adoption, mental illness

Where There is Hope: Psychiatric Service Dogs

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“I don’t think I can be safe at home.” These were the heartbreaking words of my 10-year-old daughter. Overhead florescent lighting blinked in and out, highlighted her face as she stared dejectedly at the linoleum floor.  We were spending yet another night in the emergency department at the local children’s hospital. A clinician was determining if we were safe to go home. We weren’t. Mary would need another inpatient stay in the children’s psychiatric unit. The questioning always goes something like this:

“Why aren’t you safe at home?”

“I throw things, I hit things, I run away. I’m afraid I will hurt Mommy.”

“Why do you think you will hurt Mommy?”

“I don’t know.”

“Do you remember what happened tonight?”

“No.”

“Do you usually remember what happens?”

“No. When I get scared I don’t remember. I get really mad and scared.”

So she was admitted for her fifth inpatient stay this year. Luke and I answer the same questions every time. Yes, she has an amazing trauma therapist. Mary has completed TF-CBT (Trauma-Focused Cognitive Behavioral therapy.) It was a huge success. It erased her specific, most intense, trauma triggers. Her therapist is always available by phone if we need her. My husband and I work with her partner to better our trauma parenting super-powers.

Mary has also had many, many other therapies. Partial Hospitalization, Intensive Outpatient Treatment, talk therapy, family systems therapy, art therapy, OT and many more. She has a sensory diet, we parent therapeutically, and we now have intensive in-home services. She is taking a multitude of medications because the one that worked, stopped working when she began puberty. Now she is having intense flashbacks and short periods of psychosis. She runs away from an unseen enemy into the woods or onto a road.  Mary has scabs all over her scalp where she’s picked off the skin in anxiety.

Right now she craves my attention with ferocity. She needs attention, she must have attention, she is terrified of losing the love that she has found. So we make art projects. We cuddle. We play endless board games together which she mostly lets me win! She tells me, “Mommy? I wish we could love each other more than any other type of people.”

But human relationships are tricky. They have nuances, and nonverbal cues, and require space at times. Mary cannot navigate these tricky things. Is Mom happy with her? Mad? About to abandon her forever? At times, Mary honestly cannot tell. She will alternate between being my shadow and then kicking me away or screaming at me for being a “Skank a** be-otch (sp?)”  I have, in fact, checked my rear end in the mirror. I assure you that I found not a trace of skank!

If primary caregiver relationships are so hard, might there be another way? If we cannot keep her safe at home, is there another way? If fear hijacks her brain so often that she blacks out, is there a way to help? There is. I just don’t like it. She may be safer at a short term residential facility. Or a long term clinical facility focused on trauma. I hate this way down into my very bones. The thought of not tucking my daughter in at night leaves me in a cold sweat.

So I found another way. Because that’s what parents do. We find a way. Maybe I can’t catch the onset of her panic attacks in time to “ground” her. She never knows when one will hit. We are often scrambling to pull her back from the memories of trauma and into the here-and-now. Psychiatric service dogs are trained to alert their human before the panic attack/dissociation occurs. We don’t know when she has intense nightmares, so we can’t wake her for deep-pressure calming techniques. But a service dog would. I can’t run after her when she bolts into potentially dangerous places where she may get lost. I’m not as fast. But a service dog is.

Enter “Blue.” After seeking a service animal large enough to help Mary, we found Blue. We were just plain lucky to stumble across this perfect dog. Right now Blue lives in Tennessee. She has a few more weeks to train while hanging out with Mary’s dirty clothes (to get used to the scent. Hopefully she doesn’t pass out from the socks!) A psychiatric service dog has to be trained specifically for the person they are working with. Enter an amazing trainer in Connecticut who is ready to privately train us all, humans and dog alike. Let’s face it, we all have a lot to learn. This trainer had a child who died years ago. She was touched by our story. In order to keep our family together, she is willing to provide Blue’s “finishing” privately. For free.

With Mother’s day coming up, I want what every mother wants. I want what is best for my child. So, Blue? I’m counting on you! Keep my daughter home with us. Keep her safe. Please. That is what I want for Mother’s day.

 

*If you like this post you can vote for it at https://fulltimetired.com/roundup/

**Names have been changed to protect the privacy of those involved. Except for Blue the dog. She should be famous for all of the hard work and bonding she’s about to do!

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adoption, PTSD

A Safe Place to Land

Everyone seems to know how to live this life better. This complex and confusing life of parenting children with severe developmental trauma. The life where your kids may have extreme behaviors, and/or mental health diagnosis. This life. This is a life that others are afraid to live. 

