We are busily interacting with a new care team, and getting a very different perspective. The new team, consisting of a therapist as well as TBS therapists, a psychologist and soon, a new psychiatrist, are offering an amazing level of support. Our journey will be an uphill battle, but I'm holding out for greatly improved function for Lily and more balance for our family.
One of the keys to this new approach will be the guidance I receive so that I can more effectively help Lily. Holding appropriate boundaries, helping her to see that she isn't powerless in her disorder, but that she is strong enough to effect a different outcome. I've been working on some of these boundaries for awhile, and I have to acknowledge that it's hard for Lily when I change the rules. Still, I'll continue, and I'll keep explaining to Lily as we go along why I'm making the decisions that I am. It's not a lack of love that influences my decision to enforce a boundary, rather it's the strength of my love that allows me to make a change that's hard, that makes Lily unhappy.
In the end I simply want our whole family to function in a healthy, more free way. A better environment will help heal Lily's relationships with the family and will lower my stress level.
Towards that end, I returned to school this week and am still working on getting Lily's school placement organized. For me, it felt amazing to get back to the university. The drive over was beautiful, focusing on fine tuning my schedule and contemplating the material I'll be studying was great. I even have a social dance class for my PE requirement. I was intimidated, but it seems like it'll be low key and fun. I love dance, and I have no illusions about being a competitive ballroom dancer, but I love the movement, rhythm and joy of a waltz or the hustle. Two sides of a coin.
I'm going to consider this a move towards getting our lives back. I know there will be challenges, but if I've learned anything this past year, it's that we don't want to stay on the path we were walking, and I refuse to believe we can't do anything to make it better. Yes, we can.
Friday, August 26, 2011
Saturday, August 6, 2011
Wonder of Wonders
I was concerned about Lily's cycling early in the week - but things are markedly better. Whew! We haven't had to add in the Zyprexa, and I'm hoping that her current med cocktail is therapeutically building up in her system. Because we went up to 50 mg of Lamictal, Lily is a little rashy. We'll treat that with Benadryl and watch to see if she adjusts and that improves. Fingers crossed here.
More good news is that we are scheduled to have therapeutic behavior services come in next week, and we are being offered family partnership services as well. I may get some respite care, which would be such a welcome blessing.
More evidence of Lily's continued improvement: Lily has been talking to her brother and doing fun things with him. They're getting along better than they have in more than a year. No matter how long it lasts, it's a great sign, and so healing!
Best of all, Lily has had these lovely periods of smiling and laughing this week. At first it looked like it was tied in to some mania, but as that has subsided, the smiles and laughter have surfaced again. Yes among tears, but still . . .
I am counting my blessings today.
More good news is that we are scheduled to have therapeutic behavior services come in next week, and we are being offered family partnership services as well. I may get some respite care, which would be such a welcome blessing.
More evidence of Lily's continued improvement: Lily has been talking to her brother and doing fun things with him. They're getting along better than they have in more than a year. No matter how long it lasts, it's a great sign, and so healing!
Best of all, Lily has had these lovely periods of smiling and laughing this week. At first it looked like it was tied in to some mania, but as that has subsided, the smiles and laughter have surfaced again. Yes among tears, but still . . .
I am counting my blessings today.
Tuesday, August 2, 2011
Ouch!
We're suddenly in the midst of some big mood swings, seeing laughter one day and tears all day on the next. We had cut out all Zyprexa and titrated up to 3 mg of Risperdal. Lily is also having panic attacks multiple times a day. I feel so bad for her, and once again so powerless to reach her. When she's in this space, her health fears take over as well. So - we're off to our family doctor tomorrow to reassure Lily that her heart is healthy and the scary symptoms she's having are only temporary and will be manageable.
I had an interesting conversation with DocD last week about Lily's transition to the new care team. She shared what she most wants us to be able to share with the new psychiatrist, including tracking the psychosis with anxiety, indicating that the hallucinations may have been a function of the mood disorder as opposed to schizoaffective disorder. I dearly, dearly hope so.
I asked her for her thoughts on Lily's continued struggle with auditory sensitivity, and she said she sees that as an adhd symptom, not being able to filter out background noises. I finally understand why she prescribed the Intuniv! That sounds bad, and it's not like we didn't discuss the benefits of Intuniv before starting Lily on it, but her explanation at the time was that it would help with the anxiety.
