adoption, family

Drowning in Trauma

He puts his little 10-year-old hand into my hair and fiddles around with the curls. He’s smiling at me and watching the long strands of hair boing back when he tugs. We are giggling and being silly.  Little Carl looks into my eyes and twists one strand around a finger. He tugs gently but steadily. Something changes in his eyes. He is looking at me intently. He pulls hard and firm on the strand of hair. I gasp and throw up a hand over my scalp as he yanks the strand right out of my head.

“No, Carl. That hurts. We have gentle hands,” I admonish in a firm yet bewildered voice. He is smiling.

My husband walks over and Carl immediately falls to the ground wailing, “She hates me! She won’t even let me near her! She never loves me! All she does is yell at me!” He screams and thrashes around. Then he slams both fists on the seat and runs off.

It’s been weeks now. Weeks of leaving bruises on my arms from where he has “snuggled” me. Strangers exclaim about how loving he is. How sweet he is to me. He climbs into my lap smiling. He yanks my arms around him and then digs his fingernails into the soft flesh of my forearms. “What an affectionate child” I hear. They don’t see me bleed.

He has started to hurt his sister. He swears at her and shoves her down. He tries to bend her to his will. He does the same with me. A “no thank you” or “perhaps later” response is met with threats from him. When asked why he threatened to hurt his sister or why he punched her or kicked her or shoved her he shrugs. “She deserved it” he says.

There is violence from him. So much violence. He rages and screams and yells. He breaks apart his room and the house. He hurts me. He hurts his sister. Then he screams at us some more because after all, this is our fault. Women should listen.

When my husband is not around he will let me know that I am going to “learn my lesson.” He holds a fist to my face and steps forward. I stand my ground and repeat that I will not allow hurts in this family. We are a safe family. This is a safe house.

Only, I’m not telling the truth. Not really. Because we aren’t a safe house at the moment. We are a house caught in the past trauma of a 10-year-old boy. He is reliving the domestic abuse suffered at the hands of his biological family. As he faces these things in trauma therapy, he becomes caught in the past.

No longer is Carl the tiny boy being whipped with the metal of a belt buckle. No longer is he the victim of multiple men telling him to “learn his lesson” or that he/his siblings “had it coming.” Now he is bigger and stronger. Now he feels safer not being preyed upon. Now he has taken on the role of the aggressor. If only he can control his environment, he will feel safe.

But love is never safe. Falling in love means taking a risk that you could be hurt. “It’s ok to love us,” I want to tell him. “It’s ok to trust that we won’t hurt you.” I want to tell him. I do not say these things. He wouldn’t listen right now. He cannot hear a mother’s words. To him, in this moment, they are the words of the enemy.

Instead I wait. I pray. I try not to drown in the deep waters of his trauma. He has an intake tommorow for a partial hospitalization placement. I hope it will help us. It isn’t just the trauma’s effects on a little boy anymore. Right now our whole family could use a lifeline. We are drowning.

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family

Reactive Attachment Disorder: Who Cares?

RAD, PTSD, ODD, ADHD, BP, BPD, SPD…who cares? Children from hard places come with a veritable alphabet soup of labels and diagnosis. The one thing these kids have in common is trauma. It’s tough for them. It’s tough for us. It’s tough all the way around. So my question is simple. Why do we care so much about Reactive Attachment Disorder? Why should we care about RAD?

Way back in the early 1900s B. F. Skinner, a behaviorist, was studying human behavior. He placed an infant known as “Baby Albert” in a small empty room. Then he put in a little white rat. At first, the baby delighted in the soft fascinating creature. Then, Skinner began to pair the entrance of the rat  with a loud, frightening noise. Pretty soon, Baby Albert was terrified of the rat even without any paired noise. He was also afraid of other white creatures, such as a bunny, even when there was no longer any sound. Skinner called this fear of other similar objects, “stimulus generalization.” The child was afraid of things that had not been part of the initial traumatizing experience.

