Update on The Princess

Things are still hard for The Princess.  We are both very thankful for the people who have encouraged her through some pretty rough middle-school-mean-girl junk.  Thank you if you know us and you're one of those people who have taken time to edify her.

Mean Girl continues to be particularly cruel.  It doesn’t look like that is going to change any time soon.  The Princess can’t even glance her way without getting a dirty look.  Mean girl goes from laughing and joking to glaring at her and then turns her back and laughs and jokes some more.  The other day at track practice, the girls were told to get into groups.  The Princess started walking toward one particular group, but so did Mean Girl.  Mean Girl told her they didn’t need her in that group, making the decision for all the girls there.  The Princess has decided being on the track team isn’t all that important to her.

However (and this is a big “however”), she is doing very well handling all this.  She is really employing her tools to navigate a tough social situation.  She’s not talking to the girl.  She’s refraining from sending notes, trying to “fix” things (something very hard for her to do since she really does want things fixed).  And she’s being kind – to the very best of her ability – even when someone is unkind to her.  She comes home hurt every day and I hate, hate, hate that.  But I am very proud of her for the way she’s handling herself.

In therapy this morning, she told our therapist she knows she cannot control someone else’s behavior.  This is HUGE!  She knows that even though it hurts when she is treated poorly, it is because the other person has a problem and it’s not really about her.  She knows there are things she needs to continue to work on to improve her social skills.  She also knows she’s come a long way.  I am so proud of her.  I just wish more people understood.

Another thing that was great – wonderful – fantastic – totally awesome in therapy this morning was when our therapist told The Princess that even grownups sometimes struggle with these things.  She said she knew that.  She’d witnessed someone who had to deal with something similar lately.  Then she looked at me.  She said she knows when something’s going on even if people don’t tell her.  The therapist asked her if she wanted to tell her about that.  She said, “It’s not my story to tell.”

YEP!  She said THAT!  My 13 year-old said that!  How I wish some 40, 50, 60 year-olds understood that.  (Both the therapist and I looked at each other and got a little teary and proud.)

So yes, it’s been a hard few months around here.  But look how far she’s come!  I have a great kid.

What Kind of Therapy Should We Use?

One of the questions I often hear is, “What KIND of therapy should we use to help our child?”  My answer is always, “I don’t know.”  (Real helpful, huh?)  The thing is, I don’t believe any ONE therapy will help.  Our kids’ “stuff” starts at different places and different ages.  Trauma that happens early (and often) is often much more difficult to treat therapeutically than trauma which happens when a child is older. 

When I started trying to sort through all the therapy options 4.5 years ago, it seemed everyone I knew was singing the praises of Beyond Consequences, Logic and Control (BCLC).  This method was started by Bryan Post (who calls himself “Dr.” but does not hold a doctoral degree from any accredited institution -- only an online and now defunct diploma mill, and who was disciplined by the state of Oklahoma in 2007) and Heather Forbes, LCSWC (who has distanced herself from Post and now runs BCLC without him).  I read all the BCLC books.  I read articles on Forbe’s website.  I learned techniques from other parents who’d attended her trainings.  However, some of the BCLC stuff was easily manipulated by my very smart kids.  Besides, my kids NEEDED to feel as though someone was in “control.”  They’d had to control too much in their lives, too early.  They needed the direction of an authoritative parent.  (Notice I did not use the word, “authoritarian.”  Authoritarian parenting results in rebellion and steps backward in the healing process.  Authoritative parenting lets the child know who is in charge, and gives them a sense of safety, consistency, and protection.  My kids need that.)  In short, BCLC had some things that worked, and some things that didn’t.

We have used a lot of play therapy and family therapy (and play therapy as family therapy).  These methods have helped a lot with attachment.  It is SO important to find a therapist who really knows about attachment and trauma.  Activities such as playing games and using sand trays have helped us find breakthroughs for both The Princess and Youngest Son.  For example, our therapist uses the game “Sorry” and adds some rules of her own.  If we get a “1,” we get out onto the board, but only if we say something good that’s happened since our last session.  If we get a “2,” we have to say something that concerns us.  If we get a “3” we have to say something that our family does together that we like, etc.  These games almost always never go on very long before our kids are working, without ever feeling (terribly) pressured to “go there.”  This method helps us deal with specific issues, using Interpersonal Therapy (IPT) methods.  It is the method by which I’ve learned the most in how to BE a therapeutic parent for my kids.

Cognitive Behavior Therapy is a very traditional therapy.  We use it a little bit, but only when things are going well.  When things hurt, and when a kid is dealing with trauma stored in the emotional part of their brain (amygdala), it’s nearly impossible to process things in the front part of their brain where cognition happens.  Still, it’s a therapy that has helped my kids feel as though they have some control over their lives -- when things are going well.

