adoption, mental illness

Mania and Matricide: It’s Not OK

cdadlock

Installing deadbolts

It’s not OK to hit me. It’s not OK to bite me. It’s not OK that I have a scar on my head from where you split it open with a high heeled shoe three years ago. It’s not OK that our son has to live at my parents house because he isn’t safe here. It’s not OK for you to plan on stabbing me and stabbing your brother. Not with a kitchen knife OR with a bottle opener.

It’s not OK that we’ve installed cameras with motion sensors and night vision in all the public areas of our house. It’s not OK that we have combination locks on the cabinets where we keep all the “sharps.” It’s not OK that we had to install deadbolts on the doors to our bedrooms. It’s not OK that the motion sensor alarm goes off to wake me up at 12:30 AM when you are wandering the house in search of a “stabbing weapon.”

It’s not OK that you told your therapist today that “Mom has to die!” and then threatened to kill yourself and your brother. You’ve been planning this ever since your last few hospitalizations. Last time they called you “depressed” and started a course of SSRI medications. Not OK!

When you came home your depression became a manic state. You became a child with pressured speech so fast that you stopped using consonants. You started your “hyper phase,” which means you never sleep. You laugh harder and harder until you are screaming and then breaking things. It is not OK that we had to “toss” your room and remove all of the hard furniture and sharp objects. It is not Ok that your service dog found a jack-o-lantern carving knife and gave it to us (well, actually it’s very OK with me that the service dog probably saved our lives.) Did you find it during a night of wandering around the house? Your hand was always holding things under your blankie, ever aware of the cameras. This is not OK.

dakota1

Dakota Blue, the service dog

You want to know what else is not OK? It’s not OK that the inpatient doctors refused to call your PHP, your psychiatrist, your trauma therapist, or your in-home service team. It’s not OK that they sent you home with an active murder plan and a spiraling state of mania that escalates into more grandiose and diabolical schemes. It is not OK that the state’s voluntary services program we applied for does not consider planning murder to be “clinically acute” enough for a short-term residential placement.

There are some other things that are not OK. It was NEVER ok for you to be neglected as a baby. It wasn’t OK that your pediatrician never reported to anyone that you were in the 12th percentile for weight and selectively mute. It is NOT ok that DCF had been involved with your bio family for 10 years before removing all of you. They were getting hotline calls before you were ever born! It is not OK that any attention you got from your bio mom often became abusive. It is not OK that you lived in terror and learned how to survive the ever-rotating bevy of strange men in your home.

It is NOT OK that I wasn’t able to be your mom in the beginning, when the bad things were happening. It’s not OK and it is not your fault.

Here is what is OK. It is OK that we knew about your mental health concerns when we adopted you. We chose you because you are more than a diagnostic label. You are an amazing girl. You are OUR girl. It is OK that you need to be somewhere safe right now until you stabilize. It is OK to need medication to help you do that. It is OK to grieve the first mother you ever had. God, I wish I could give some of that back to you. The good parts at least.

Our family is going to be OK. It isn’t easy getting there. Yes, we “chose” this life. But I still say we chose the best children. Nothing in life is easy. The best things are hard. I’ve seen parents with profoundly disabled children flourish. I’ve seen severely autistic children learn to read. So yes, we will be OK. It is OK to decide we are not going to try for a biological child. It is OK to stick with the family we have.

it’s OK that it takes an attachment-disordered child a long time to overcome the fear of love. It’s Ok that you inherited some of your bio mom’s mental health concerns. It’s OK because you will never struggle on your own the way she had to. It’s OK as long as we can all stay safe. And I pray that we can. We have done everything in our power. The rest is up to you, sweet girl. Don’t doubt yourself. Mental health can be a manageable illness. Love will always be there for you. No matter what.

ycameran

night vision camera

 

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

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adoption, Attachment Disorders

If I Die Before I Wake

I pray the lord my soul to take. I wish these were just the words of a bedtime prayer. In my case, these words are real. If you’ve been following my blog, you know that our children have experienced an intense level of unspeakable trauma. Luke and I know this. We know how to parent therapeutically. We know how to get as many services as possible for our daughter. It doesn’t matter. She is a real danger to me and to her brother right now.