I’m simplifying it, of course, but my point remains. When you teach a child to fear something, or that something is unpleasant and uncomfortable, they will believe it. Kids coming from scary caregiver situations will soon generalize this fear to other caregivers. It takes a long time for the fear to go away. Therapists describe attachment challenges as falling into categories. There are some estimates that place about 80% of kids coming into foster care as having what is referred to as “disorganized attachment.” This basically means that the child has no consistent response to caregivers. they may react with fear and/or avoidance when presented with a caregiver. they may become distraught and afraid when that caregiver leaves. I’ve often heard of it referred to as sort of a “push-pull” situation where the child pushes the caregiver away but then desperately tries to pull them back in.

Kids in the foster care system are also more likely than a returning US war veteran to experience symptoms of PTSD. Think about it. Just being ripped from their biological family and everything they know is traumatizing. They are grieving a huge loss. Add to that any neglect or abuse and it is no wonder they are experiencing distress.

What does this all have to do with the DSM-V label of “Reactive Attachment Disorder?” Well, the diagnosis for this has changed. It used to be listed under “disinhibited” and “inhibited” types. Now it seems that only inhibited type is in the manual, and the disinhibited type moved into another disorder known as “Disinhibited Social Engagement Disorder” which may or may not have any prior caregiver-related trauma. The following are the criteria listed for an official diagnosis of RAD:

A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:

  • The child rarely or minimally seeks comfort when distressed.
  • The child rarely or minimally responds to comfort when distressed.

B. A persistent social or emotional disturbance characterized by at least two of the following:

  • Minimal social and emotional responsiveness to others
  • Limited positive affect
  • Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.

C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:

  • Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caring adults
  • Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)
  • Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios)

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).

E. The criteria are not met for autism spectrum disorder.

F. The disturbance is evident before age 5 years.

G. The child has a developmental age of at least nine months.

Specify if Persistent: The disorder has been present for more than 12 months.

Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Sometimes older children sort of move on from the RAD diagnosis into Borderline Personality Disorder. It can all get very tricky in terms of diagnosing the conditions that kids from hard places present with. Parents of these children need diagnosis for several reasons. The first major reason is for insurance purposes in order to get necessary treatments. The second is to just have someone else recognize that you need assistance and your child’s struggles are not just “typical kid behavior” that they might “grow out of.”

I think some people have very negative feelings about the RAD label, because it sparked some highly questionable treatment methods in the 80s and 90s. There was a scary “rage reduction” techniques practiced under “Attachment Therapy.” Children were humiliated, abused, and frightened. It looks horrible and it must feel horrible. This practice is not the same as the actual disorder. In fact, it isn’t even the same as therapy today involving building attachments. The negative connotation of these dangerous practices has unfortunately permeated the very diagnosis and led many to deny the very existence of attachment challenges in children from hard places.

This all comes back to the question of, “Who cares?” I will tell you who cares about RAD. I do. Other parents fighting to bond and build trust with their children care, too. Parents who are fighting a war against their child’s past experiences. Parents who are fighting a war against their child’s past trauma. Parents who are fighting a war against attachment challenges.

The label doesn’t really matter as much as the child does. The child is clearly in distress and in need of love and safety. It sin’t surprising to me that children would have problems trusting or bonding with new caregivers. It’s surprising to me that others would deny this could be a problem.

Regardless of the diagnosis, we should all try and empathize with families and children dealing with trauma and loss. We should all try to be understanding. This is a hard road to walk and it doesn’t need to be walked alone. The label doesn’t define the child or the caregivers. We are all soldiers here.

**Want more Information of RAD and attachment challenges? Please visit

–This website has many resources:

http://www.attachmenttraumanetwork.org/

–This post has a great analogy about kids with RAD and attachment:

http://talesfromourhouse.blogspot.com/2016/02/things-to-consider-when-child-with-rad.html

–Another blogger from the trenches!

http://adoptingfaithafathersunconditionallove.org/

 

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adoption, family

Hating Mommy: Adventures in Displaced Anger

I have done the unthinkable thing. The unforgivable thing.The thing that cannot be undone. I have gotten sick.  What’s worse than that? The fact that I am already “mom.” These two things are the worst things that one can be, according to Carl. These two things combine to seal my fate.

