adoption, family

When the Grass is Greener: Residential Treatment

That old adage about the first year of marriage “being the hardest” is a myth. When I married Luke ten years ago, I had no idea what it would really be like. It was a whirlwind of anticipation. At the time, I wondered what the grass really looked like on the other side.

The first year of marriage wasn’t hard. The first year was delightful. It was filled with blustery New England storms. They’re called “Nor’Easters” and I love them.

Luke and I would curl up together in front of our apartment’s floor-to-ceiling windows. We listened to the wind howl as a soft white blanket covered the world. We’d sip hot, exotically flavored, coffee Luke would brew. I’d clutch my mug of “almond toffee” or “coco-mocha” and tuck my feet underneath my new husband’s lap. My hands and toes would warm me into a languid, dreamy state of contentment.

Old folk sayings never do these things justice.

“Everything happens for a reason.”

Then why did all of these terrible things happen to our children before we knew them?? Why weren’t we there at the beginning?

“The grass isn’t always greener on the other side”

It is greener. Being married to Luke is sooo much better than before-Luke. Our daughter’s residential treatment center is sooo much better than the psychiatric treatment facility where she was. 

I didn’t realize how effective the residential school would be. I didn’t realize how much good they would do for our daughter. I didn’t realize how supportive they would be to our whole family. I didn’t know how much it would hurt. They are doing what we could not.

Mary is finally in a place that truly understands developmental trauma. The non-profit that runs this residential school specializes in adoption-related difficulties. They know complex trauma inside and out. They use effective, evidence-based treatment models. They all communicate. The staff are all well trained and on the same page. Mary is being kept safe.

I’ve never heard her take ownership of any part of her treatment. Lately she’s been talking about what she can do to reach goals that she has set for herself. She’s responding to the structure and boundaries of this place. Hugs are for families, not staff. Mary cannot call any of the staff “mom” or “dad.” She doesn’t sit in laps or snuggle the staff. They gently remind her about what her family is there for.

She isn’t allowed to call me between 10 and 30 times per day to scream at me when she is unhappy. Instead, she is encouraged to build better family relationships. She may call once a day and she is explicitly taught about how to speak to her parents respectfully.

The best/worst part is that it is all working. We are having pleasant visits. We enjoy our phone calls with Mary. She is making connections about what they are trying to teach her. I know we are only at the very beginning of residential treatment but I have such newfound hope. So far it’s everything we weren’t able to help her with and more. The grass is so very green here.

“Jealousy is a green-eyed monster.”

I am so jealous. I am this monster. Why couldn’t we have accomplished this at home?

Their program is nearly identical to what the kind of therapeutic parenting we practice. The relational model we use is the same. We don’t have their staffing. We didn’t get their results. It hurts.

This first year of RTC is shaping up to be so successful. Will it be the hardest? I don’t know.

“Hindsight is 20/20”

What I do know is that ten years into marriage, I can look back and laugh at my worries. Perhaps, when she’s been safely at home for ten years, I will look back and see the same. Until then I will curl up with Luke while the wind is howling. I still have a warm place to tuck in my feet while we wait out the storm.

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

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adoption, family

Are You My Mother?

What is it like to love someone who doesn’t love you back? Or maybe the better question is what is it like to love someone who isn’t capable of loving you in a reciprocal way? I ponder this all the time because I live it. Loving my daughter with attachment difficulties is one of the hardest things I’ve ever done.

I’m her mom. To me, nurturing her comes second nature. I want her to be happy. I want her to do well. I so desperately want to help her after all she has been through.

For Mary the word “love” has an entirely different meaning. Nurturing in her experience means having a female figure who helps her to survive. The woman must give her attention at all times because even a glance away can mean death. Mary can remember what severe, chronic neglect feels like.  A woman who yells at her or hits her is still providing the attention Mary feels is necessary to survival. It no longer even matters who the woman is.

