family, Therapeutic Parenting

Anatomy of a Trauma Trigger: Responding to My Child’s PTSD

ccard

I slept until 11:00AM! Instant panic on my part. Was Carl OK?! I went to bed at 9:00 PM the night before.  I was exhausted after the physical therapy session I had at my house. I took my first steps without my walker (2 in grand total.) Thank goodness my husband was awake to care for Carl in the morning and meet his needs. It doesn’t matter that Carl is 11 and not 5 anymore. This can set off the trigger alarm.

 You see, my kids come from a home with a junkie mom. She was an addict. She had mental health conditions. She would go to bed and not get up for weeks. Sometimes she would lock the kids out of her bedroom and let them take care of themselves. Mary was 4 and Carl was 5 when they were removed from her care during a drug raid.

I know it sounds harsh, but these are the facts. An unresponsive mom in bed has been a terrible threat to their survival in the past. It doesn’t matter how much of this trauma they remember. It stays in their brains and tells their bodies, “Warning! Fight or flight! This is survival!”

Later that day I ended up back in bed, crying from terrible back spasms. The pain ripping through my spine was nothing compared to the pain I could see on my son’s face. Minutes before we had been goofing around as a family, and my husband startled me. Somehow I jumped or moved in surprise and set off a series of merciless spasms through my surgical incision and deep into the muscles surrounding my spine. I took my pain meds, got on my ice pack, and reassured everyone that I was fine.

It didn’t matter, because in Carl’s mind suddenly his caregiver was unreliable. The following is the closest I could come to understanding the conversations we had with Carl the rest of the evening:

Carl: (whining,moaning and stomping around) I don’t want to take a shower tonight! I’m not as smelly as you guys think! I don’t have to shower!

Carl’s Brain: I must stay where I can see my caregivers. Something bad could happen to mom. No one would take care of me and then I could die. I must get some control over this scary situation. Control lets me feel like I can take care of myself.

When he is scared we offer choices to give him some control. He can pick to shower downstairs in his shower or upstairs in our shower, using my trendy new shower seat (you KNOW you’re jealous!)

Carl: (from inside our shower, where he has successfully showered many times before) “You guys have to help me! I can’t turn the water on! It isn’t working. I need help!!”

Carl’s Brain: Are my caregivers still out there? I’m scared I might be alone. What if they aren’t able to take care of me. I have to know they are still caring for me or I will be all on my own again. And then I might die!

My husband “fixed” the shower for him. Carl called out to us every so often and we responded from close by. Showers tend to soothe him. He came out of the shower and demanded (really close to bedtime, and quite rudely) to build the new crystal growing science kit he got for Christmas.

With soft words and soft eyes, I responded, “Are you asking or are you telling? Would you like to try that again? It sounds like you have something important to tell me but I need you to use your nice words.” (I am totally attempting to channel Karyn Purvis)

Carl: (Taking a deep breath) “Can we please build one of my crystal growing kits?”

Carl’s Brain: Are you still able to take care of me? Can I rely on you? If I cannot win your attention and care I will be all on my own again and I might die!

Me: “It sounds like you’re asking for something we may not be able to finish tonight. (Carl huffs and stomps and moans) Bring both kits up here and let’s see if we can make a compromise.

In the end, after lots of groaning from Carlos, one of the kits was a 15 minute project. I suited up in my back brace and got on my walker. Carl ran and got all of the necessary ingredients. Now we are growing crystals on top of a filing cabinet upstairs. We agreed the big glow-in-the-dark crystal growing experiment would be saved for Thursday.

As I said goodnight to Carl I could sense he was panicking again. I held him close to my chest in a big hug as we practiced our deep breathing. I looked him in the eyes and said, “Honey I know you were having some big feelings tonight. You were panicking a little bit.” He nodded in agreement. “It’s OK, honey, I will always be here. I am always going to take care of you.”

After another giant hug and our normal goodnight routine, he followed Dad downstairs without any further issue. It seemed like he finally felt safe. Not every night goes this smoothly. Fear is tricky, because it can come out looking like anger and defiance. Tonight I was able to translate the trauma trigger coming from Carl’s words. So tonight, I’ll take that as a win.