I'm reminded again that this psychiatrist has been more in tune with what's going on with Lily than I realized, but her communication with me, even when I asked what she thought, was very limited. I think she was being cautious, wanting to see what would happen with Lily over a longer period of time. The difficulty was that I was living with the fear and stress that came with trying manage Lily's illness while handling a life beyond the illness. Work, bills, other kids, housework . . . And nothing can compete with handling someone in full psychosis, so most of the regular day to day stuff went by the wayside.
So, my lesson about this is, treatment for an individual with mental illness has to include the family. My ability to help my daughter has absolutely been influenced by the other needs and stresses in my world. I need to be calm, strong, and not distracted, in order to take the very best care of Lily. Family support is one piece that has been missing this long year.
Finally, I'm worried that these mood swings will interfere with the start of the school year, for both Lily and I. I'm trying to get back in to finish my degree this year. And I so want some normalcy for Lily. I sound like a broken record. The truth is that I want her to feel stronger, more capable, proud of herself. She's an awesome, beautiful, talented girl. I want her to be able to feel that. And yes, I want to be able to move forward for my own benefit as well.
An option for Lily, if things destabilize further, would be to add some Zyprexa back in during this transition. Lily is opposed to that, but I swear if she shows signs of mania, I'll force the issue before I'll leave her at risk to be hospitalized again.
I had an interesting conversation with DocD last week about Lily's transition to the new care team. She shared what she most wants us to be able to share with the new psychiatrist, including tracking the psychosis with anxiety, indicating that the hallucinations may have been a function of the mood disorder as opposed to schizoaffective disorder. I dearly, dearly hope so.
I asked her for her thoughts on Lily's continued struggle with auditory sensitivity, and she said she sees that as an adhd symptom, not being able to filter out background noises. I finally understand why she prescribed the Intuniv! That sounds bad, and it's not like we didn't discuss the benefits of Intuniv before starting Lily on it, but her explanation at the time was that it would help with the anxiety.
I'm reminded again that this psychiatrist has been more in tune with what's going on with Lily than I realized, but her communication with me, even when I asked what she thought, was very limited. I think she was being cautious, wanting to see what would happen with Lily over a longer period of time. The difficulty was that I was living with the fear and stress that came with trying manage Lily's illness while handling a life beyond the illness. Work, bills, other kids, housework . . . And nothing can compete with handling someone in full psychosis, so most of the regular day to day stuff went by the wayside.
So, my lesson about this is, treatment for an individual with mental illness has to include the family. My ability to help my daughter has absolutely been influenced by the other needs and stresses in my world. I need to be calm, strong, and not distracted, in order to take the very best care of Lily. Family support is one piece that has been missing this long year.
Finally, I'm worried that these mood swings will interfere with the start of the school year, for both Lily and I. I'm trying to get back in to finish my degree this year. And I so want some normalcy for Lily. I sound like a broken record. The truth is that I want her to feel stronger, more capable, proud of herself. She's an awesome, beautiful, talented girl. I want her to be able to feel that. And yes, I want to be able to move forward for my own benefit as well.
An option for Lily, if things destabilize further, would be to add some Zyprexa back in during this transition. Lily is opposed to that, but I swear if she shows signs of mania, I'll force the issue before I'll leave her at risk to be hospitalized again.
Tuesday, July 26, 2011
Our Mixed Bag
We're transitioning to a new care team for Lily - and I'm very happy about our first contact. We met with a fabulous district psychologist for an assessment in order to access mental health resources through our public school district. The end goal is to help Lily be successful in school. She's extremely bright, and she has high academic expectations for herself.
Last year was so hard on so many fronts. And yes - we're still struggling in many ways, Lily won't/can't stay alone, her anxiety is still sky high, her auditory sensory issues are worse, as are her fears about meat contamination. But her psychosis symptoms occur rarely, and her mania is nearly non-existent. Best of all, she hasn't required hospitalization since last October.
The transition to a new therapy/psychiatry team is long overdue when I evaluate Lily's level of functionality. But like Lily's academic expectations, my expectations for therapy and psychiatry are high. Lily and the rest of us still desperately need to make progress and develop a more workable day to day existence.
