This girl has a history of PTSD, and a mother who has a history of giving her attention inappropriately for factitious medical ailments. Now she is in my residential program, and has been chronically complaining about various minor medical problems. When she doesn’t get the attention she feel she deserves she can become encopretic and assaultive. I have argued with the nurse about providing her access to first aid equipment so that she can minister to herself. I am worried of course about creating a dependency on these things, and that she will continue to up the ante and desire more and more intrusive medical interventions. However, nothing else has really worked, like non-reciprocation or validation. This is really the most effective way to get attention and she is loathe to give it up. I have tried these paradoxical interventions with adults but never with anyone so young. Does anyone out there have experience with such a patient? I have found nothing online.