As I’ve written in earlier posts, for Youngest Son, Dialectical Behavioral Therapy (DBT) is the therapy that has changed his world (and ours).  However, this type of therapy would not have been possible with him even a year ago.  It is really just this school year that he’s matured enough, and has become stable enough on his medications, that he WANTS to change the way he responds to things.  Because DBT emphasizes responsibility for one’s own “stuff,” it was able to move him into a place where he could work cognitively and truly “own” his response to the things that trigger him.  It is only in recognizing that he DOES have PTSD, and that there ARE things that trigger him, that he is able to grasp hold of those triggers and change his behavior.

There are a lot of other things we’ve tried, as well, including “out-crazying the crazy.”  (Which is fun!)  We’ve even used (gasp!) traditional parenting methods in our therapeutic approach.  Like any of the above, sometimes it works and sometimes it doesn’t.  In my experience, raising hurt kids is a very fluid enterprise.

I found a PDF which may be helpful to some.  It describes various therapy methods in very basic terms and is a good introduction to the world of therapy.  You can find it HERE.  It might serve as a conversation starter when talking to a potential therapist for your family.  There are also lists of questions to ask available on various blogs and websites.  One good list is HERE.

Please feel free to share other ideas in the comments section.

Busy Morning

Nothing finishes off a busy morning quite so well as an unplanned, but very pleasant lunch with The Princess’ school counselor.  I like him.  He’s a good guy.  He helped me a lot with Youngest Son when he was in middle school, and was really there for me during our boy’s rough stuff last year.

We chatted a bit about the mean girl stuff that’s been going on with The Princess.  He’s frustrated, just like me.  He said, “Man, these girls can hold onto things forever!”  He also reassured me that he thought I was handling things well.  He said he wished more parents realized their girls were just as nasty as the ones they complained about – if not worse.  He said the lying the girls do drives him insane.  (Me, too.)  He said if people just got real and dropped their defenses, we’d be able to teach kids a lot more.  (I agree.)

Backtracking a little bit in the day, the morning started off "normally."  Yes, I mean OUR normal.  Youngest Son was dragging his heels.  The Princess was trying to talk me into allowing her to wear shorts and flip flops.  I was telling her she knows when she is allowed to wear shorts and flip flops.  It is not March.  I don’t care what other parents allow.  Besides, I think these girls standing around in shorts (that are too short) and flip flops, shivering, as they hold their hoodies close around their skinny little bodies, with the hoods over their heads, jumping up and down saying, “The wind is so cold out here,” are ridiculous.  (Am I the ONLY one tempted to yell, "Well, DUH!?")  So anyway, we had the normal clothing war stuff this morning.  We also had the normal "Come on, let's get moving" stuff this morning.  It’s a daily occurrence since 2007.  I’m used to it.

Our girl went off to school, reviewing our mantra:  NO NOTES, be kind, ignore other people who want to be unkind.  She was okay.  Track starts today and she’s looking forward to that.

After dropping her at school, Youngest Son had his therapy appointment and a med check.  Everything went well.  He’s working.  The psychiatric nurse that monitors his meds said she noticed he’s been “bright-eyed and bushy tailed.”  He grinned and blushed.  No med changes.  He liked that. 

I just keep praying he stays on track and continues to do well.  Once again, I cannot sing the praises of DBT therapy enough.  Be sure to read about that sometime.

We talked about Youngest Son getting his driving learner’s permit on the way to taking him back to school.  He’s excited.  I’m excited for him – and nervous.  I was nervous for all four of his older brothers, too.  I promised him I’d stop by the DMV to pick up the state law book he needs to study for his test.  When I did, I learned he’d have to go to a state office (not our regional office) because he was internationally adopted.  I can’t just show his Certificate of Citizenship and birth certificate to the regional office.  They have to register him at the state level.  (It’s not like they don’t already have enough paperwork on this kid at both the state and federal levels.)  It boggles my mind.  Well, I have the book.  When he’s ready, I guess we’ll take a day off of school to go to a state level office. 

So again, It was a good and busy morning.  When I got home and was getting out of the car, I pulled my back out.  Oh well, so much for getting the laundry done.  

Testing, Treatment & Medications

Neuro-psych test

I know some of my fellow trauma mamas fight long and hard with physicians and psychiatrists (even some neuro-psychiatrists) to have their children treated with medication.  Some of them even have to fight just to get them tested to see what’s going on.  (But at least they fight.)  It is amazing to me how people do not want to “label” children.  What they do not realize is while they’re taking all that time not labeling them, they are perpetuating the neglect they’ve already suffered.  Yes, I wrote that.