I've left my job so that I can care for her, but will not be able to do that indefinitely. Nor am I the best candidate to facilitate Lily's progress. I can do my part on the home front, trying to keep things calm and help her feel safe. But she needs, or maybe I need her, to be able to function in a world outside our doors. And yes, the truth is that I very much need to have a life outside our home. I'm suffering from cabin fever because Lily is still on crutches and hates to be outside. I'm happiest outside.
So, my hope is that we can help Lily feel capable of attending school, getting out with friends, doing some of the normal things a 14 year old does. Gain some level of independence. I'm hoping against hope that's not too much to ask. Please, please, don't let that be too much to ask.
This is where I have a small concern about the psychologist from the district. In discussing options for school this fall, she kept going back to homeschooling. That's not an option for me, not a good option for Lily. Certainly not the best way for Lily to get a good education. I understand many amazing parents home school. Hats off to them. But I can't do that. I can't stay home, indoors, isolated, out of work, with an unfinished degree, and do a good job of educating Lily. I'll crash and burn.
So, here's to hoping Lily's new team, with some calm and smart advocate action on my part, will help her make the progress we all need her to make. If we fall short here, I'll have to find a way to get some respite time. I've been fighting that, afraid of setting Lily back if she doesn't feel safe and happy, but I'm teetering on the edge, hanging on because I see relief possibilities with the new resources.
Last year was so hard on so many fronts. And yes - we're still struggling in many ways, Lily won't/can't stay alone, her anxiety is still sky high, her auditory sensory issues are worse, as are her fears about meat contamination. But her psychosis symptoms occur rarely, and her mania is nearly non-existent. Best of all, she hasn't required hospitalization since last October.
The transition to a new therapy/psychiatry team is long overdue when I evaluate Lily's level of functionality. But like Lily's academic expectations, my expectations for therapy and psychiatry are high. Lily and the rest of us still desperately need to make progress and develop a more workable day to day existence.
I've left my job so that I can care for her, but will not be able to do that indefinitely. Nor am I the best candidate to facilitate Lily's progress. I can do my part on the home front, trying to keep things calm and help her feel safe. But she needs, or maybe I need her, to be able to function in a world outside our doors. And yes, the truth is that I very much need to have a life outside our home. I'm suffering from cabin fever because Lily is still on crutches and hates to be outside. I'm happiest outside.
So, my hope is that we can help Lily feel capable of attending school, getting out with friends, doing some of the normal things a 14 year old does. Gain some level of independence. I'm hoping against hope that's not too much to ask. Please, please, don't let that be too much to ask.
This is where I have a small concern about the psychologist from the district. In discussing options for school this fall, she kept going back to homeschooling. That's not an option for me, not a good option for Lily. Certainly not the best way for Lily to get a good education. I understand many amazing parents home school. Hats off to them. But I can't do that. I can't stay home, indoors, isolated, out of work, with an unfinished degree, and do a good job of educating Lily. I'll crash and burn.
So, here's to hoping Lily's new team, with some calm and smart advocate action on my part, will help her make the progress we all need her to make. If we fall short here, I'll have to find a way to get some respite time. I've been fighting that, afraid of setting Lily back if she doesn't feel safe and happy, but I'm teetering on the edge, hanging on because I see relief possibilities with the new resources.
Thursday, July 14, 2011
Frustration, Resentment, Surrender
Just when I think things are good - I get a reality check. I finished my sunshine post earlier this evening and went into dinner/evening activities. Feeding animals, getting the bunny out for his exercise, getting out the separate meals for the vegetarian and non-vegetarians . . .
Lily started too get sort of whiny - I imagine she's feeling frustrated and down, getting a little bored and feeling neglected by friends. I get that, I can sympathize and problem solve. We agreed to call friend A and set up a fun day for next week. But then she started in on her brother. She doesn't want him to clap, make funny kitty sounds, typical annoying little brother stuff.
OK. There ideally would be some negotiating, some compromise. But they're siblings, only 16 months apart in age. She yells, cries, whines, he responds by doing more of what she doesn't want him to do, neither one listens to me, Lily works herself up into a case of hysterics. At some point I get him to back down and her to calm down.
By now I've chased the bunny around because he doesn't want to go back up to his cage, he wants to hang out and play with the cat - and - poop all over my living room. As I'm working on luring bunny up the stairs with some fresh romaine, Lily is deciding she's hungry again. About two hours after I've cooked a full meal. I offer foods easy to get out, fresh peach, instant organic oatmeal. Nope, she doesn't want those. Saltines? She doesn't like them. She wants stir fried carrots. It's going on 10:00 PM. I don't want to stir fry carrots. I again offer other easy choices. Lily wants none of them. Lily is hungry, and wants only stir fried carrots. If she doesn't get her carrots she's going to fall apart. Loudly.
