adoption, family, parenting, PTSD

Tales from Our Bathroom: Adventures in Trauma Triggers and PTSD

fear ladder

Playing Uno in the bathroom? Go Fish? Perhaps a bathroom snack of apples and peanut butter? Sounds great, pull up a bath mat and let’s get started! Yes, that’s me, attempting card games with Little Mary in the bathroom floor. The bathroom is one of her biggest triggers. Right now we are attempting to gradually expose her to the bathroom in a non-scary way. We need to provide this corrective experience in order to lessen her fear.

In fact, Carl and Sean have the bathroom as a trigger as well. Whatever happened to them there must have been terrifying to stay with them years after being out of their bio home. Taking a shower or a bath can cause them to re-experience the trauma they suffered in this location. Then their “fight or flight” response kicks in and they panic.

For Mary, any added stress or anxiety in her life can exacerbate her fear of the bathroom. Recently, she has been showing us her elevated fear levels by fussing and tantruming before it’s time to take a shower. Mary has also been avoiding going to the bathroom unless someone waits outside the door and talks her through it. When she is finished she flushes, jumps off of the toilet, and bolts out of the room. She refuses to wipe, but she will wash her hands in the kitchen sink.Her fears include the mirror, having the door all the way closed, being alone, and being naked.

To alleviate her fears we have implemented the following:

  1. The door is always cracked open.
  2. Someone waits outside. Sometimes all of us wait outside. And we sing silly songs loudly and off-key.
  3. We play soothing music.
  4. We send in back-up. Mermaid Barbie to the rescue.
  5. We colored all over the mirror with Crayola Window markers. We made encouraging messages and silly pictures.
  6. We taped wallet-sized pictures of me on the mirror, next to the toilet paper roll, and yes, even in the shower. That way mom can be with Mary the whole time. Creepy? Maybe. But we’ll try anything.
  7. We let her go into the shower with a dirty shirt that has been worn by either Luke or me. This way it has our comforting smell, and she has the job to “wash it.”
  8. We play car-ride type games to activate the “thinking” area of her brain, because her emotional-survival brain is taking over. My favorite is the ABC game. You take turns naming your favorite food starting with “A is for ___” Next, the other person takes a turn but they have to repeat all of the other letters and foods that have been named, before adding a new one. You have to focus on your memory, language, and coming up with a food name. This can be awesomely distracting if you can engage the child before they become too escalated.

Despite all of our interventions, Mary had an incident one day when she refused to brush her teeth. Luke and I stood outside with the bathroom door open and promised to stay with her while she went in. She couldn’t do it. She screamed like she was being murdered. As Luke attempted to talk her down from her sobs, and I attempted to comfort Carl, she switched into “flight” mode. She turned and ran across the hallway with her head down and head-butted the door to the basement. Twice. It happened so fast we couldn’t even catch her and we were right next to her. I ended up in the ER with her, making sure she didn’t have a concussion. She has a bump and a bruise, but otherwise she is physically alright. The poor thing was so scared of brushing her teeth, that she preferred a head wound.

Currently Mary is in the midst of her Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). She is writing a narrative with her therapist about the trauma she experienced in her bio home. I’m no therapist but I will try to paraphrase what I’ve learned about it. This particular kind of therapy helps the child to confront and process their past trauma with the support of a therapist. Our children’s therapist is amazing. She showed us (including Little Mary) a graph representing the research on what happens when a person represses and tries not to think about traumatic events in their past. When the past event is ignored and not thought about, temporary relief is gained. However, over time, the fear grows into epic proportions when the child is confronted with any reminders of the traumatic events. This causes all kids of maladaptive response behaviors, including Mary’s tantrums. She is a survivor and her brain’s “fire alarm” is going off, even when there is no fire. With TF-CBT, she is opening up old wounds, in order to heal them. Exposure therapy is intended to help her face her triggers, in this case, the bathroom, a little at a time.

In her last session, Mary was able to express why the bathroom was so scary. This is progress for her. Her therapist helped her to come up with a fear thermometer and a fear ladder. This helped Mary to see exactly how afraid she was in what circumstances. When Mary was able to express and quantify her feelings in this way, she gained a measure of control over her fear. A million thanks to this therapist who is putting Mary back in charge of her emotions. I believe there will come a day when she is no longer at the mercy of her past, her triggers, and her “big feelings.”

She still cries when she gets into the shower and screams for a minute before washing up. We will continue to reassure her that she is in a safe home now. Until she internalizes this safe feeling, we will be there. You can find me right outside the bathroom. Or inside, playing Hungry-Hungry-Hippo! We will take it one day at a time and we just keep working on it. She will never have to face these fears alone, ever again.

**Names have been changed to protect the privacy of those involved.

If you’ve ever considered fostering or adopting, I encourage you to start your adventure, today!

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3 thoughts on “Tales from Our Bathroom: Adventures in Trauma Triggers and PTSD

  1. Pingback: The “Do-Over” that Didn’t | Herding Chickens and Other Adventures in Foster and Adoptive Care

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