Regression

This section is for questions relating to therapy, assessment, formulation and other aspects of working with people in mental health services.

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chixta
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Regression

Post by chixta »

Hi all,

A friend of mine has been sectioned as she has regressed to age 7/8. I don’t know lots about regression in adults, but I’m assuming it’s a response to feeling overwhelmed and stressed in her day to day life. She’s had mental health issues before including depression and anorexia. Does anyone have any general tips on how to approach this issue ? We want to go and visit her but currently she doesn’t have capacity to even agree to see her husband. I’m feeling that surely seeing familiar people would be helpful for her but I feel I’m up against the system. She’s in an out of area hospital and I can’t imagine how frightened she must feel. Any advice/suggestions/support? Thanks all x
lingua_franca
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Re: Regression

Post by lingua_franca »

I'm sorry she's struggling so much at the moment. This must be frightening and overwhelming for her and for you all. I don't think I'm qualified to give much advice, as I've only seen this in children, but one thing I would say is to be cautious of thinking of her as having regressed to a particular age. As Winnicot pointed out, development is not a rigid linear process, and all of us can and do revisit those earlier 'parts' of ourselves - it's not the case that either you're an adult woman, or you're mentally 7 or 8. Your friend the adult woman is still present.

Regarding the visiting, I definitely don't feel qualified to comment. I hope that you're able to see her soon, or at least hear some reassuring news.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
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ell
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Re: Regression

Post by ell »

Is there a patient and liaison advice service at the hospital, they may be able to give specific advice on liaising with the hospital in question?

Sounds a really difficult situation for all involved, I hope your friend gets the support and help she needs.

(Edited to remove comments on particular situation, as we cannot offer advice re personal mental health circumstances on the forum.)
alexh
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Re: Regression

Post by alexh »

The next of kin has rights under the MHA. Even where capacity is lacking a best interest decision could easily be made wrt to seeing husband and friends.
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miriam
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Re: Regression

Post by miriam »

Just sending good wishes, as we can't really offer advice about a specific individual. However, perhaps phoning Mind or other mental health charities would help you think about the available options?
Miriam

See my blog at http://clinpsyeye.wordpress.com
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chixta
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Re: Regression

Post by chixta »

Sorry I think I was unclear in what I was asking. I don’t want specific advice on her (I’ve omitted loads of info to keep it confidential but perhaps not enough...) I’ve never worked with adults who have regressed before, so my question was more about how do I respond to her? What’s the best way to generally speak to her - as the 7 yo or as an adult? This is not a clinical case, this is a friend but being the psychologist in the friendship group, everyone keeps asking my advice and I really don’t know! General advice /websites/references welcome. Thanks
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Geishawife
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Re: Regression

Post by Geishawife »

I'm not sure if this will be helpful as, like you, I've not worked with adults who have regressed. I have, however, worked with many older people with dementia who can appear to be "regressing" as the disease progresses. One approach that I have found helpful is validation. Put simply, validation looks at the message that is being given by the person, rather than the specific content. So, for example, a person saying they are 7 and at school and when will mum collect them could be relaying the message that they are scared and vulnerable and mum represents security. So, when talking, you don't see the person as either the adult or the child but talk more generally around what's being said - "Tell me about your mum" rather than "You're not 7 and your mum's dead". That's a VERY simplistic outline, but it might be worth exploring? Naomi Feil's work is worth looking at. It's not new, but I have found it a gentle and supportive approach. I hope your friend is OK.
alexh
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Re: Regression

Post by alexh »

Detained patients have a right to visitors under the MHA unless there is a clinical or security objection. Patients lacking capacity similarly do not forego their rights to visitors simply because they cannot consent to seeing under the MCA. They should in general have visitors unless it is thought to not be in their best interests, for example that it evidently causes great distress, or the patient has indicated in some way that suggests some unwillingness to be visited. That's because the alternative, denying visiting due to a lack of capacity to consent to it, would be ludicrously unjust and harmful.
Unfortunately you will quite possibly find significant confusion, particularly about the MCA, within services.
You could see as an example how Sussex Trust's policies deal with some of these issues. https://policies.sussexpartnership.nhs. ... nts-policy If you have trouble visiting then, as suggested above, PALS should be able to assist.

I find it curious that they have been detained 'for regressing' but maybe this is not the place to get into that and there is likely more to it that you have omitted to protect their confidentiality.

As to the interaction itself, I expect you and others will find it much less difficult in person than you anticipate, particularly if you retain a flexible approach rather than any fixed idea of how you should respond. The general rule of 'meet the person where they are' is normally helpful in confusing situations. I would start from a position of treating them as an adult who is trying to cope with a severe difficulty through this coping response rather than treating them as a child per se.
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miriam
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Re: Regression

Post by miriam »

chixta wrote: Mon Apr 26, 2021 11:22 pm Sorry I think I was unclear in what I was asking. I don’t want specific advice on her (I’ve omitted loads of info to keep it confidential but perhaps not enough...) I’ve never worked with adults who have regressed before, so my question was more about how do I respond to her? What’s the best way to generally speak to her - as the 7 yo or as an adult? This is not a clinical case, this is a friend but being the psychologist in the friendship group, everyone keeps asking my advice and I really don’t know! General advice /websites/references welcome. Thanks
I'm really sorry to be a pedant, but this is asking for advice on a specific person, and is outside the role of the forum. Maybe if we move it to the qualified section for peer consultation you'd get more support, and it wouldn't feel as much like *professional advice in the absence of personal knowledge of the case* which is what we are struggling with.

But as a general principle I'd agree with Geishawife that I'd respond to the underlying emotion being expressed, and not the specifics of her "age" or content that isn't contextually appropriate at a factual level. So I'd tell her that you care about her, and are sad to see her in such distress, and that you understand she needs looking after rather than to feel responsible for others at the moment, rather than trying to challenge how she is currently expressing her needs, or trying to interact with her as you would with a child. I'd focus on her being a person in distress that you care about, rather than trying to respond to her as an adult or a child.
Miriam

See my blog at http://clinpsyeye.wordpress.com
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nettyb
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Re: Regression

Post by nettyb »

I do a significant amount of work with clients who present with dissociation, who would very much meet criteria for DID, some of whom have been admitted to acute wards when dissociated and presenting as younger than chronological age. The general advice within this field is to communicate with the adult part of her but absolutely validate the feelings and concerns of the younger parts. I hope your friend is back home very soon.
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