As far as Carl’s experience goes a puking mom is a drunk mom. A mom who needs to sleep in bed probably won’t get up for days or weeks because she is using. Therefore I should never be sick. What’s worse is that in Carl’s experience, moms hit kids. They don’t wake up to take their children off of the school bus. Moms are scary and unavailable and unpredictable. Therefore, I should never be “mom.” Too late.

First Mary and Luke got sick, then Carl, and then me. Because of his past experiences, Carl is over-the-top mad at me. He is convinced I am drunk and I am lying and I must be plotting against him. He thinks I have stolen his toys and forgotten his dinner. His rages and anger against me this week are off the charts.

When we sit down to dinner he hates the food. He hates me for making the wrong food. He can’t eat without a fork. If I wasn’t so stupid, I might have gotten him a fork. No, he will not eat that. I only ever listen to Mary. No, he will not apologize to Mary. No, he won’t have a “do-over.” No, he won’t shower. And if he must shower then, no, he will not be using soap. When he has to go back in and try again it is only because I am ruining his life. This is in large part due to the fact that I am stupid and mean and drunk. Oh yeah, and someone needs to “put me in my place.”

Last night he was raging in the car. Luke was working the overnight shift and Carl was refusing to be left with me. I was stuck driving him home from practice while daddy went to work.  After demanding several late night no-nos like donuts, he gave up and began to beat the car with his fists and his feet. He screamed at the top of his lungs that I was a liar and he hated me. I was a big fat stupid old lady and I didn’t love anyone.

I simply said, “I see that you are feeling mad and I love you too much to argue with you.” Then I cranked up the Bob Marley. Mary and I sang along while Carl screamed and raged and kicked the seat in front of him. When we got home he threatened to punch me and then began a rather serious fist fight with his bedroom door. I let him know that I was there to keep him safe and I would talk when he was ready. Eventually he took a shower and apologized and went to bed.

All in all he wasn’t unsafe and that’s a win for us. I was able to let him know that I loved him even when he had big feelings. Basically, I felt like we were able to narrowly avoid a mobile crisis call so I’ll take it as a small victory. Of course, he has been like this all week. He avoids me at every chance unless he sees an opportunity to make a demeaning comment or show me in some small way that I can’t possibly love him.

This week I feel like I am at the end of my rope. I am tired of being hated and threatened and screamed at. I am tired of all the property damage and drama and noise. So I do the thing that so many others would do in this situation for comfort. I go to my mama. I go crying to my mother’s house for hugs and understanding and unconditional love. That’s when it hits me. Of course I go to my mom because I have always had her support. Where does Carl go?

This week I feel like I am at the end of my rope. Imagine how Little Carl has felt these past 10 years.

NoBohnsAboutIt

<a href=”http://www.nobohnsaboutit.com&#8221; target=”_self”><img src=”http://www.nobohnsaboutit.com/wp-content/uploads/2016/01/AdoptionTalkButton2016-e1452013232524.jpg&#8221; alt=”NoBohnsAboutIt” width=”225″ height=”225″ /></a>

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

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adoption, family

Let the Hunger Games Begin: Sibling Rivalry in Adoption

It’s no secret that siblings fight. Arguments, disagreements, the pilfering of someones favorite toy or hairbrush are common themes in sibling relationships. The siblings closest in age are typically the biggest competitors.In a stable household siblings may fight and argue, but at the end of the day there are enough resources to meet their basic survival needs. Even in stressful situations they have adult supervision, enough food not to go hungry, and no imminent threat of physical danger.

