Last week was a difficult one for Karen, and for all of us. Without going into the details, her school called us on Tuesday to pick her up at around 10 am after she behaved horribly and nearly caused a riot in class. I kept her home from some of her after school programs and she spent most of the week thinking about her behavior and how disappointed we are that she hasn’t been able to maintain a moderate level of equanimity regardless of what we and the school try. Almost 2 years of therapy, hard work on our part and on hers, and still, she lost control and continues to lose control when she thinks she’s being slighted or attacked. She perceives slights even if another student gives her a “look”.

In spite of the situation at school, she’s been a real joy at home. It’s almost as if she needs to get the anger out. Either she releases it at school, and then can be more relaxed at home, or else she holds it in all day, and then takes it out on me when I pick her up.

It’s so hard for her. She clearly made a huge effort to control her behavior for several weeks leading up to her birthday. She knew that if there were any major problems, we would cancel the party. Now that her birthday is over, it seems her incentive is gone. She is an excellent student and is reading well and even began doing multiplication this week. The school seems at a loss as to how to deal with her. I think they are also finding it very confusing to see a girl who excels at school, yet who sometimes reacts violently to the smallest slight.