The part that most don’t understand is how this particular life could be one that I love. One that I have chosen. This life is fulfilling and joyful for me. I can be a hard person to buy material gifts for because I honestly just don’t care. I already have everything I could ever want.

Sometimes, though, I am scared. How will I continue to handle aggressive rages and outbursts? After almost 3 years of physical safety from my daughter it is hard to go back to that place. The place where her most common expression is one of anger. Her reactions to the slightest disappointment become violent outbursts. She is 10 now, and much taller and stronger than when she was barely 7.  I wonder how we got back to this place?! 

Loving my daughter is never the question. Sometimes, when I am in my deepest, darkest place, surviving her becomes the question. No matter how much love we put in or how many resources we find, the trauma continues to plague us all. This past week I’ve woken up several times in terror, covered in a cold sweat. I feel as though danger is imminent and I cannot catch my breathe. Since when do I have such a  visceral response to basic nightmares? Probably since Mary started raging again. 

There could never be an expiration on my love for her. There could never be an expiration on my commitment to her. Is it possible there could be an expiration on my ability to handle her violence? 

How did this happen? I naively thought we had conquered the worst parts. We still battle past traumas alongside our children. They still go to therapy. But I thought the days of her physical attacks were long gone. Perhaps that is why my reaction is one of panic. We left this place so far behind. Can we get through it all over again? 

I understand that professionals have a different perspective. In fact, they often lack perspective entirely. This life that I have chosen is actually quite rare. Not many “older children” get adopted from foster care. In essence, there is less chance of a doctor coming across a case like ours. The goal seems to always be to change their behavior. Change my behavior. To fix it. To fix her. How ridiculous.

I cannot fix what is already beautiful. All I can hope for is a bit of healing mixed with trust. I can love until forever. And I can hope for a safe place to land. For all of us. 

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

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adoption

Emotions: Mine or Hers?

I forgot that I had feelings. No, I’m not being sarcastic. I actually forgot! Who does that? Am I some sort of automaton? I really and truly have been-hyper focused on my daughter’s current emotional upheaval. Keeping an eye out for my own safety has caused me to lost track of my own emotional barometer. In the epitome of irony, this is what happens to kids from hard places. They become so stuck in survival mode that they cannot interpret their own feelings without support.

Therapeutic mom-me is on hyper-alert lookout. I check for dysregulation. I help identify feelings and provide my children with the voice they need to share said feelings. I offer do-overs. I engage playfully with a sort of perma-smile that I didn’t even realize I was wearing. Don’t misunderstand, I do have fun and smile with my children. It’s just that recently, I’ve been hyper vigilant for signs of danger with Mary. Is my 10-year-old hearing voices? Is she disassociating? Is she about to attack or become violent?

I orchestrate her world so carefully in order to provide her with a chance for success. I allow her to stay suffocatingly close to me at almost all times. She has been craving me and panicking when she is more than a few inches away. Her fear of losing me is so acute that I, in turn, begin to fear an imminent psychiatric hospital stay for her (in the end, my fears were realized.) The tighter she clutches me in, the more violently she will push me away when her emotions turn.

And then come the outsiders. People who just aren’t in our family and/or don’t practice therapeutic parenting. Professionals who have never heard of the work of Dr. Siegal or Dr. Karyn Purvis. It’s hard for me to comprehend there are those who’ve never read The Connected Child, because it has been a game changer for us.

They don’t understand the value of connection as opposed to compliance. I’m not raising automatons, I’m raising emotionally intelligent human beings. I am providing them with the tools they need to regulate their feelings. I am the external modem helping them to sort information and identify what their body is feeling and how to get their needs met. The only way our children will learn to emotionally regulate is through practice, practice, practice. Sort of like a sports player needs to practice in order to improve. Our kids are in survival mode. They are learning to feel safe. I work so hard to disarm their fear. But in the process, have I become the automaton?

No one ever suggests that sleep deprived mothers of newborns should “return their horrible creatures to the hospital.” No one ever says, “Well this one is up all night. Why don’t you get another one. A good one. A baby that is better than this screaming thing.” But for adoptive facilities different. I’ve heard similar sentiments many times.

“Well, you knew what you were getting into. This is what ‘those’ children are like”

“Kids in the system are damaged goods. They won’t ever be normal. Why would you want a kid like that in your house?”

“I could NEVER do what you’re doing. I just couldn’t put up with it!” (By the way, yeah, I know. You definitely couldn’t do what I do. You’re just not mom enough!)

“Do you ever think about just quitting? After all, they weren’t born to you. It’s not like they are your real children.” (This one came from a primary care physician of mine. FORMER, obviously.)