I'm trying to hold this boundary. I've been fetching and cooking and doing for Lily all day. Since she got up at 8:00 AM.
Lily says she'll cook the carrots herself. I say fine. I'm going to get ready for bed. But Lily can't slice carrots while she's on crutches. I grudgingly slice carrots and announce I AM GOING TO BED. Lily crutches her way into the kitchen and asks me to get out the garlic press. I tell her to get it out herself because if she can stir fry she can certainly get out the garlic press. I'm regressing into my own adolescent huff. Ugly.
Lily gets out the garlic press and tries to manage it while balancing on her crutches. She does not want to do this. She wants me to give in. She cries. She drools on the floor while crying. She's very good at this whole routine. I know, because I was also very good at it once upon a time. See me, I'm sad, I need someone to care enough about me to do this for me. If you don't do this, you don't love me enough.
I do realize Lily's mental illness issues influence her distress. But again, there has to, has to, be a way to hold appropriate boundaries so that her brother and I maintain some sense of sanity. I've written about this many times. We keep coming back to it, because when I do try to hold a boundary and I see her falling apart, I do give in. But not graciously. With frustration and resentment and then, with remorse that I wasn't gracious and cheerful about meeting needs beyond what my energy level seems able to support.
So I stir fried carrots and complained and scowled. I vigorously brushed my teeth and made my displeasure known as I got ready for bed. And I felt awful.
I gave in, and then proceeded to make Lily feel bad about my choice. Some days I manage with so much more patience. I love this kid. And some days I'm the last person she needs in her space. I would never intentionally do something to hurt her, but my frustration and inability to maintain rational actions on my tired days do hurt her.
I spent a few minutes on my bed, trying to be still and regain a sense of calm. I went back out to talk to Lily, just to remind her that when I get upset it doesn't mean I don't love her, that I do in fact love her. I make sure she's settled in and I gently touch her soft brown head before heading back to my room.
Tomorrow morning I'll again ask the universe to give me the strength and patience to be a good parent to Lily and her brother. I gave up my childhood Catholic prayers many years ago. My belief system fell apart. But I have a huge need to reconnect with that part of myself that could find comfort in surrender.
Some Sundays I'm sorely tempted to drive up and park outside a church just to hear the music. I can't bring myself to walk in and declare a belief I no longer hold. But I sure don't have any answers now, so why not take comfort where I can find it?
Lily started too get sort of whiny - I imagine she's feeling frustrated and down, getting a little bored and feeling neglected by friends. I get that, I can sympathize and problem solve. We agreed to call friend A and set up a fun day for next week. But then she started in on her brother. She doesn't want him to clap, make funny kitty sounds, typical annoying little brother stuff.
OK. There ideally would be some negotiating, some compromise. But they're siblings, only 16 months apart in age. She yells, cries, whines, he responds by doing more of what she doesn't want him to do, neither one listens to me, Lily works herself up into a case of hysterics. At some point I get him to back down and her to calm down.
By now I've chased the bunny around because he doesn't want to go back up to his cage, he wants to hang out and play with the cat - and - poop all over my living room. As I'm working on luring bunny up the stairs with some fresh romaine, Lily is deciding she's hungry again. About two hours after I've cooked a full meal. I offer foods easy to get out, fresh peach, instant organic oatmeal. Nope, she doesn't want those. Saltines? She doesn't like them. She wants stir fried carrots. It's going on 10:00 PM. I don't want to stir fry carrots. I again offer other easy choices. Lily wants none of them. Lily is hungry, and wants only stir fried carrots. If she doesn't get her carrots she's going to fall apart. Loudly.
I'm trying to hold this boundary. I've been fetching and cooking and doing for Lily all day. Since she got up at 8:00 AM.
Lily says she'll cook the carrots herself. I say fine. I'm going to get ready for bed. But Lily can't slice carrots while she's on crutches. I grudgingly slice carrots and announce I AM GOING TO BED. Lily crutches her way into the kitchen and asks me to get out the garlic press. I tell her to get it out herself because if she can stir fry she can certainly get out the garlic press. I'm regressing into my own adolescent huff. Ugly.