The “woman” is interchangeable. It could be anyone. Mary isn’t able to tell the difference between a healthy bond and an unhealthy bond. A woman who has just met her has the same value as one who provides food, shelter and affection. There is no standard here. The only burning need Mary must have fulfilled is that there is another woman and then another and another one waiting somewhere after that. This way Mary can never run out. This way she feels as if she can survive.

I do my best to meet the challenge of parenting a child like this. I always fall short when it comes to giving her enough attention. Having anyone else in my life is too much for her. My going to the bathroom is too much for her. When I watch the road while driving the lack of attention drives her into a panic. No one human person can provide enough for Mary to feel safe.

She will throw herself into my arms and snuggle and play and be happy for a time. I will feel like we are making progress. Maybe she is feeling safe. Then I will find secret letters she has written to strangers with nice jewelry. They will say, “I think you should be my mother now. My parents don’t want me. Maybe you can adopt me and we can wear necklaces.”

It sucks. I mean it is heartbreaking and sad. I know that the minute she can no longer see me I am forgotten to her. She’s moved on to another way of getting her needs met. She is a survivor and she will love the one she’s with.  I really hate this part of an attachment disorder. I understand it in a logical way. I just hate it.

Trying to explain attachment disorders to the staff at her last psychiatric facility (PRTF) is akin to nailing jell-o to a tree. “Please keep reassuring her that Family is forever. She has a biological family and an adoptive family that love her. We will always be here.” That facility let her call some of the staff “mom” and “dad.” A lot of them meant well, but were ill-informed.

They told her that her command hallucinations were “the devil,” and that she should keep him out. Don’t ask me how a psychoiatric facility has staff that aren’t familiar with auditory hallucinations, complex trauma or attachment disorders. They were the only PRTF for a child her age. Insurance gave us this or nothing. Mental health care (or lack thereof) in our country is a whole different story…

I found that some PRTF staff members had made secret pacts with our almost-11-year-old. They’ve told her they can call each other from Mary’s new RTC program. They told Mary it was alright not to mention it to us. They will find each other someday. They have known Mary for all of 7 months.

We moved her into the new residential treatment center (RTC) a few days ago. They specialize in complex trauma and use reserch-based treatment methods. I am pretty sure they don’t beleive the devil is causing her to hallucinate, or that she is collaborating with him etc. Instead, they greeted us with “Welcome Mary!” signs everywhere. They remembered everything from the information we provided. They kindly but firmly stated that staff are referred to by name and that only famililies have titles like “mom” or “dad.” Every staff member on the beautiful campus greeted her by name immediatley.

This is  a 45 day diagnostic placement to determine if she needs a residential setting to keep her (and us) safe while accessing her right to education. Keep your fingers crossed for us. We were beyond lucky to get her this placement  through an IEP with her school district. It’s almost impossible to do. Almost.

Impossible isn’t a word we use in this family. Nothing is impossible. Not even love.

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

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family, mental illness

The Hard Truths

Goodness knows I wish I didn’t have to face the hard truths. If there was a place I could hide from them I’d probably be there right now. Our daughter is not doing well. She isn’t getting any better. I’d like to protest and remember all the progress she had made. I’d like to remember the years where she was stable. I’d like to believe she is improving. Unfortunately that is not the truth of things. Her hallucinations are becoming stronger. I feel like our girl is slipping further and further away from us.

Mary is about to switch into a longer term residential facility. It will start with a 45 day diagnostic placement. Based on the recommendations of the program, she will stay with them for up to a year. We were lucky enough to get this residential school through an IEP. Without that we surely wouldn’t be able to afford this treatment. What we need is the truth of things. Will this next step help our Mary?

I also think we need to face a harder truth. Is there ANY treatment that would help Mary? Would anything else keep her safe at home? The answer is probably not. I think this truth is made so much harder by the fact that we had a few good years. She was relatively stable. She was relatively safe, at least physically.

