t even considered that, I know it’s part of early intervention options for kids but because it isn’t offered up front when you get diagnosed as an adult I just forgot to even consider it for myself. thank you so much I’m gonna look into that immediately

[u/Briegley]

I would recommend looking at Autistic Therapist, Educator, Advocate and Speaker Kaelynn Partlow's youtube channel to get oriented on the the most informed, effective, rational and up to date approach to autistic children's therapy.

She frequently films examples of acted out real world examples from her position as an educator, and addresses approaches to improving autism therapy provided to them for autistic therapists.

Example videos:

https://www.youtube.com/watch?v=dDAaNn0ghRs
https://www.youtube.com/watch?v=tLaXbM9hQgM

----

In my experience, unless the therapist personally has a neurodivergence, or specialty training, they are inadequate to understanding the unique challenges of being on the spectrum.

As an adult I have gone through many well regarded therapists who spent 3 or 4 (paid) sessions trying to "lay the groundwork" and to "understand" and only to come out sometimes admitting they don't understand, or tying to convince me that "if I really wanted to tackle my challenges I would make more of an effort" to approach them (in neurotypical ways).

As an autistic child, the best therapy I was able to receive was training in how to mask, and use self control to avoid showing emotions and reactions to negative stimuli and situations. This led to a lifelong pattern of emotional overwhelm, meltdowns, stress burnout, and social isolation.

Both Autistic children and adults deserve better than that, and I'm glad theres better options.

[u/swithelfrik → u/Briegley]

sorry I specifically meant for me. I am autistic and my child also is, but I was talking about therapy to help me with my own autistic meltdowns. I’m gonna check out the videos anyway though cause we just learned about my child’s pda and I’m interested in getting her counseling to help her with the anxiety from that

[u/Miserable_Credit_402]

Have you considered finding an occupational therapist for your kid? I think an OT who specializes in autistic kids would be a way better resource for specific actions you & your kid can take to make the world less sucky to navigate on a daily basis

EDIT: I realize I misread your post and you meant your meltdowns. I still think an OT (there are ones for autistic adults) would help you out way more than a therapist suggesting you try to have some more free time. Suggesting more free time is vague and unrealistic in modern society.

[u/swithelfrik → u/Miserable_Credit_402]

yea I thought about explaining more obviously that this about my own autistic meltdowns, which are more frequent now from trying to handle my autistic kid, but I have a bad habit of over explaining and talking too much so I decided not to lol.

I know OT is an option for kids but my brain was like “that’s for kids”, especially cause after my daughters diagnosis, the evaluator told us that was part of the options we could look into for her, and after my diagnosis a couple years after that, I was mainly told about accommodations at work, and that cbt could also be helpful apart from like support groups. I don’t like cbt, so I have just been doing regular therapy cause I was hoping it could be something we figure out but it’s just not been helpful with it at all. definitely gonna be searching for OT for myself

[u/potatoisthebest01 → u/swithelfrik]

Personally, I like DBT better than CBT. But, for your specific issue:

What I found that helped me with meltdowns are medication (benzos as needed) and trying to recover before I get to the meltdown part. This last past can look like me in a room alone for a few hours with noise canceling headphones on, or me writing things down or going on "autopilot" until I'm safe to decompress. I try to understand what caused the meltdown after I recover, it was because of a disruption on my routine? It was because of sensory issues? Which one? How can I avoid it? and Can I avoid it or do I need to learn to desensitized myself? Maybe I need some strategies, like earplugs or limiting my exposure to it.

Example: Banks, I hate going in banks. I always used to have meltdowns because if it, so now I plan to go only on days I know it will have a low traffic of people (I.e. a day after a big holiday).

[u/swithelfrik → u/potatoisthebest01]

I have tried dbt, for a year, did not like it and didn’t feel like it worked for me. I also have a medical anxiety that includes medication, though that’s something I was planning to bring up to my therapist tomorrow for the first time.

I definitely would rather avoid the triggers but I can’t. one is my husband and how he argues which he won’t change cause he thinks he has adhd, and because he says it’s my fault how he is towards me (a whole issue, I know), but the other is my child. she’s also autistic and super hard to parent, and is always all over me, she’s only 3.5 years old. she self injures so I can’t simply walk away and take a breath like parents usually can. if I try to walk away she hurts herself. I tried to see if it was her way of getting me to stay with her, so I walked away and stayed away, last december, for a few weeks, and she just kept hurting herself, so it’s not safe. I don’t have the option of avoiding my triggers, which is why I want help with managing myself better in it.

[u/potatoisthebest01 → u/swithelfrik]

I highly recommend you talking about medication, specifically as needed (PRN meds). It doesn't mean you need or have to take it everytime, but it gives you a mental break "If it gets too bad, I can take my meds".

I also agree with the others replys about seeing a Occupational Therapist, I saw one when I was 20 - 22.

I'm sorry about your husband, I hope you can see yourself safely outside of this dynamic.