Lily gets out the garlic press and tries to manage it while balancing on her crutches. She does not want to do this. She wants me to give in. She cries. She drools on the floor while crying. She's very good at this whole routine. I know, because I was also very good at it once upon a time. See me, I'm sad, I need someone to care enough about me to do this for me. If you don't do this, you don't love me enough.
I do realize Lily's mental illness issues influence her distress. But again, there has to, has to, be a way to hold appropriate boundaries so that her brother and I maintain some sense of sanity. I've written about this many times. We keep coming back to it, because when I do try to hold a boundary and I see her falling apart, I do give in. But not graciously. With frustration and resentment and then, with remorse that I wasn't gracious and cheerful about meeting needs beyond what my energy level seems able to support.
So I stir fried carrots and complained and scowled. I vigorously brushed my teeth and made my displeasure known as I got ready for bed. And I felt awful.
I gave in, and then proceeded to make Lily feel bad about my choice. Some days I manage with so much more patience. I love this kid. And some days I'm the last person she needs in her space. I would never intentionally do something to hurt her, but my frustration and inability to maintain rational actions on my tired days do hurt her.
I spent a few minutes on my bed, trying to be still and regain a sense of calm. I went back out to talk to Lily, just to remind her that when I get upset it doesn't mean I don't love her, that I do in fact love her. I make sure she's settled in and I gently touch her soft brown head before heading back to my room.
Tomorrow morning I'll again ask the universe to give me the strength and patience to be a good parent to Lily and her brother. I gave up my childhood Catholic prayers many years ago. My belief system fell apart. But I have a huge need to reconnect with that part of myself that could find comfort in surrender.
Some Sundays I'm sorely tempted to drive up and park outside a church just to hear the music. I can't bring myself to walk in and declare a belief I no longer hold. But I sure don't have any answers now, so why not take comfort where I can find it?
A Good Week!
Considering this is my first official month of retirement, it's been awfully busy. But we're getting so much done - it's both exhausting and exhilarating. I have health benefits through the end of the month, so all medical, dental and vision check ups have been in full swing. Vaccinations, fillings, crowns . . . we're happy to be getting that stuff done. Strange, I know.
But the best news for now is that I had an intake with the county psychiatrist to push through an evaluation for Lily in connection with her IEP. This professional was wonderful - insightful, patient, thorough. She indicated she'd push for an extradited process because she knows we're trying to get Lily's psychiatric care set up for continuity as we change health plans on August 1. She offered to help. Offered. I went a little crazy and got a mocha frappuccino to celebrate on my way home!
Being busy has been a blessing in some ways. Lily will be on crutches for another 4 weeks, she needs to be kept occupied, and I'm dying to get out of the house. We've been so busy running off to appointments that we haven't had time to dwell on any of that. I still have creative/summery things I'd like to do before we're all back in school, but I'll have to be patient about fitting in those fun projects.
Lily is more calm these days, perhaps a result of the introduction of Risperdal as we titrate down on Zyprexa. She still gets anxious about what school she'll go to this fall, she wants answers now. Gee, where'd she get that?
What I know for sure, is that in this moment, on this day, we're OK. I'll take that.
But the best news for now is that I had an intake with the county psychiatrist to push through an evaluation for Lily in connection with her IEP. This professional was wonderful - insightful, patient, thorough. She indicated she'd push for an extradited process because she knows we're trying to get Lily's psychiatric care set up for continuity as we change health plans on August 1. She offered to help. Offered. I went a little crazy and got a mocha frappuccino to celebrate on my way home!
Being busy has been a blessing in some ways. Lily will be on crutches for another 4 weeks, she needs to be kept occupied, and I'm dying to get out of the house. We've been so busy running off to appointments that we haven't had time to dwell on any of that. I still have creative/summery things I'd like to do before we're all back in school, but I'll have to be patient about fitting in those fun projects.
Lily is more calm these days, perhaps a result of the introduction of Risperdal as we titrate down on Zyprexa. She still gets anxious about what school she'll go to this fall, she wants answers now. Gee, where'd she get that?
What I know for sure, is that in this moment, on this day, we're OK. I'll take that.
Monday, July 4, 2011
Freedom As Motivator
Well. We're floundering again. Lily sprained her foot and is prohibited from putting any weight on said foot for 6 weeks. We're halfway through, but the restrictions are making all of us bonkers.