I find myself seeking truths from other blogs. Does anyone else have a child who hallucinates voices that want her to hurt people? What do people do with children who are so mentally ill that they can never be left alone? Ever? People send me words of encouragement and I appreciate it. People also send some rather strange advice. I mean we have obviously tried in-home intensive treatment and every possible combination of outpatient programs, medication, and therapeutic strategies. (It seems unlikely that your magic oil will prevent Mary from stockpiling knives and trying to capture her brother alone in his room. I like essential oils but they are not a safety measure by any means.)

Truth is an evasive thing. I used to think almost anything could be found on the internet. This is not so. I simply cannot find stories of families like ours. Where are all the other parents of children with developmental trauma or attachment issues or Bipolar Disorder? Have they found any treatment that works? Or are we simply alone? This truth is a hard truth for me.

They are silent. Families like ours are silent in the truth of their struggles. They are silent about what they endure or how they fight against their child’s demons. I can find a hundred blogs about families with physically ill children. They are applauded for speaking their truth through the tribulations of cancer, diabetes, and rare genetic diseases. Not so for the parents of children facing mental illness. We are left in shadow and told to be quiet about our experiences. There is a shameful stigma to this kind of thing. People would rather not face this truth.

So I share our story. I don’t want others to feel alone on this road. It’s a difficult one but it exists for more children than just our daughter. We got hard news today in a meeting with the clinical director from the new residential school. They have an amazing, cutting edge program based on the latest research around complex trauma. However they don’t have good news. For a case like Mary’s the results are mixed. Many kids who are this dangerous need years of residential treatment to go home, if they ever can. Even the best treatment cannot work if she won’t try.

I have no answers. I have only truth. Only our truth. I share it with you so that hopefully some of you feel less alone.

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

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adoption, family, mental illness

At Least She is Safe

The holiday season is the WORST for our daughter. It always has been. This is when Mary is typically hospitalized. This year is no different, except that she is safe in a psychiatric treatment facility. When Mary is with others outside the PRTF or the home, she is happy and pleasant. When she is with her attachment figures, it can flip in an instant.

Mary’s already had multiple violent outbursts this month. Earlier this week, she threw herself backwards down the stairs during a meltdown. Now she is covered in bruises. She’s been running away from school.  Yesterday, at her PRTF, she threw a weight directly into plaster wall, leaving a hole.

Tonight the staff called me to help “support.” I am not sure if I was supporting Mary or the staff there. She had been in a protective hold twice for attacking the staff. She went after her primary caretaker there. When I asked why my daughter said, “She deserved it. I don’t care.”

But Mary DOES care. That’s why she goes after the mother figure closest to her. It comes down to triggers specifically about the shower and the holidays. Also, having a mother-figure is a huge trigger, in addition to being something she craves. Mary’s longtime trauma therapist says there may be some kind of pre-verbal trauma Little Girl doesn’t even remember. We may never know what it is. But somehow we must learn to deal with it.

I can’t eliminate shower/bathtime. I can’t eliminate Christmas. I can’t eliminate moms. And I can’t do the therapeutic work for her. EMDR, play therapy, IOP, PHP, TF-CBT, attachment therapy, psychiatric service dog and in-home services are just a few that we’ve done over the last 4 years. And we won’t stop trying…it’s just…well…

I hate to say this but I’m glad she is safe at her PRTF. I’m glad we are all safe here at home. Mary needs residential. It’s so sad to admit that. We’ve tried everything possible to keep her safe here. We cannot meet these needs in a home setting. Now she will be transitioning to a new program. We start with a 45 day evaluation and then see if Mary qualifies for the program. It’s a prestigious school that specializes in complex developmental trauma and relational problems. It was not easy to get her there.

Now we have to hope that her new therapeutic residential school helps. She will start there sometime this month. And, yes, I have to tell this story. Because who else will? This is what parenting through mental illness and developmental trauma looks like. If you are a parent out there struggling to help your child, you aren’t alone. If you are the praying kind then please pray for us.

 

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

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adoption, family

While She is Gone

So many things happen while she is gone. There are birthdays, holidays, and family outings. There is so much lost time. And yet, I ask myself: what really happens while she is gone?

