Monday, November 14, 2011

Identifying PTSD and RAD/RADish Issues:

If It Walks Like a Duck, and Quacks Like a Duck, It’s Probably a Duck!

One of my biggest frustrations for families is when parents refuse to acknowledge the fact that their adopted child has suffered trauma and has attachment issues.  Usually it’s the mother who is actively “in denial.”  The fathers I’ve talked with admit they don’t usually think about how to deal with post-adoption issues unless their partner brings it up first.  They know they get irritated and frustrated at certain behaviors, but once the situation has passed, they move on (until it happens again).  The thing is, dear parents, your adopted child (especially if he or she is an internationally-adopted child who spent time in an orphanage) has suffered trauma, and does, indeed, deal with attachment issues. 

No, not all adopted children have full-blown RAD (mine don’t) or PTSD (mine, like most IA kids, have suffered significant traumatic events plural!).  All adopted children have suffered at least two traumatic experiences:  being separated from their biological family (even if at birth) and the process of being adopted (placed with a family they do not know and, in the case of international adoption, do not understand due to language barriers and cultural differences).  While not all adopted children will suffer from a full-blown case of Reactive Attachment Disorder (RAD), where they are neither completely “disinhibated,” forming shallow and meaningless attachments to just about anyone who offers them a piece of candy and/or a smile, nor “inhibited,” where they avoid any real relationship with anyone for any reason, I have yet to meet one who does not have issues with attachment on some level.  The same thing goes for PTSD.  I have yet to meet any adopted child who does not respond strongly to at least one or two trauma triggers.  (What triggers a child is unique to the child.)  While there are varying degrees on the scale, our kids are on that scale! 

So what are some signs of attachment issues?  Even “experts” with multiple degrees wrestle with definitions.  Many therapists even refuse to “label” children with RAD or “RAD-ish” issues.  In my opinion, that’s a shame.  Children often miss the help they need (parents, too) when people don’t want to admit there is anything “different” about a child, and their ability to form solid relationships.   If you’re not afraid to look, here are some things that may help you identify the fact your child is dealing with attachment issues:

          Disinhibited Type:

*Being way too “cute” and charming, especially as a means to get what they want, whether it is attention or material objects/food.
*Acts like a baby/uses the “baby voice” and behaves
  inappropriately younger  than their age.
*Exaggerates about everything, especially their
 “need” to be helped.  (My daughter is a straight
 “A” student, yet cries for “help” to do homework
 she already knows how to do, for example.)
         *Easily/readily goes off with strangers and/or seeks 
            affection (i.e. hugs) from strangers.
         *Makes friends with a lot of other children (usually
 younger than themselves), but is not very close to
 any one of them.
        *Talks a lot – asks a lot of “crazy” questions (I’ll post on 
           this topic soon!)
        *Makes up stories – long, long, stories.
        *Wants just about everything they see and feels 
           “unloved” when they do not get it.
        *When they do get the item, pays attention to it for 
 only a short while and then either breaks it or 
 puts it away and ignores it/forgets about it.

Inhibited Type:

*Avoids relationships and is in a constant pull-push mode with the people trying to be close to him, such as parents.  (Gets close enough to get what he wants, then pushes away again.)
*Resists affection / stiffens when you try to hug them.
*Avoids eye contact (unless lying, then will look you straight in the eye and forcefully deny anything, even obvious things).
*Is always “on guard.”  (Whenever you want to talk with them, they get defensive and think they’re in trouble.)
*Keeps score.  Knows exactly what he “got” vs. what his brother got for birthdays, Christmas, etc.
*Has very few friends.  The friends he does have are not all that close.
*Prefers to be alone.
*Lies a lot.  “Crazy lies” about things that do not matter.  Believes own lies.
*Engages in self-soothing behaviors rather than seek comfort from parents.

Either type:

*May hoard food, trash.
          *May steal.
          *May argue about ev.ry.thing.
*May act completely different than the type they
 usually exhibit.  (For  example, my disinhibited
daughter may shut down and be surly from time
to time, while my inhibited son may act silly and
much younger than his age occasionally.)