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

 

 

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adoption, family

Making My World Smaller

walker

I’ve been confined to the upstairs of my house. My bedroom and bathroom are here. There is a hallway and an “art loft” that overlooks our living room. These are the only areas I can be without assistance.Back surgery is tough. Everything else is downstairs and I have absolutely no control over what is happening there. So far I’ve made it down twice. Once with my paramedic husband, and once with my in-home physical therapist. Hooray for me.

I have a snazzy new walker that is sure to be the envy of every other 35-year-old mom. I use it every so often to do some laps upstairs. (Impressive, I know) If I’m lucky my hubby will help me get into my shower seat with the grip bar on the side of the tub. Then I can shower with the removable shower head he gives me. Yeah, this is the life. Glamourous, I know.

The rest of the time I am sitting on my bed with the special wedge pillow my nurse got for me. I read books or magazines or I watch TV. Visiting nurses, Occupational Therapists, and Physical Therapists come to work with me. The rest of my time I spend wondering about my family. Is Luke Ok? Does he have too much to do? How can he possibly juggle having me relatively immobile, Mary in the hospital, and Carl in Lacrosse? Impossible, right?

Wrong. He’s got it covered. He has stepped up his game like a boss. He organizes offers from friends and church members to provide dinner for us. He tries to do the laundry but he gave in and let a friend from church come to clean our house. He organized his time and gets Carlos to Lacrosse games, even when Luke is working. I haven’t had to plan a thing.

Believe it or not, the family didn’t fall apart without me. If Luke works the night shift, he arranges a sleepover for Carl with Nana and Papa or with friends. We have so much support from my parents. The kids’ godparents have helped out. No one has died. No one has been left neglected. In fact, as far as I can tell, the world is still spinning without all of my frantic planning and intervention.

We moms work ourselves into sort of a frantic pace of action that barely allows us time to breathe. And for what? Things will still continue all of our planning and listing and intervening. It may not all be perfect or perfectly planned, but who cares? When was perfection ever a goal anyone could achieve?

I’ve been so wrong. Silly me. Carl cuddles up next to me and put our favorite TV show on, “Fresh Off the Boat.” We snuggle and binge-watch a few episodes. Then he turns to me and says, “You’re the best mommy. I love you.”

“But why?” I ask him. “I haven’t done anything this week.”

“You’ve been my mom. You’ve been loving me and you’re right here,” he says slowly, as if talking to a very dim-witted adult. “Plus, you adopted me.”

Oh. Well if that’s all it takes then I guess I’m mom of the week. Yes, I am the mom that stuck around and yes, I am loving him. I’ll concentrate on my recovery. I’ll let Luke do all the planning. I will stay in my small upstairs area.

And I will have faith. I will have faith in this little family we created through adoption. Maybe I don’t need any more than that in my world right now. Maybe that is enough.

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

 

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mental illness, parenting

Having a Child With Mental Ilness: Adventures in Living on a Prayer 

yme

I love this little girl all the way down to her little pinky toe. I love her to the moon and back. I love her like a jelly bean at Easter. These are the things I have to say to her over the phone. So far away. “I miss you major,” I tell her.

Unfortunately Mary is back at the inpatient unit in the psychiatric hospital.She only made it home for about a week. I am just home from 5 days in the hospital after having spinal fusion surgery. We had a few days together before it just got to be too much for her.

Maybe my surgery was a huge trigger. Maybe the onset of puberty is like a freight train running us all over. Maybe her medication just isn’t there yet. There are so many pieces to this complicated puzzle, that is part of our daughter.

Mary slept over at a friend’s house one night and told her friend’s mother she was too scared to sleep upstairs. She claimed she could see her biological parents waiting for her up there. Her visual delusions have been increasing.

Friday at school she had an outburst, yelling at a girl who was absent (presumably for being absent.) After school she has another tantrum at her Partial Hospitalization Program. She was screaming and kicking and generally unsafe.