Mary has been at a psychiatric residential treatment facility (PRTF) for 5 months. People will ask me, “Do you get to see her?” Yes, of course we get to see her. She isn’t in jail. We have visits and day trips and we’ve even made it up to almost 8 hours at home on a handful of occasions. Ok, maybe just 2 occasions, but we are working on it. It’s just not enough.

Luke and I travel the hour drive one-way to see her about 3 times a week. Once is for a day-trip visit. once is for a family therapy session at the PRTF. The third is for an attachment-focused therapy session “off-grounds” with a psychologist. This last one is the ONLY therapy session in which she will participate. I’m almost certain the psychologist is part wizard.

In the PRTF session she mostly screams at the clinician, Mrs. T. Mary runs away, laughs uncontrollably and then smashes things during Mrs. T’s sessions. Afterwards she asks me to take her to lunch as if nothing has happened. Instead, I’ve begun to call in for the PRTF sessions because nothing beneficial is happening during that time.

Mrs. T has decided that whatever happens in therapy will be Mary’s choice but if she won’t go to session her “level” will drop. So Mary goes and sits in the room. She screams and slams things. Mrs. T assures her they will only talk about what Mary wants to talk about. They will only do what Mary wants to do. Not being a therapist herself, Mary makes some interesting choices. She chooses a lot of yelling and foul language at said clinician. Eventually she colors some pictures about why she hates therapy. Mrs. T praises Mary and sends her on her way.

I know they care about Mary at the PRTF. Mrs. T wants her to do well. Everyone wants Mary to improve. Everyone except Mary. Maybe she is too scared to try. So all of us keep trying while she is away. Mrs. T acquiesces and cajoles to no effect.

Not so with Dr. P, the off-grounds psychologist. He calls Mary out for her avoidance tactics. He lets her know that mom and dad will go to lunch and she will stay behind if she won’t participate. After all, it’s her session. She has to finish it but we do not. Oddly, she isn’t upset by this. Instead, she responds fully. He somehow magically draws her out of her shell. She would never scream at him. So Luke and I attend this weekly session together, every week. Dr. P has Mary sit in between us to “feel the love all around her.”

Dr. P has many insights into why it’s so hard for Mary to share Mom. He is very, very good. I still spend so much time wondering: what is really happening with her? How much progress is really taking place while she is there? While she is gone, we are all safe. Are we really accomplishing anything else?

Because life is happening while she is gone. Our family is healing while she is gone. The world continues while she is gone.

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

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adoption

Out of Our Home


Where is she? Where is the little girl that stuck so close to my side that we nicknamed her “Barnacle?” She is at a short-term residential treatment facility. She isn’t home. Her bed is empty and her room is spotlessly clean. After all, arranging her things neatly seems to be about the only day-to-day “mothering” I get to do right now.

Being separated from my 10-year-old daughter makes me wonder about biological parents with children in foster care. Do they wander through their child’s empty room, burying their faces in a discarded favorite sweater? Do they wonder at every visit why their child hasn’t been prompted to use soap, or wear clean clothes, or why they are watching so much TV? Or maybe that’s just me. I am a walking cliche.

Mary has been at the treatment center for almost 3 months now. We see her three times per week. Two therapy sessions and one weekend visit. It seems like the program intends for children to go home on the weekends. Parents pack up their child, have a great sleepover, and then send them back to continue treatment. Only, no one can figure out how to do this with our girl. She still claims that she is afraid to hurt us. She acknowledges that she wanted to “kill us by stabbing,” but she doesn’t know why. We can’t keep her physically safe here.

We tried to have Mary home on a day pass. She cornered her brother and whispered death threats to him. He was further traumatized and Mary was dysregulated. Rather than being a productive bonding experience, it gave Mary the opportunity to keep me away from anyone else. Once she had me, she either pointedly ignored me or tried to say hurtful things. It is as confusing to me as I’m sure it is to her. After a few hours, we called it quits. So, no overnights for us. Especially not while she still threatens her brother.