A child whose past trauma is triggered will likely exhibit several of these signs at one time, and they may be even more exaggerated than usual.  My kids can be triggered by sights (violent TV shows, for example), smells (fried potatoes), sounds (a full laundry basket falling to the ground, a siren, a fire alarm at school, or a loud/sharp yell), and sensory feelings (a certain touch, a particular fabric, cold weather).  

My daughter, when triggered, will get even “cuter” and even more hyper-active than usual, and behave even more like a baby.  The voice will get syrupy sweet, and one of her shoulders will go up, while she bats her eyes at you.  She’ll ask a lot of silly questions, one right after the other, and will try to engage in a conversation of no importance.  

Conversely, my son will shut down or become surly (especially towards me).  He’ll retreat to his room and draw the same car he’s drawn 1000’s of times with the precision of a graphic artist.  He’ll look at me with that “if looks could kill” look and treat me as though I’m the stupidest person in the world.  

NEITHER kid knows they’re doing it when it’s happening.  It’s a reflex reaction – just like it’s a reflex reaction for you to jump if I come up behind you and yell, “SURPRISE!”  As a parent, I have to watch my own triggers, sit back, take a breath myself, and remember what’s really happening with them.  (I’ll post on this soon, too.)

Your child may show much more mild signs of past trauma and attachment issues than mine do.  I also know some of you deal with much more significant signs of PTSD and RAD, including violent reactions or complete shut downs (where it looks like your child’s soul has left his body – and actually we had that with my son, too during the first two years home).  Again, the range is broad.  Just don’t be fooled into thinking you’re not dealing with trauma and attachment issues on SOME LEVEL if you’re an adoptive parent.  Help your child deal with this.  Acknowledge their past.  Don’t be afraid to call a duck a duck.  You’ll both be better off for it.


marythemom said...

Great post. Thank you!

CW said...

We adopted our daughter at the age of 13 from Ukraine. She's been with us for almost 5 years and even with all the therapy and research reading and videos and support groups we've endured (that we had not really been warned could be a possibility and were caught very unprepared on proper response), we as parents feel burn out and almost like we have developed PTSD from being in a constant "war zone" with our daughter. She will be 18 in 3 months and is determined to move out, which is a big transition step for us that we're not sure how to handle. However, our relationship (specifically with her and I, the mother) is tumultuous at best. Can you offer some insights on how best to make the transition into adulthood?

Thank you so much.

Trauma Mama T said...

CW - Sorry it took me a while to post your comment. I've been away from the blog for a while. Your question is a very good one and it sounds worthy of its own blog post. We are in the midst of Youngest Son's coming "of age." He is 18, yet, as you know, about half that age emotionally. Some days it almost feels normal around here, but I am always on hyper-alert, too -- just like him. I firmly believe we develop secondary PTSD from our hurt kiddos. It is exhausting and you are not alone.

I hope to answer your question more thoroughly soon, but for now, I would say, try to identify her feelings for her when she isn't able to do so herself. When she's calm talk to her about ALL of us have two basic driving emotions: fear and love. Help her sort out what she fears and what she loves. If she's treating you like a piece of doo-doo, and she's over 18, you can (and I would risk saying "should") be tough. You wouldn't let any other adult treat you that way, why should you let her? Be ready to allow her to walk out the door. And hey, it's even okay if it hits her in the hiney on the way out.

We had to have a talk with Youngest Son not too long ago and really put some things on the line with him. We told him we didn't WANT to kick him out and he had a choice to stay, BUT that meant he also had obligations to obey our rules and be a part of our family. We explained that while he doesn't have to obey our rules and he doesn't have to listen to us because he's now an "adult," we also did not have to do some things any more -- because he was an adult. We didn't have to provide him a home, food, transportation, etc. etc. It went both ways.

That's hard...but things have been better since we did it.