Our daughter has learned to survive. Her current diagnosis are PTSD-dissociative subtype and Reactive Attachment Disorder, with periods of psychosis. There is a lot of chatter about the RAD diagnosis, which I won’t get into here. Because I don’t care. Whether it be Developmental Trauma Disorder  (DTD, which never made it into the DSM-V) or RAD or PTSD or DMDD or any other diagnosis she’s had, it doesn’t matter. She still wants to kill me. A mother’s love is something she craves so badly that it hurts her. It twists her happy feelings into anger and possessiveness.

It all started the month we needed to buy her bras. She’s only 10 but here comes puberty. And so it began. In with the bras. Out with the effectiveness of her medication. She began hearing voices. SHe started to journal about my death. She began to tantrum and scream and fight invisible foes that only she could see. Oh, my dear little Mary, how I wish I could fight them for you.

Her love for me is desperate and all consuming. She needs me every second of every day. If I take a shower, she tantrums, if I leave the room, she explodes in a fit of rage. If I ask an innocuous question such as, “Do you like your new shorts?” She hears, “I hate you. I no longer love you. I am abandoning you.” When I turn to her brother for a momentary comment, she attacks. She will circle me and chase me with her little fists flying. She is trying to hit me in the spine. She will cripple me before allowing me to speak to Carl. So far, it hasn’t worked.

“If I can’t have you, ” she tells me, “no one can. I will stab us both.” In the night or early morning, she will loom over the bed, watching me sleep. “Mama?” she whispers, “Do you love me?” Of course I do. But I can never show her enough to quell her fear of losing me. She will make comments on my facial expressions. Why did my eyebrow twitch? Why did I move my top lip? Am I trying to get away? Have I stopped loving her?!The last 3 years of Trust Based Relational Intervention made all the difference, until now. TF-CBT made all the difference. Until now. Her anti-psychotic medication made all the difference. Until now.

The worst part is that it becomes unpredictable. We play mirroring games, and we snuggle, and I giver her all of my attention. Our time is spent connecting. As close as I stay to her, and as much love as I provide? I can never guess when a momentary glance at another person or thing will invoke her uncontrollable rage. We keep our knives and “sharps” locked up. You need the combination for a screwdriver in this house. Only, she finds other things. She shows me a bottle opener I’ve overlooked.

“You know this is sharp enough?” she casually quips, “I could stab you with this.”

The part that gets to me is how she discusses my murder without any observable emotion at all. Her brother tells me that earlier that she’s tried to figure out the combination for the lock on the knife cupboard. We only use plastic silverware in our house now.

As far as I can tell, nothing has changed. Nothing except the onset of puberty. Her intense violent rages happen every day. She injures herself most frequently.  She rips out her hair or punches herself in the face. She screams about murder. And blood. And the death of everyone on this planet who has ever hurt her. The bio-mother who abandoned her and hurt her. The mother she has now who sometimes needs to shower.

She is being released from the inpatient psychiatric hospital for the 5th or 6th time tomorrow. I’ve lost track. We have in-home services. We have an amazing trauma therapist who has worked with her for 3 years. We have a parent therapist for Luke and I. We have a partial hospitalization program set up that she has used more than I could even count over the last 3 years. There aren’t anymore services, unless the state agrees to help. Her medication no longer works. Today the inpatient hospital program told us they are releasing her tomorrow because there isn’t anything more they can do for her on the unit. Ever.

We’ve called a meeting with all of her providers for safety planning. We have PHP, Trauma team, And IICAPS (Intensive In-home Adolescent and Psychiatric Services) all concerned for safety is she is home. I miss my girl. I want her home. I’d just like to remain alive for her childhood. She hasn’t managed to truly hurt me yet, beyond a few arm and leg bruises. She hasn’t hurt Carl yet. It isn’t for lack of trying. It’s because Carl and I are too quick. We lock ourselves away and call for help.

Luke and I are doing the only things we can do. We are installing security cameras in all of the common areas of the house. Everywhere except for bedrooms and bathrooms. We need to objectively see what is happening. It’s entirely possible that we are unwittingly triggering her in some way. It is entirely true she doesn’t want anyone to see the things she does in the privacy of our home.

It is also highly probable that she’s spent a lot of time talking to “Josie” the “ghost” who orders my death (and possibly that of her brother.) The therapists in our home see her mood fluctuation and dangerous actions. So does her long term trauma therapist. But to most other clinicians? She is the sweetest most charming girl of all. She has always had to be this way, in order to survive her biological home. My Mary is a fighter. A survivor. For this, I am proud. I only wish she didn’t feel the driving need to survive being loved. 