For siblings raised in consistently traumatizing circumstances, the opposite is true. Our kids spent their early childhoods in a very scary and unstable place. There wasn’t always enough food. Carl and Mary spent toddler years climbing in the kitchen and reaching whatever they could in order to eat. When Mary first came home she thought Baccos Bits were a good lunch option. Sometimes affection came in small doses between their birth mom’s mental health episodes. If Carl or Mary didn’t get her attention then, they would have to wait weeks and even months for her to get out of bed and start interacting with the family again.

This all leads to a different type of sibling relationship. Mary and Carl are fiercely loyal to each other and protective of each other. In outside settings, they cling together and block out the world around them. Throwing a mom and dad into that relationship shifted their dynamic. All of the sudden they had a resource that they both desperately wanted. Deep down, they still believe this resource is fleeting.

That brings us back to this week. It’s been disastrous in terms of health. The stomach bug has swept through our household like a plague upon humanity. Mary was sick first. I cradled her head in my lap on the bathroom floor for about five hours. She was feverish, wrapped in a cocoon of blankets, and snuggled into me for all she was worth. Mary alternated from deep sleep to intense vomiting the entire time. I held her hair back, cleaned up her face, and rubbed her back until she slept again.

Meanwhile, Luke was fast asleep with a fever as well. He wasn’t sick to his stomach…yet. Carl was fine. He wanted to play with me outside. He was utterly mystified that I needed to stay in the bathroom with Mary for hours. This is where his trauma history and attachment problems came out to torment him. Soon Carl was convinced that I didn’t love him. I only enjoyed being with Mary and I would never want to be with him again. He yelled at me for never loving him and stomped away downstairs.

I’d like to say that he found something constructive to do. I’d be happy to think that he played with his hundreds of toys or read one of his many books or even played outside. Mostly, Carl watched TV all day and complained that he needed a better family to spend more time with him. Every attempt I made at comforting him was met with thinly veiled contempt. By evening time, Mary was so dehydrated that Luke had to wake up and take her to the ER for IV fluids. The poor girl couldn’t even keep down ice chips. I spent the evening worried about her. Carl celebrated that she was gone. At 8:00 PM he gleefully suggested that we could go outside to play now that she was “finally gone!”

Of course, it was time for bed. I did my best to give him some extra snuggles and mommy love. My aching back protested and my energy was completely drained. Still, I withstood hurricane Carl’s emotions as he railed at me for the unfairness of bedtime. He voiced his disdain at parents who didn’t know how to “do anything right” or spend time with him.

The next morning, Mary stayed home from school. She was sick in the bathroom with diarrhea while Carl was getting dressed for school. He stormed through the house screaming at her for smelling so bad. He yelled that he shouldn’t have to have a sister like her because she stinks. He was mad at me for going to work. He was mad at Luke for staying at home. He was mad that Mary was home from school because, “we loved her more” and just “wanted to spend time with her.” Carl was convinced that he was missing out on a great party we were all having without him.

The thing is that Carl cannot see beyond his own fear. He confuses his wants with his needs. He feels like he NEEDS time to play outside with me, no matter what is going on. If his sister is getting attention then he NEEDS to be there in order to ensure she is not taking up all of the love and attention that is supposed to be his. He believes this. He is afraid we will stop loving him. I am afraid my back will never recover after 5 hours of sitting on a tile floor.

So here we are. This is just one of the many times we will weather the storm of Carl’s trauma. It isn’t rational, it doesn’t come at the opportune times, but it is there nonetheless. Yes, we can give him extra attention. Of course we will try to show him how much he is loved and valued and treasured by us. We will delight in what he does and love him. Families have to bend, though. On this day and many more to come, our family had to bend in order to take care of it’s members.

I cannot erase his past trauma. What I can do is just continue to be there even when his sister seems to be “winning” in the attention department. Even when I’m tired and depleted and I’m pretty sure my backside has a permanent tile imprint on it. I’m still here for Carl. I hope someday he knows that. Until then? May the odds be ever in his favor!

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

 

 

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