When calm, Mary was able to tell them she hears more voices than she admits to anyone. The voices tell her to kill me and she is afraid of them. She has drawn and written a lot more about my death lately. She is so afraid her mommy will die. After all, her biological mother left. I am sure these are all fears pertaining to her trauma that are flooding back now to take control of Mary.

Over the weekend, she had another melt-down. Papa wouldn’t let her touch something dangerous in his workshop, she was defiant. When he raised his voice and repeated his direction, she lost control. She ran out of the house to the road. She wasn’t wearing shoes or a coat and it was winter. 

My husband was able to pick her up and bring her home.  I was locked in my room, my parents had Carl, and Luke was keeping Mary safe.I Face Timed her from my locked room to talk her down, and try our deep breathing together. Luke was able to give her a PRN to calm her. She fell asleep in her room still adamant that nothing was wrong and she didn’t need to wear shoes. Ever.

As Mary slept, the crisis worker gave us a safety evaluation. We reviewed the safety plan we had with him.  We explained why we locked up our knives, removed  sharps from her room, and activated the locked door plan when she was triggered. He looked at us for a long time, silently, and then asked us if we felt safe. Not, “Do you feel safe with the plan?” But just, “Do you feel safe?” 

The answer is no. We mulled it over until the next day, but truthfully, we weren’t safe. Mary has not been physically violent or disassociating since 2014. Her medication isn’t working anymore. Therapy is an ongoing process, but without the right medication, she is trapped inside this cycle. We made the decision to send her back to the inpatient  unit while her new medication continued to be titrated. We will not take chances with her safety. We cannot take chances with mine. This is nonnegotiable.

All of this happened as I lied helpless in bed. I felt like we were suddenly back in 2014, watching her fall apart all over again. To be honest, I felt a bit defeated. She’s had ups and downs but she hasn’t had these kind of meltdowns in years. She’s been living a relatively normal life (albeit with a the help of medication and therapy.) It’s very hard for me to admit that things have been spiraling with her for a short while now. It’s just that she’s overcome so much. She’s living such a full and happy childhood. For the last few years she’s been so in control of her moods.

As I hobble around in my walker, or lie prone in my bed, I get a sense of helplessness. I need to recover. I need to be strong enough to be the mom she needs. Lying helpless in bed behind a locked door is all I can physically do for now. So here is where I pray.

“Please,” my prayer starts, “Please let the medication help her. Please don’t send us back to the starting line. And please, please, let me be strong enough to be the mom she needs.”

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

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mental illness

Thank Hospital Vacation?

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I must be the weirdest mom ever to think that my major spinal surgery seems like a vacation. Trust me, a little fusion surgery was nothing compared to the chaos Mary was experiencing at home.  I had some complications, and needed a cat scan. They found one of my vertebrae was actually fractured. I sobbed in pain while they gave me every narcotic pain killer intravenously they could. Finally strong muscle relaxants were administered and I calmed down. I clutch Luke the entire time while he whispered soothing things into my hair and stroked my arm. Vacation, right?

I had trouble breathing so I went to the ICU for a day. I had an oxygen tank sort of plugged into my nose in order to help me continue breathing. Vacation, right?

I am in constant, excruciating pain. However, my meals are brought to me, and my daughter Mary isn’t attacking me here. There is significantly less screaming here than Mary is doing at home. I feel deep pain at the incision sight where the doctors cut so deeply into my spine. It doesn’t matter.  I’m safe and safe feels good. Yes, even with the deep and unrelenting pain, this might be a vacation.

Everyone smiles at me and offers to bring me things at the hospital. They help me use my walker (really hard for me to walk right now.) I get to order my meals from a menu. No one yells at me. No one is throwing things. And I haven’t seen one tantrum since I’ve been here. Not even from the patients! This MUST be some form of vacation.

The truth is I’m doing very poorly. The Physical Therapist came to see me and opened with,”I’m not trying to be mean” before helping me to a chair. That is where she wanted me to try and sit for an hour. I couldn’t do it.