“He/she is so defiant. You need to spank them to teach some respect. If they don’t work out, can’t you just trade them?”

My all time favorite comes from a social worker. She said, “Well how much is too much? At what point do you feel you’ve had enough? At what point do you decide this isn’t the right fit? At what point do you give up?” Of course I asked her the same question about her biological son. She was stumped.

It creates this defensive wall inside of me. A wall that shows other people my optimism that our children are healing. That we can find solutions. That we are so happy to be parents to these amazing kids. All of these things are true. It just isn’t the whole picture. I don’t tell about the sleepless nights. I don’t talk about the bruises. I just don’t. I can’t stand to have people judge our daughter.

She’s my precious girl. She isn’t “bad” she is hurting. And we are fighting together, as a family, against trauma. So, no, I never let those other feelings show. My perma-smile conveys only the wonderful parts of adopting children from hard places.

Today a psychologist held a mirror up to my face. It was the Doctor assigned to our daughter’s case during her inpatient stay at the psychiatric hospital. She asked me how I felt and how I was dealing with the stress. The question confused me. This is our normal, it’s not new and scary for me. I mean, right? I’m healing from my second major back injury. I’m exhausted. My father died this summer. And now my daughter hears voices that tell her to kill mommy. She tantrums frequently. Her brother isn’t sleeping through the night. He stays up to scream at us for being stupid idiots that he hates. I’m lucky to get to bed at midnight! For him, I have a firm voice and firm boundaries. For everyone else?  I am wearing my, “We can do this!” mom-smile. All. The. Time.

“So how does this feel to you? Take off your therapeutic mom hat. Let the clinicians handle the therapy. What is your emotion about this?” She hypothesized that part of the reason my daughter is so mad at me is because I am always analyzing her. I’m always reading her emotional cues and adjusting accordingly. I’m being a therapist more than I’m being just a mom. I am out of touch with my own feelings.

Still, I feel that TBRI is important. It’s second nature to me. I hated her ideas about using a token system to help Mary stop attacking me. How on earth would a token system keep her from hearing voices? I will never give up therapeutic parenting. I listened to the doctor, but then I expected her to listen to me. So I sent her a copy of The Connected Child in the mail.

She had a point about my feelings. She was way off-base with the stupid token system. She also misunderstood that trauma is fear, not defiance. I’ve spent so much time focused on TBRI and keeping our daughter out of the hospital that I lost track. I am asking her to check her “engine” to see how it’s running. When I am I checking my own? I expect her to share her feelings, but do I share mine? Nope. I’m always the strong mom. Firm, nurturing, forgiving, and never out-of-control.

When did this happen? It wasn’t on purpose. I just sort of forgot about my own feelings. I spent so much time advocating for Mary and convincing others that she isn’t a bad kid, that I forgot. I spent so much time researching the work of Dr. Siegel, Dr. Karyn Purvis, Deborah D. Gray and Bryan Post, that I forgot!

I spend so much time explaining the hurt and fear behind Mary’s behaviors, that I forget my own feelings. I feel like I should be reading more, researching more, and finding more therapeutic resources. I spend so much time educating other professionals (my own PCP, pediatricians, ER staff, intern clinicians, emergency response teams) about the effects of trauma that I forgot about my own. I, too, have been traumatized.

Mary’s psychologist made it clear that I should share my real feelings with Mary. It took me a few minutes to see that I’d been so defensive I couldn’t admit that I was scared and sad. My children have taken the domestic violence they experienced in their childhoods, and have turned it on me. Their “safe” person. The one who will love them, no matter what. Except now I am in the domestically abusive situation scratching my head and wondering how I got here. The doctor asked me to share these feelings honestly with my daughter. So I did.

Mary came into the session and I was already crying. With tears streaming down my face I told her how much I missed her at home. I told her I missed her fuzzy cat slippers. I missed her little chicken noises in the morning. I missed the creative off-key songs she invented in the shower. I told Mary that I loved her. I also told her that I was scared about her coming home. I was really scared that she would hurt me someday. Both of us would have a hard time recovering from that. I was afraid I wouldn’t be able to help her. And love. I love her so damn much.

I cried. I sobbed. I am by no means a pretty crier. I have streaming tears and booger-bubbles. My eyes get red and puffy. I sob until I hiccup, and my mascara runs raccoon-style, all over my face. It’s a rather alarming sight and I try to do it as little as possible. I braced myself for Mary’s reaction.