Mary flipped out and began to yell at us and her inpatient therapist in the hospital today. She doesn’t like the cameras. She doesn’t want others to see her violence and destruction. She doesn’t want anyone to see her try to hurt Carl or try to attack me. When we don’t make progress with her on-call crisis team, we call 9-1-1. She will scream at the police and yell at the EMTs, but they never hear her plan my murder. Once we get to the psychiatric ward she is completely calm. Perhaps the video will help us to show what happens. After all, she only threatens or attacks those she loves the most. This kind of deep attachment-related trauma won’t be seen on a psychiatric ward. She simply does not require or crave deep relationships with revolving staff.

What she really needs from me is proof of my unconditional love. I try to give this as much as I can. Is it enough? It never is. What she is getting is 24/7 surveillance. Just in case. Because our daughter is trying to literally love me to death.

So if I never blog another post? Well then, I guess you’ll know why. 

 

yletter3

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

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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, 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?

ynote2

 

**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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adoption, family

Therapeutic Strategies for Sleep Disturbances

Our Daughter has such a difficult time sleeping at night. She used to physically fight for her life when bedtime came (you can read about it here.) Bedtime triggered her fight/flight response because she experienced trauma at this time in her biological home. Luckily we have the very best trauma therapists to work with us and out children with therapeutic strategies. These are some of the best strategies to calm our daughter’s fear response at night. She needs to feel safe in order to rest.

  1. Comforting Smells: I like to use lavender scented baby lotion to give her arms a deep-pressure massage before bed if she needs it. She will also put a drop of essential oil onto a tissue and rub it together. Then she holds it to her face and breathes in slowly. Smells activate the brain’s Amygdala, which triggers memories from the hippocampus and can activate an emotional response. The mom-massage is a good smell, thus triggering feelings of love and safety. I also rub a bit of my hair conditioner in her hair before bed sometimes.
  2. Comforting Sounds: We have a noise machine for both of our children. They can choose to listen to white noise, rain sounds, a forest, the ocean, a brook, etc. They use these sounds as a coping skill when they need to calm down throughout the day. The sounds also give them a sense that they are not alone in a scary place.
  3. Soothing Light: Our children have always needed a night light to sleep. Complete darkness means they can’t see if any danger is approaching. Although there isn’t a real threat inside our home, our children have an overactive fight/flight response. In order to calm this fear we provide creative nightlights. Our daughter had one that was activated whenever a the light was turned off. We also have a mushroom nightlight probably intended for infants. It projects a series of flowers and stars onto the ceiling with slowly changing colors and designs. This is mesmerizing to look at and soothing for her to watch. Our son has a moon-light that comes with a remote control. He can switch the phases of the moon depending on his mood. A quarter moon if he feels safe, a full moon if he is feeling afraid, and a rotating phase moon to look at if he can’t sleep.
  4. Soothing Taste: Fruits and vegetables are always available for our children in the house. Our kids choose an apple or a clementine (Yuck! After brushing teeth?) before bed. Sometimes our daughter will choose to eat a lemon. I can’t explain that one! Tasting food before bed helps to ease the constant fear that there won’t be enough food and they will starve. This is another leftover fear from their bio-home.
  5. Calming touch: We have given our children physical objects that they can hold throughout the night in order to help them. One of these is a giant stuffed dog named “Mr. Luke” that my daughter has slept with since she got home. It always wears one of daddy’s dirty shirts (preferably from that day) so that she can hold it and feel like daddy is there, protecting her. We also bought Mary a large body pillow and our family wrote positive messages all over it. We used fabric markers but permanent markers might have been just as good. Then we wiped my deodorant all over it and dressed it in my dirty shirt from that day. This way Mary can feel like she is sleeping between mommy and daddy.
  6. ROUTINE, ROUTINE, ROUTINE: Every night we keep the same schedule so that our children know exactly what is going to happen. This gives them a sense of control over a world that was previously chaotic and unpredictable. Their bedtimes remain the same, even on weekends (with maybe a 30 minute difference.) While one child showers, the other child gets to choose an activity  with mom or dad, completely led by them.  Every night I say the same goodnight. I rub their backs, slowly counting down from 10. Then I touch their faces in the same pattern and say the words, “I love you forever, no matter what, and I am so glad your home!” Then we both make a “pop!” sound with our lips and hug each other.