The pain was so unbearable that I clutched the chair arm and  sobbed for a half an hour straight. I had an ice pack. I tried the PTSD calming strategies we use with Mary. I grounded myself by what I could see and hear. I sipped water and counted my breaths, trying to breathe in and out slowly. I tapped my fingers in a method I learned at a trauma workshop. I tried to picture the happy place I keep in my mind. I counted to 100 and back. I asked for a stress ball, in between giant, hiccuping sobs. There was mucus everywhere. Tears soaked my hospital gown I just couldn’t stop sobbing. .

“Stop crying,” they kept telling me, “You’ll hyperventilate.” 

“I’m trying!” I gasped, “I’m using my coping skills!”

Did it work? No. They ended up peeling me out of the chair after 30 hysterical minutes. I even had them close the sliding doors so I couldn’t disturb the other her ICU patients. I wanted to be so strong and finish the full hour sitting in a chair. I wanted to stop my sobbing hyperventilation and soldier through. I wanted to be in charge of my own body! But I was basically locked into an adult form of out-of-control behavior. I didn’t yell or throw things. I was very polite when I could get a word out. “Please,” I’d say, “I’m trying!”

I just couldn’t do it. They put me back in bed and administered strong pain medication and  more ice packs. My doctor was baffled. She didn’t know why it hurt so much but she was very concerned that I was adamant to keep going.

My doctor and the PT were concerned with my pain. I wasn’t. Here’s why: my pain is physical. When Mary sobs uncontrollably, tantrums, or panics, her pain is emotional. We can’t administer more pain medication and send her back to bed.

Her trauma is as real as my surgery. Her emotional pain is as real as my physical pain. I’ve made it home now and all I can do is be grateful. That was the absolute worst vacation ever.

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

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family

What’s a Dad All About?: Adventures in “Real” Family 


In my experience, family is created by love more than biology. I don’t just mean the kind of intangible ideal or even the feeling. It’s my opinion that actions speak louder than words. You can love someone but parenting requires rolling up your sleeves and putting in the actual work.

I often feel a sort of impractical guilt that I wasn’t there when my children were small. During their infancy and early years when they could have used someone ready to roll up those proverbial sleeves and do the work. Mary sometimes expresses anger at me that I “wasn’t around,” when she was a baby. Either that or I wasn’t around to “adopt her bio-mom” and teach her coping skills.

Neither scenario is plausible. It doesn’t matter. I still ask myself if I can ever make up for what’s been lost? Is it even possible? When I look at Carl and Mary’s history I feel unsure. There is so much bad that overshadows the good. Did Luke and I show up too late in their lives? Is this sort of like subbing in new players during halftime?

By looking at my own life I think I have my answer. No way. It doesn’t matter when your family comes to you, so long as they come. So long as they are willing to do the hard work loving someone requires. So long as they are willing to be there.

How do I know this? I know because I have a great step-dad. He kind of showed up in the fourth quarter. He and my mom grew up together and reconnected at a high school reunion. I was in college when they married.

He’s “Papa” to my kids. To me, he’s just plain family, by any title you care to use. The father I was born to loved me in a sort of distant, hypothetical way. Roger never figured how to put in the hard work needed to raise me or be there for me.Roger loved me so long as it pertained to him. He tried.

Roger (my own biological father) never could develop an interest in my family. He saw them as extraneous factors that simply didn’t apply to him. Roger could talk a great game. He had many words to profess his love. He just never could back them up with actions. I loved Roger in my own way. I’m sure he loved me in the best way he was able to.

Papa is a sharp contrast to him in so many ways. He moved across the country (literally) to be closer to our family. He doesn’t have to say he loves us , but his actions speak louder than any words. Papa brings me to my doctors appointments when I can’t drive. He rode on the ambulance with Mary when she went for her latest inpatient stay in a psychiatric hospital. He never judged her for hearing voices or behaving differently than other kids. He just loves his granddaughter.


He’s fixed faulty lighting in our house. He’s prayed with us in church. He taught my kids to play the keyboard. He hangs out with my husband like old buddies. He lets the kids bang away on his priceless Steinway while making up their own off-key lyrics to the music.