Then, she did the most profound thing. She took a tissue and wiped away my raccoon makeup. She took a swipe at my puffy eyes and my bubbling boogers. She looked into my eyes and told me how much she wanted to come home. She told me how much she wanted to be safe. This doesn’t mean she will be. Some things are beyond her control. But, it was a moment of deep connection. And I didn’t even have to create it. I just shared my truth.

We are bringing her home tomorrow. It was hard to say goodnight and leave her there. I stumbled home and finally got off of my walker and into my bed. My body felt too spent to do much beyond quiet reading. I looked at the new book on trauma and physiology I’m reading. Then I looked at my new horror novel with creepy houses and severed heads.

You know what? I went with the severed heads.  The only therapeutic thing I’ll be doing tonight is grabbing a glass of wine to drink while I read this trashy paperback. I’m off duty. Tonight I’m just getting reacquainted with a very important person. Me.

If you liked this post, feel free to vote for it here.

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

**To learn more about TBRI (Trust Based Relational Intervention) go to http://www.empoweredtoconnect.com

 

 

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family

Monster Feet in the Night

The force is strong with Carl tonight. He is trudging up the stairs into our bedroom about every hour or so. I hear a quiet, “Mommy? Daddy?” and squint my eyes open. There is Carl standing in the doorway in Star Wars Pajamas and monster-feet slippers. Yes, the force is strong. The force of wakefulness.

All manner of emergencies happen. He has a stomach ache. He needs to blow his nose. He had a bad dream while he was awake  and he cannot fall asleep. I know exactly what this means. Mary has been gone for a week straight now. I believe that Carl is afraid because he was separated from his sister for so long in foster care. The 11-year-old boy who is a fierce athlete by day, has become a frightened child with monster-feet slippers at night.

What he really needs right now is a little nurture. What I really need right now is a little sleep. He asks to sleep with the cardigan I wore that day. I hand it over while realizing I’m missing about 8 cardigans because the children like to sleep with the smell of mom. I’m either going to have to go shopping, or go digging around under their beds. But first, I really need to sleep.

“Do you feel safe now? Do you have everything you need?” I hear Luke say this as he escorts Carl back to bed for the 6th time. And it’s only 1:00 AM. I do not know how people with infants do this! Luke then asks Carl to please stop coming up the stairs and knocking on our door. He explains that we all need to sleep. If Carl can’t sleep he can do one of his crossword puzzle books or read for a bit. Carl agrees in a sincere and determined voice.

2:00 AM rolls around. I am woken by something. Carl is standing at the bottom of the stairs (not going up) and whisper-yelling, “Mommy? Mommy!” Well at least he isn’t banging on the door to our room. He has a headache this time. I administer tylenol and take him back to bed. Hey, he attempted to follow Dad’s directions.

3:30 AM comes and, believe it or not, I am woken again by a little whisper-shout from the bottom of the stairs. “OK, Kid.” I say, “You’re scared. Grab the nesting materials from our closet and set up a place to sleep on the floor near our bed.” He agrees with palpable relief.

It’s that little high-pitched voice that gets me. Soon it will change and deepen. He will only be my little guy in Star Wars PJs for a little longer. Carl rustles up a soft bed made from a large down-feather quilt and several different kinds of “nesting” pillows we keep on hand for the kids. It’s usually used for watching movies. We don’t co-sleep, but whatever. Did I mention the part about 3:30 AM?

Finally, we sleep. The next morning I stumble downstairs like a bleary-eyed zombie. My face feels puffy. Carl is industriously putting his things in his backpack and getting ready for the day. I can’t seem to manage actual words so I grunt and mumble my way over to the couch. That’s when Carl hands me a fresh cup of coffee. Just the way I like it. My little big guy is now dressed in Nike sports gear and operating kitchen appliances.

Soon the days of monster-feet and the little voice will be gone. He is growing so quickly. Adopting kids from hard places is a long, difficult journey. But it’s amazing. It’s moments like these where It’s nighttime again, once more. These are the moments I can reflect and write about our lives. It’s all worth it. He has learned to show empathy. He has learned to trust. He has–wait…is he up? AGAIN?! Yes, he’s up.

What I meant to say was:

Please send coffee!!!!

 

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

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adoption, mental illness

When It’s Not Enough: Adventures in Getting Help

Yhosp1

It’s not enough. I’m not enough. All of the work we have been doing for the last 3 years is not enough to help our Little Bit. 10-year-old Mary is starting puberty. She is also starting to unravel in terms of her mental health. She is back inpatient again at the psychiatric hospital. So, yes, I feel like I am not enough for our girl right now.