I was able to get a used wheelchair for longer treks as Lily can't manage crutches for more than short distances. I imagined long walks on the cliffs, museum visits, getting out and about. But it's out of Lily's comfort zone. When outdoors, Lily becomes hysterical if she sees bees or other flying insects nearby.
Lily likes shopping. She's up for a trip to the mall, and loves to go to the market. Here's the but. She doesn't like to wheel herself around in her wheelchair. It's not easy, so I've been pushing the chair when we're out. Which is mostly okay, unless I also am managing a shopping cart. I'm a Dr. Seuss push-me-pull-me, live action model. The other shoppers don't appreciate my predicament. I'm in their way.
My crankiness meter is on the upswing. My bad mood doesn't help Lily.
So it's easier to stay home. But, here comes another but, I'm lousy at setting healthy boundaries for my kids. So, I fetch and open doors and turn lights off and on all day and well into the night. Crutches plus OCD equals a level of disability I'm not prepared for. I'm awful at this.
It comes down to expectations. I had expectations of afternoons at the beach, excursions to the public tennis courts and swimming pool, visits to the library and lots of walking. Notice that most of those activities are outdoors, because I love being outside. I'm an outie. Lily is an innie. These expectations are unrealistic. I do however, believe in the power of negotiation, and an occasional parent directive for the well being of all.
Positive expectations for Lily's behavior are also in order. We're working on putting those boundaries in place. She can't carry something heavy while navigating on crutches, but she can open household doors and turn lights off and on. She has disinfectant wipes and rubber gloves to manage her germ phobias. She's trying.
The efforts include modifying behavior towards others. Lily is always hardest on her younger brother. I've been consistently stopping her when she's unkind or unreasonable. She gets pretty angry and needs an outlet, so it's time to get creative again. Lily is extremely verbal, so a new journal may be in order. I obviously believe in the power of the written word when the need to vent arises.
Because she's fourteen, I run the risk of discouraging her by suggesting something, but I don't know how to manage this without being direct. But this is a great tool, and she can be in complete control of what she expresses on the paper, no limits. Maybe that will appeal to her because it would be private and uncensored. Let freedom ring.
I was able to get a used wheelchair for longer treks as Lily can't manage crutches for more than short distances. I imagined long walks on the cliffs, museum visits, getting out and about. But it's out of Lily's comfort zone. When outdoors, Lily becomes hysterical if she sees bees or other flying insects nearby.
Lily likes shopping. She's up for a trip to the mall, and loves to go to the market. Here's the but. She doesn't like to wheel herself around in her wheelchair. It's not easy, so I've been pushing the chair when we're out. Which is mostly okay, unless I also am managing a shopping cart. I'm a Dr. Seuss push-me-pull-me, live action model. The other shoppers don't appreciate my predicament. I'm in their way.
My crankiness meter is on the upswing. My bad mood doesn't help Lily.
So it's easier to stay home. But, here comes another but, I'm lousy at setting healthy boundaries for my kids. So, I fetch and open doors and turn lights off and on all day and well into the night. Crutches plus OCD equals a level of disability I'm not prepared for. I'm awful at this.
It comes down to expectations. I had expectations of afternoons at the beach, excursions to the public tennis courts and swimming pool, visits to the library and lots of walking. Notice that most of those activities are outdoors, because I love being outside. I'm an outie. Lily is an innie. These expectations are unrealistic. I do however, believe in the power of negotiation, and an occasional parent directive for the well being of all.
Positive expectations for Lily's behavior are also in order. We're working on putting those boundaries in place. She can't carry something heavy while navigating on crutches, but she can open household doors and turn lights off and on. She has disinfectant wipes and rubber gloves to manage her germ phobias. She's trying.
The efforts include modifying behavior towards others. Lily is always hardest on her younger brother. I've been consistently stopping her when she's unkind or unreasonable. She gets pretty angry and needs an outlet, so it's time to get creative again. Lily is extremely verbal, so a new journal may be in order. I obviously believe in the power of the written word when the need to vent arises.
Because she's fourteen, I run the risk of discouraging her by suggesting something, but I don't know how to manage this without being direct. But this is a great tool, and she can be in complete control of what she expresses on the paper, no limits. Maybe that will appeal to her because it would be private and uncensored. Let freedom ring.
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