Papa loves my mom with actions that border on insane. Take, for instance, the time he fell and sustained a head wound on a concrete floor. My mom wanted to drive him to the hospital as soon as possible. Knowing how long the ER took, he insisted that they stop at the McDonald’s drive-through on their way to the hospital. Why? So my mom wouldn’t miss dinner while he waited to get his head fixed.

Nothing says, “I love you,” like pressing a bloody bath towel to your skull while ordering a burger with fries.

In the end, Papa accepts all of us for who we are. And he is THERE for us both metaphorically and physically. No judgements.

My husband Luke believes family is the most important thing.  He’s a dad because he works for it. Our family isn’t always easy. It’s almost never “normal” (if there even is such a thing!) Luke gets along with Papa because they are a lot alike. No, not just because they are weird. It’s because they are family men. 

I’m pretty sure “normal” is overrated. I’ll take Luke dancing in the kitchen to “New Kids on the Block,” to cheer Mary up. I’ll take Papa teaching Carl to use a flame thrower. I will take what we’ve got over simple biology any day. This is family. This is love.

I love you, Papa!


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

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family

Contingency Plan: In Case I Don’t Make It

The back brace Mary decorated for me

Anyone who reads my blog knows that our daughter, Mary, has been inpatient at the psychiatric hospital for almost 2 weeks now. It’s her second stint since right before Christmas. It’s been terribly hard on all of us. Children with attachment issues need to be close to their caregivers. Mothers of any kind need to be near their children.

In this case, safety is paramount in all of our decisions. I have a serious spinal injury, . Therefore I cannot physically assist in any way, if Mary has a dangerous dissociative episode. She hasn’t had one in almost 2 years until now. Just our luck that it happens when I’m at my most vulnerable, physically.

They’ve been titrating a new medication for her. We aren’t sure yet if it’s at a therapeutic level. Her emotions are still all over the place. She fluctuates from one minute to the next. She is angry, then giggly, then despondent within 10 minutes. She’s had several physical outbursts on the unit. She’s been defiant towards staff, throwing things at them. During one incident, she pounded on the window of her door, trying to break it. Too bad we don’t have unbreakable plexiglass on our windows at home.

No, she isn’t “there” yet. She isn’t at that place that keeps her safe enough to access all of the therapies and interventions we have in place for her. No amount of TBRI parenting, PHP treatment, TF-CBT therapy, coping skills, or sensory diet can help her until her brain is in a place to process it. The medication helps her brain to get there.

I need a contingency plan. I admit, I plan for all scenarios as much as possible. It helps me to feel productive and in control. Frankly, there are some things entirely beyond my control. But I’ll probably never accept that. At least, not in this lifetime (I swear, I’ve tried!)

My spinal fusion surgery takes place this Tuesday. We are taking our girl home from the hospital on Monday. We will have a meeting to hear the results of the full psychological evaluation they gave her. Maybe we will gain some insight. Maybe not. Either way, she comes home with us.

We have to take her home because I need all of my chickens together on Monday night. We’ve planned a “Pajama Party” where we all pile onto the king-sized bed in our matching Jammies (lame, I know!) and have popcorn.

The next day is my surgery. This is a big long, serious operation. I can face anything if I’ve had my family with me. I’m one tough Mama so I feel like it will turn out just fine. But if it doesn’t? I’ve had that one last family night.

When I was little, my mom used to read to me all the time. Even a series of books called “Sweet Valley  High,” which she hated yet read anyway. My mom has probably made me macaroni and cheese thousands of times. She’s tucked me in, kissed my boo-boos, and generally made things better for me my whole life. She’s taught (or tried) to teach me good lady-like manners my whole life.

I’m not the best student but she loves me anyway (remember my zombie centerpiece at Christmas dinner, mom?) She has perfect hair, perfect make-up, and a perfectly dirty joke when you least expect it. My mom could give Emily Post, Lauren Bacall, and Elizabeth Taylor a run for their money. In the same breathe she can out-do Chris Rock for shockingly funny dry wit. And she’s mine. I’ve gotten to have her for my entire 35 years on this earth. Lucky me.