Instead, Luke and I visit her in the community. We take her around to local places so that staff support is close, if needed. This has been relatively successful. Mary enjoys this full parental attention (so do we!) along with new clothes and fun activities. Although, I’m not sure at all how this is preparing her to come home.

“Older child adoptions can be hard,” the residential therapist says. I know this. “There can be attachment difficulties.” Again, I know. “I am changing her diagnosis to Childhood Bipolar Disorder.” Yes, she has been diagnosed with this in the past. “These issues may be ongoing.” Yeah, I got that part of the equation a long time ago.

“Maybe you should have her get an Occupational Therapy evaluation.” Done. And actually, unless you’re worried about fine motor or visual motor skills? It’s mostly an observation and maybe some checklists. Then you get some sensory processing information. Like, say, a sensory diet. Which Mary has. Which I wrote in the 30 page intake packet the residential therapist had us complete. (As an aside, I cannot tell you how much I miss her outpatient trauma therapist!)

Sigh. At the end of the day, I don’t think this place offers the kind of help Mary needs. Every day they go out to the beach, the movies, an amusement park, Chuck E. Cheese, or out to eat. I fear that all she will learn here is that she likes to be taken somewhere fun at least once a day. They don’t have any specific social or behavioral goals. They just go. They don’t have any kind of background in complex trauma and attachment. So I arranged for attachment therapy with a psychologist. It’s the best I can do.

This feeling of helplessness cuts me deeply. We couldn’t keep everyone safe so she needed to be there. Do bios feel this way when their child needs to go into foster care? It’s horrible, like having slimey day-old fish residue stuck in your throat. I don’t know what to do. I am looking for answers. And I am looking for my daughter. Always.

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

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How Are You? 


It’s such a loaded question.

“How are you?”

“I’m in pain. I still can’t drive. I’m pretty sure the anesthesia from my surgeries has caused some major hair loss. A rare reaction, but then I am the Murphey’s Law of patients. And when I tuck my daughter in I have to do it via phone call because she’s in a therapeutic facility. Because we weren’t save when she was home. Because she wasn’t safe. Oh yeah and sometimes I have to ask my husband or son to tie my shoes.”

Ok, it sounds bad, I know. But adopting children from hard places can be…well, hard. And then the rest of life happens.

Let’s try this again.

“How are you?”

“Fine,” I reply. “Getting better every day. I’m working really hard in physical therapy.”

“How is your daughter?”

“She’s working hard in therapy.”

She is. And so am I. Only it’s really slow going.

But that’s not all that is happening. My parents are here with me. They moved halfway across the US to be near my family. Luke and I got to adopt the most amazing kids. We really did.

I have great friends. We have support. And they never give up on me. I have rides. I have encouragement. We are not alone.

And get this, I am a mom! Yeah, that’s me, the proud Mama milking every last moment for family-goodness. Sorry about all the pictures, Facebook. My family is CUTE!

Our son is flourishing. Carl has become a topless chef. Yeah it’s true. He cooks dinner without a shirt. He bakes pies and cakes without a shirt. Who needs an apron?!. We fill our days measuring and mixing in the kitchen. Then we spend the evening playing card games like Uno, Skip-Bo, Monopoly Deal and Exploding Kittens (that last one is, believe it or not, is a real game.)  Oh yeah, and there are no meltdowns. I mean, none. I hope I’m not jinxing this! 

Having peace in the house has had an amazing effect on all of us. We aren’t walking on eggshells. For the most part I’m sleeping at night. And when we visit Mary our time is spent having fun rather than struggling to get through.

The truth is that developmental trauma sucks. It’s an ugly beast. Disorganized attachment patterns suck. Mental illness? It’s so hard. And our daughter deals with all of these things. And we deal with all of these things, too. It kills me that I cannot protect her from any of this. When I became her mom, it had already happened.

So how am I? That’s a tough question. Right now I’m just counting my blessings.

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

*If you’ve ever struggled with “How are you?” I’d love to hear from you in the comments below!

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