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

Standard
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. 

Standard
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.

Standard
mental illness

Thank Hospital Vacation?

hosp

 

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.

Standard
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. 

Standard
mental illness

Trauma Team Super-Heros: Safety Planning

ykill

It seems like we are running through grade-school fire drills, but that isn’t the case. Right now we are preparing for our daughter, Mary, to return from an inpatient stay at a psychiatric hospital. She’s been having violent outbursts on the unit, so it’s possible she may still have them when she comes home. As they adjust her medication in the unit, we are making adjustments at home.

As we create a safety-plan for her return home we are simultaneously planning for my impending spinal fusion surgery. It’s all going to happen at some unknown point in time that is also very soon (?!??) Here’s what the plan looks like:

  • I will not be alone with Mary at any point in time until I am fully healed from surgery. Period.
  • We will remove heavy objects or anything that could be thrown, knocked over, or smashed from Mary’s room. This is for her safety and ours.
  • We will increase the amount of coping skills she can access from her room: body sock, thera-bands, play-doh, cardboard to crush, paper to rip, journal for writing, soft objects to throw or punch etc.
  • Luke and I have our phone always on us. If Mary shows signs of escalating we call for the mobile crisis team to come out. If she has auditory of visual hallucinations we will call mobile crisis for a safety evaluation.
  • If she becomes violent or dangerous, we call 911 for transport back to the hospital
  • Luke stays with Mary to keep her safe until help arrives.

Also, we have super heros helping us!

The Super-Hero Team supporting us when Mary transitions home consists of:

Superman: Their trauma therapist has some serious skills that can only been described as Kryptonion. Her X-Ray vision can see right through our kids into what’s really going on with them.  Her Trauma Focused Cognitive Behavioral Therapy has had almost supernatural success over the years. Sort of like Superman flying up to catch our kids when they were falling through trauma and PTSD. She sees the children no matter what other kinds of therapy they are having at the time.

Batman: The therapist at the partial hospitalization day program Mary will be attending is definitely batman. She has a batcave (office) with tons of coping skills (bat-gadgets.) She’s worked with both of our kids before, and she knows our family. You might even say she is familiar with Gotham City!

Wonder Woman: My husband and I see a therapist while our kids are in session to get better at being awesome trauma-informed therapeutic parents. She is Wonder Woman, because she has the “lasso of truth,” and can always get us to open up honestly about things.

Alfred: I think the Psychiatrist that will treat Mary at PHP is a lot like Alfred was to Batman. Instead of gadgets, he will be titrating Mary’s medication which will allow Batman to do her job.

The Scooby Gang: This consists of my parents, our children’s godparents, and family friends who are willing to watch the children (in separate settings) while I am in surgery. My parents have offered to take Carl for a few days if Mary isn’t safe with him while I’m in the hospital. This way, Luke can help Mary settle and regulate, while Nana and Papa spoil Carl.

 

I think we are about as prepared as possible. Now all we can do is wait.

Dear Trauma,

You might have won this time, but we’ll be back. And next time we will be ready for you!

Love,

Dedicated Trauma Parents

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

Standard
mental illness

Tantrums From Beyond the Grave

rogerme

Roger with me at age 12

 

Roger was telling her to hurt me. Mary was writhing on the floor scratching and clawing at her hair and face, as she spoke to him. She then tore apart her bedroom and started screaming at other people who weren’t there. She screamed the neighbor’s name a few times shouting, “Call the police! We need the police!” She alternated between asking for the police because I was hurting her or because Roger was hurting her. In the meantime I attempted to hold her arms down away from me as she attacked me. I was lucky enough to leave the room, before I could get hurt.

Mary launched a fully loaded plastic bin and a trunk out of her bedroom door and down the hallway. Even though it’s been 2 years since she has had a violent outburst directed at me, I remembered to hide behind the bathroom doorframe. As soon as I could, I closed the door to her bedroom and called for help. Yes, the police would be coming after all.

While waiting for the ambulance I could hear Mary screeching from the other side of the door. She was relatively safe as I had already removed scissors and sharp or dangerous objects from her room. Obviously I hadn’t thought about the plastic bin or the trunk, but she’d removed them herself when launching them down the hall.

Half of her screams are wordless cries and howls. Some of them are directed at “Roger,” and another unidentified person. Sometimes she broke into an almost gentle, crooning song. Then she yells at me, “I hate spending time with you and I don’t want to be in this family! Roger tells me you make all the bad choices. He hates you! I HATE you!!! I don’t want to live here!” She throws her body against the door as if trying to physically break through it to get to me. In her all of her rage, she has forgotten that her door, like all bedroom doors, opens inward.

There is nothing I can do. She isn’t listening to my words. She is listening to what Roger is telling her about me. I can’t go in and physically restrain her. With my back injury I can’t even sit or stand for longer than 10 minutes. She hasn’t been like this since 2014. I am surprised to say the least.

When my husband comes and the ambulance comes she is still in her room screaming at me for being a “stupid B*tch” who “never gets anything right.” In the ambulance and at the hospital she tells the same story. Roger was being mean. He told her to hurt me. He told her to do these things. Imagine everyone’s surprise to learn that Roger is my deceased father. A man she never even met when he was alive.

She is admitted in-patient again, for safety, at the psychiatric hospital. I am tired. I am frustrated. I am mad. It’s not anger at my daughter. She can’t help the mental illness that is causing these auditory hallucinations. Somehow I am irrationally mad at my father. We always had a strained relationship, at best. Now, somehow, it seems he has managed to find a way to mess with my life from beyond the grave. Thanks a lot, Dad.

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

 

Standard