Mary hasn’t had me since infancy, so I’m making up for lost time. By my calculation, I still have dozens of horrible books from a predictably plotted children’s series to read to her. I have thousands more mac and cheese meals to go. And let’s face it, I’ll probably never have the center-piece thing down. But still. Mary is owed the full mommy experience. The kind I got to have. The kind that always makes it better.

My kids need me. They can’t afford to lose another mom. But if the worst should happen, I cannot, I WILL NOT allow Mary to think that it was all somehow her fault.

It like an oncoming storm. Maybe it will hit and maybe it won’t. Maybe my surgery will be a shining success, maybe it won’t. Maybe Mary has to go back inpatient this week, maybe not.

Either way, we are going to batten down the hatches, and ride it out. Together. As a family. Because that is the most important thing I have ever had in this lifetime. My family.

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

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religion

Knocking on Heaven’s Door?

ccandle

Since when did I become religious? As I write this I’m listening to Bob Dylan croon away about knocking on heaven’s door. In my youth, I attended congregational church with my mom. I liked the sense of community we had there.

As I got a little older, I changed. My mother supported my exploration of other denominations and faiths. I was so curious. Faith is such a personal thing and I wanted to see where I fit in. I went with friends to evangelical churches, baptist churches, catholic churches, and a pentecostal church. I just wanted to know, to see.

Years later, in my ultra-liberal college days I left that quest far behind me. I had changed again. What I heard about church and faith came from horrific tales from the Westboro Baptist Church and Jerry Falwell. Christianity, as it seemed to me, wasn’t about love. It seemed like punishment and judgement on those who were different. I couldn’t wrap my mind around the same Jesus who loved sinners, disciples, and prostitutes, persecuting same-sex love. What kind of religion is against love? In those days, it seemed that religion just wasn’t for me. “To each his own,” was my motto at the time, and it still is in many ways.

Early in my marriage, I had another change. It seemed that family was my religion. Love was the thing I turned to in times of strife. Let others have their own beliefs. I believed in Luke and me. I thought whatever brought people comfort, was good for them. As Bob Dylan would say, “Don’t criticize what you can’t understand.”So I didn’t.  I also didn’t think about it much.

When we adopted our children, everything changed. I was trying to show them the kind of unconditional love they hadn’t experienced before. As they went through tremendous struggles, I began to sink into the depths of their trauma. The times, were indeed, changing. As Bob Dylan would tell me I had to start swimming or I would surely sink.

My mother started flying into our little New England town from her home in the midwest to help us wade through the quagmire of trauma we were sinking in. She had become Episcopalian so she took us to the Episcopal church in town. I felt so welcomed and so accepted. I’ll admit that the tradition and structure of the service was hard to follow. I did my best. After the service, my children asked me, “God really loves us? He doesn’t even know us.”

Eventually my mom went home, but I kept going to church. I was walking the “40 miles of bad road” that Dylan sang about, but I didn’t feel so alone. My children started to learn about a different kind of love. A love so big that it could handle whatever mistakes we humans could make. Our church didn’t disparage anyone that was “other.”  Being gay was accepted. A parishioner has an incarcerated son who was accepted, loved, and prayed for. A former alcoholic was accepted, loved, and prayed for. So was I. So was our family.

Over time, I started to believe that there was more than just me out there. I didn’t have to have all the answers. My kids changed when they started to believe that God’s love was so big it could last through anything. We weren’t just crazy parents talking about this weird unconditional love thing. Other people felt it, too.

Finding faith has been an interesting journey. Some days I still feel like I’m not there, yet. But I’m working on it.  Some days I get mad at God over what my kids have been through, among other things. When I pray, I express that anger. My reverend says that God has big enough shoulders to handle my anger.

Our church supports us. I believe God supports us. Everyone (even my children) will have their own beliefs, and that’s fine with me. Differences are OK. Bob Dylan might find his religion in music. I find mine at church. Find your own where you will.

I’m still the ultra-liberal girl I was in college, I’m just also a person of faith. I’ve changed. And as Dylan would say, “There is nothing so stable as change.”

 

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

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