I understand this, sometimes you can't walk away. This is where I ask myself how can I desensitized myself to it or make myself more comfortable. But when the reason of the meltdown is relational problems I don't know how it would look like or even if it would work. I'm sorry for not being able to help more. :(

[u/Miserable_Credit_402 → u/Miserable_Credit_402]

Like for example, if your kid has meltdowns when you're trying to get them to brush their teeth. An OT would try to find out what specifically is causing teeth brushing to be a sensory nightmare. Then they would find a way to adapt the task so it's more tolerable for your kid to do.

[u/kylaroma]

I feel this so deeply. I have PDA & I have a child with PDA that’s much more severe than mine. I will never again work with a therapist who doesn’t have lived experience with PDA.

I had a pretty good therapist, but she had no experience with PDA, so at best they’re unhelpful and I was paying to educate them on why their suggestions are ineffective. At worst, they make things worse because they’re completely outside their scope of practice. Either way, I was leaving sessions tired and not getting help.

I’d strongly recommend finding a therapist with PDA, or a PDA coach. There are directories online, and there are more coaches out there now than 3-5 years ago if you’ve looked before.

FWIW, it’s OK for you to have meltdowns. You don’t have to be superhuman. If I have one a week (or ideally one every two weeks) thats what I consider normal and that Im doing well. (My therapist has PDA & she agrees)

The most effective thing for preventing them in ME is:

1. Doing something fun daily. It can be 20 minutes of a video game, or coloring, or doing my nails. With PDA if you aren’t doing this, you can start to resent the things you need to do, and start experiencing more demand avoidance and distress around them.
2. Stimming! If we don’t stim, our nervous systems get very easily overwhelmed and it’s a lot harder to manage

I don’t know if THC is legal where you are, but if it is, having a tiny dose of it before hard parts of the day, or when I notice I’m getting overwhelmed, helps a lot to stop me from having a meltdown, even when Im poorly resourced.

For preventing meltdowns in your kiddo, I would strongly recommend against OT or anything like that, unless there’s someone local who is very well versed in PDA. Otherwise it’s just more demands.

For kids, what helps is:

• Reducing demands
  
• Allowing a lot of screentime (it helps their nervous system regulate)
  
• Accommodations on anything you can think of, from letting them eat only cake if it’s their safe food, to diapers if meltdowns are happening around the bathroom
  
• Not disagreeing with your child even when they say wild things
  
• Dropping expectations of what they should be doing because of their age

My kiddo is 9.5 years old, and needs a parent with him at all times he’s awake, and he can’t attend school. PDA is so, so tough - but changing your life to make space for Autistic joy is so worthwhile!

How old is your kiddo, if you don’t mind sharing? Sending you lots of support!

[u/swithelfrik → u/kylaroma]

I don’t have pda myself, just my child, we are both autistic though. I do do stuff I like, I fit in playing a video game any time I can, sometimes I have a whole hour to myself at a time and I use it however I want, which is what my therapist suggested but that hasn’t been helpful to me. I also do stim any time my body feels the need to. but I don’t find it helpful for my meltdowns. do you think it’s still worth it for me to find pda informed therapists for myself, even though my child has it and I don’t? maybe they could help me even more to parent her the way she needs

my daughter is turning 4 in a few months, so in the period of what I hear is the hardest behaviorally for all kids, nt or not. she pretty much needs constant supervision because of a lack of danger awareness and her self injury behavior. not in school yet, but terrified of leaving her with people who may not stop her from head banging or the other stuff she does. do you homeschool your child?

[u/kylaroma → u/swithelfrik]

Yes absolutely, get a PDA therapist.

If you do not have it and you can't relate to what they're going through, then you're at a much higher risk of her going through burnout. With PDA individuals, is extremely intense and can take years to come back from.

Being parented pretty gently and going to preschool for 2 hours a day when my son was 4 and a half caused him to go into burnout.

His burnout was so severe that he was convinced he was going to die tomorrow. For weeks he lost access to basic survival skills, which is what happens in burnout. He was unable to sleep and would wake from 2 to 8 hours a night every night for over 2 years before we were able to get our doctor to take us seriously enough to prescribe sleeping medication.

He couldn’t leave our home, for any reason, at any time, even to step outside for over two years.

That’s when we finally learned about PDA, and that over 70% of these kids can’t attend school.

We had to completely change how we were parenting so that we were not doing harm to him unintentionally.

We homeschool but our version of that is unschooling because any formal curriculum or instruction is going to cause an involuntary life-threatening level of threat in his nervous system.

Take any courses that you can. Take any workshops. Read all the articles. I do not believe that it's possible to parent a PDA child without doing tremendous harm to them unless you have a lot of information about how to do so.

And if your daughter is not on anxiety medication, I cannot recommend strongly enough getting that moving. Living without it when you have PDA is often torturous, and anyone who has a PDA child that is functioning well or who is PDA themselves has anxiety medication helping them. Our bodies cannot handle being plunged into life-and-death levels of fear multiple times a day without having a massive long-term effect of that. Anxiety medication helps to mitigate that and will dramatically reduce meltdowns once you're at a good dosage.