During her last meltdown she locked the door to her room and then jumped out of her window. Barefoot. Mary then got into a fight with our outside garbage bin (she won) while screaming at me. I couldn’t stop her. She ran a mile to a friend’s house in bare feet screaming that she needed the police because her mom was trying to kill her. Of course the police came with the ambulance. But they came to take her back to the psychiatric hospital.

We have used up all of the local resources. We have In-Home Intensive Child and Adolescent Psychiatric Services (IICAPS.) She’s been through trauma-focused cognitive behavioral therapy (TF-CBT,) Family Systems therapy, ongoing trauma work, Intensive Outpatient Treatment (IOP,) Partial Hospitalization Placement (PHP,) medication management, and many inpatient stays. Was that all one sentence? We’ve also read every book, checked all of the research we could find on developmental trauma, and parented therapeutically using the Trust Based Relational Intervention model (TBRI) No matter how many acronyms we throw around, she is still stuck in a downward spiral.

I am helpless to heal the deep wounds she carries from trauma. They will never be entirely healed, let’s be honest. But we want to get her to the point where she is functioning at home, as opposed to being in fight/flight mode most of the time. I think puberty has started to re-trigger some of the trauma that she had already come to terms with.

Our entire goal is to keep her safe. We want her safe at home, not inpatient. I did find a great model for attachment and trauma work done in the home. In-home services are the most effective for our daughter, but most programs are not specifically  trauma-focused. Even if they are, it is not for complex, developmental trauma. Thank goodness I found the Attachment, Regulation, Cooperation model (ARC ) through The Justice Resource Institute (JRI.)

JRI is dedicated to helping children and adolescents mental health. They are one of the leaders in the field of research on developmental, complex trauma. (Often referred to as C-PTSD. More letters, I know!) Unfortunately, they won’t take insurance. They won’t take cash. They only contract through the Department Of Children and Families (DCF.)

So we are asking begging for their help. We are in the process of applying for voluntary services. I’m not sure what will happen, but I’m hopeful. We are in the fight of our lives right now. It isn’t us against our child. It’s us fighting with our child against the trauma of her past. The question is not if we will continue the fight. The question is whether or not the state of Connecticut will join us.

So here I sit, typing away my jumble of letters and acronyms. Since when did the alphabet take over my life?! All that’s left to do is wait. And hope. Will you hope along with us?

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

**If you want information about ARC or JRI you can go to www.JRI.org or www.traumacenter.org to learn more.

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parenting

Bra-gate: Puberty and Sibling Rivalry

My son is rolling around and whining on the floor, like a pained animal. All because he isn’t going bra shopping. Yup. He’s pretty upset. Mary is 10 now, and at the beginning stages of puberty. She needs bras. Badly. I can’t drive, so Nana and Papa are up. Aaaand now I’m home with a whining and moaning 11-year-old boy who doesn’t understand puberty (you can read about our sex talk here.) Carl is lucky he’s so darn cute!

He is consumed by his anger that his sister is doing something he is not. She is going somewhere without him. Clearly the world is a very harsh and unfair place. As he attempts to explain how very, very unfair this is, I try to explain a bit about girls and puberty.

Carl: OOOOohhhhhh. Why can’t it be ME?! Why can’t I be the one to go with Nana and Papa? Why do I have to be stuck here with you?!

Me: I love you too, honey. Mary needs new clothes. Fair isn’t everyone getting to do the same thing. Fair is getting what you need. And Mary needs to buy bras. She’s starting to grow breasts.

Carl: Well why did she have to do that? I want to!

Me: Honey, boys don’t usually grow new breasts.

Carl: That’s stupid. Why does she get new shirts?

Me: Again, she needs clothes to fit her changing body.

Carl: But she never changes! She is still annoying!

Me: No, it’s her body that’s changing. She needs bigger shirts now that she is growing breasts. You got new pants when you got taller during your growth spurt. Remember?

Carl: It’s still not fair. I want to do it.

OK. Well, if he really wants to go and buy some bras, then it’s fine. I lay a few of mine on the floor and ask him which style he would prefer? Just so we know what kind of bra to get him when Nana and Papa take him bra shopping. I explain sports bras, underwire, front clasp, halter style, etc. I say, “I support you, honey. I will always meet your needs. If you need to go bra shopping then you can.”

Carl freezes and a look of pure terror dawns on his face.

“GROSS!” he says,”Mom bras! Now I’m scarred for LIFE!”

And there ends the story of bra-gate. We collapsed into full-belly giggles and decided to watch TV instead. We laughed about it for the rest of the night. I hope Carl gained some insight about girls and puberty. I also hope he has less anxiety over his sister and their rivalry.  And would you believe that he never brought up bra shopping again?

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

 

 

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