Think I'm finally getting it

After years of therapy, counseling, testing, meds, special education, special parenting, reading, obsessing, diagnosing, experimenting, I think I'm finally getting it through my head that there is nothing new out there. There is no magical technique, approach, therapy, diagnosis, or parenting strategy that is going to fix N's functioning. For three years or thereabouts, we've been seeing the experts. We've collected diagnoses. Yet he's still just as volatile, unpredictable, and poorly regulated as he was three years ago when we started down this road. Talk therapy just doesn't work, period. Oh, I'm sure it's probably worth something for his long-term personality development, for helping him to figure out how he fits into the world. It's probably helpful in some way, eventually. But for changing the behaviors? Worthless. Money down the drain. The fact is, traditional mental health approaches really haven't done a damn thing for him, or for us. The problem is, they're all built on the assumption that what happens in the therapist's office can actually be applied outside that office. And for N., that just isn't possible, or it's rarely possible, at least. He can promise the sun, moon, and stars in therapy or even during a heart-to-heart with one or both of us or some other adult. And he means it sincerely. He can articulate what he did that was wrong, and sometimes he can even articulate WHY it was wrong. He can talk about other ways to handle the situation next time. Then he can walk out the door and thirty seconds later, do the same thing all over again. 

It's all about the processing. It just doesn't transfer, all the talk and the resolutions. When he's under any kind of stress, or when he's stuck in a mental rut, or confronted with something he misunderstands, or overwhelmed (which happens easily), it's as if he's never learned anything about "self-control" or "using your words" or blah blah blah. He reverts to the level of an angry, sometimes violent, toddler, and all that talk and work and therapy and counseling? It's inaccessible. 

We haven't called his therapist in the past couple of months, just can't justify throwing any more money her way. She's great at her job, but his brain is just not able to make use of anything they do. She makes him feel great, and he likes her, likes the games they play together, but he can come home and be just as outrageous as he was before the appointment. What good is all the self-realization in the world, and all the self-esteem and all the rest, if he ends up sending someone to the hospital or getting taken into custody? 

His brain doesn't process things in a way that the conventional mental health treatments can benefit, apparently. The meds work for a while, some of them, or seem to, anyway. Then he hits a side effect he can't handle, or it stops working. It's so discouraging that all this time and effort, and we're seemingly back where we started with him. Granted, we understand better how to manage him, his triggers, why he's doing what he does. But we can't stop it. 

So the realization has come. We don't need more therapy, more medicines, more parenting books or classes or advice. What we need is human resources--help. The only thing that helps reliably with him is direct adult supervision, preferably one-on-one. He needs this, and we are going to have to rely increasingly on other adults to manage him. Beyond that, I don't want to speculate on the future. 

It's not a knowledge problem anymore, or even a psychiatric problem, per se. It's a brain processing problem, and the only thing that is going to help in a big way, help enough to really matter, is more adult management. I think it really is just about that simple.