 

At the end of the day, I wish I could tell you that everything is fine and our daughter has no trouble whatsoever sleeping with these strategies in place. Unfortunately, That simply isn’t true in our case. Ever since she’s come home from an inpatient stay, she’s been seeing “monsters” and hearing “talking things” downstairs. If I had a completely healthy back, I might sleep downstairs with her for a night to show her it’s OK. But I can’t. So we’ve moved the bedroll upstairs to the hallway right outside our bedroom. This way she knows mommy and daddy are close. My fingers are crossed that this stage won’t last long. Either way? She’s our girl and we will do whatever it takes to make her feel safe at night!

 

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

 

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family, parenting

Why I Don’t Co-Sleep, and I Don’t Care If You Do

yhair

I Lied. This entire post is about to be a lie! My husband and I always had a pact. We would be the only two people in our bed.

We would make time to spend with just each other, every night. Mom and Dad’s “Special Married Time” was sacred in our house. Yes, sometimes our kids would wake with nightmares, and we’d tuck them back into bed. But then Luke and I would return to bed. Alone. We like to spend time together and we like to have sex (and here’s how I had to explain it to my kids!) We both think it’s important to our marriage. So the bottom line is, “no kids allowed.”

But then we adopted kids. Traumatized kids who came from hard places. We did our best to maintain that boundary, until last night. It was our 9 year wedding anniversary. We’d been together for 10 years exactly (We got married on the first anniversary of our very first date.) After a decade together, we wanted to do something special. Since my recent back surgery, I haven’t been able to do much, though. The original “out-on-a-date” plan was replaced with a tentative plan to make very, very gentle love, then have chinese food and watch our new favorite zombie show in bed. I even put on make-up! (Carl’s comment was, “What happened to your face?!)

And so, we put our children to bed. Mary began to sob and cry. Her eyes weren’t even open but she was crying. She hasn’t been afraid of bedtime in almost 3 years. Ever since she got back from the hospital, and I had my back surgery, she’s been afraid again. We’ve done our best to soothe her fears. We use a soothing sounds noise machine, a sensory pillow, her blankie, essential oils, and her favorite cat. Carl even slept on the floor of his room one night so that she could see him across the narrow hallway and wouldn’t feel “alone.” He tired of that after about 3 nights of her waking up crying.

OK, I lied again. We attempted to put Mary to bed. First dad stayed with her. Then I awkwardly hobbled in on my walker to lie uncomfortably on her bed to hold her. She claimed she “couldn’t breathe” because she was so scared. I held her back against my chest as we breathed in and out together using a “belly breathing” technique to calm her. Then I rubbed her back in circles and whispered soothingly, “mommy’s here,” over and over again until she finally fell asleep. Then I clumsily angled of of her bed and back to my walker. Ouch! Definitely time for my pain medication.

Now, Luke and I knew she would wake up again at some point. She is really and truly scared, probably because she is triggered. It may be my back injury that makes her scared to be away from me. It may be that she has been away from us at the inpatient unit in the hospital. Either way, Luke and I knew our anniversary celebration was on a time schedule. So we got to it right away. And then we put our Pajamas back on and went to sleep.

Sure enough, Carl woke us up around 1:00 AM to tell us, “Mary is crying AGAIN!” Not being able to go up and down the stairs more than twice, a day I gave in. We ALL needed sleep after the last week of Mary waking to cry repeatedly through the night. “Send her up,”I said, defeatedly.

Mary came up, clutching her blankie, hiccuping and trying to stifle her sobs. “Climb in,” I told her. And she did with an instant sigh of relief. We all slept amazingly well after that. Mary was snuggly and warm. I typically snuggle Luke but this was even rather pleasant.

I realize that every family is different. Some people do this all of the time. Hey, I don’t judge that. If this is what works for a family, then why not? After last night I am able to see the appeal of holding your child close and helping them to feel safe. I just don’t personally want to do it all the time.

So I spoke to Mary about how we would need to address her new night fear with her therapists. She agreed. I explained in a gentle way that we love her and we want her to feel safe. We just don’t want her in our bed every night. I held my breath and waited for her to protest, or beg, or even cry.

Instead she nodded and said, “Yeah, I don’t want to hear Daddy snoring all night, either.” Well, there you have it!

 

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

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