Now, please understand, I am NOT saying every adopted child needs to be on medication.  I am not saying every adopted child needs on-going therapy.  In fact, Youngest Son will likely "graduate" from therapy this summer if all continues to go well.  However, if a child had diabetes, or asthma, or cystic fibrosis, or a heart murmur – if a parent or a clinician saw any sign of a possibility of any of these conditions, or hundreds more, and they did not test them – did not treat them, the parent would be charged with child neglect and the clinician would lose their license.  So why do we wait with hurt children?

My kids were home more than a year before they were ever tested.  We didn’t live near one of the big cities.  I didn’t have the money to go see Dr. Boris Gindis or Dr. Jane Aronson.  I knew it would be BEST to have my kids tested in their first language (Russian) as soon as possible after getting home, but that was a logistic impossibility here.  By the time anything could be arranged, the kids were already in what Gindis calls “language limbo,” and they could not be tested in Russian.  What I did not know at the time, however, was there are other tests – non-verbal tests – my kids could have taken before they had a good handle on English.  We could have gotten started on therapy and medical treatment a lot sooner than we did.  Because of my ignorance, they were neglected.

At 1.5 years home, both The Princess and Youngest Son went through a battery of tests at our local mental health facility.  This was after our school district gave them a test at grade level (not age level) and said they were “normal.”  I would have LOVED to have our special education director live with them for a month or two and then tell me they were “normal.”

Testing included having me fill out forms and complete some tests myself.  I completed these tests for both kids:

*PCRI – Parent/Child Relationship Inventory (Parental style) *PSI – Parenting Stress Index Both kids had the following tests at different times:  *ADHDT – Attention-Deficit/Hyperactivity Disorder Test (Behavior Rating Scale or BRS) *BASC – Behavior Assessment System for Children (BRS) *CVLT – California Verbal Learning Test for Children (you don’t have to live in CA to use this test – for Neuro: Memory/Learning or NM/L) *CAS – Cognitive Abilities Scale II (Neuro: Educational or NE) *MACI – Million Adolescent Clinical Inventory (Personality) *SCAN-3C – Test for Auditory Processing Disorders in Children (NE) *TSC – Trauma Symptom Checklist for Children (this is listed as a “Personality” test, but it’s more of an experience inventory) *WISC-IV – Wechsler Intell Scale for Children (IQ-Multitask – probably the most involved and comprehensive test ever) Youngest Son also had this test:  *Suicidal Ideation Questionnaire (Symptom Rating Scale) What going through all the testing boils down to is that both kids continue in psycho-therapy and take medicine to manage their symptoms. Medications either currently taken, or taken by my kids in the past that have had beneficial effects included: *Tenex (or guanfacine) and Intuniv (a slow-release form of guanfacine) for attention-deficit disorder or ADD.  Youngest Son is diagnosed with attention deficit, but without the hyperactivity. *Focalin XR and dexmethylphenida (same as Focalin but not slow release) for ADHD, emphasis on the “H.”  The Princess is very active and attention deficit.  This is combined with a keen sense of hyper-vigilance.  She rarely feels completely safe unless she is with me, and even then finds it difficult at times. *Wellbutrin – for depression *Abilify – for depression *Seroquel XR (both 50 mg. and 150 mg.) – for depression and to treat strong, inappropriate emotions and acting out behaviors (such as trying to tear your mother’s arm out of its socket). Meds that caused problems for my kids: Concerta (Methylin ER and Methylphenidate) – for ADHD.  The Princess became aggressive on this medicine and set fires.  She’d never done that before and has not done it since going off the medicine. Celexa – for depression and anxiety.  Made my kids too sleepy and “out of it.” Cymbalta – for depression.  Gave Youngest Son massive headaches. Strattera - for ADHD.  Gave The Princess massive, daily afternoon headaches. Natural herbs used at times (with psychiatrist’s consent): Gaba – for anxiety Valerian Root – for calming effect Bottom line, in my opinion, is this:  Don’t be afraid of tests.  Don’t be afraid of well-tested and time-tried medicines. They just may be one of the best tools you have in your tool box to help your child heal. THE ABOVE POST is shared as my personal experience only and is not to be substituted for the care and instruction of your family's own personal physician/psychiatrist.

Stepping Back Into the Light

Yes, it was therapy day for The Princess and I this morning.  If you’ve read this blog for a while, you know therapy has not been a very productive or fun time these last couple of months.  Today was different.  The Princess was engaged, made appropriate eye contact, paid attention as much as her ADHD would allow her to do, and she PARTICIPATED!  She was even pleasant.  I believe our happy, sweet girl is on her way back.

We have eased out of using Seroquel XR 50 mg/day over the last month, and have slowly added Abilify.  The Princess has another med check on Friday, but I believe this is working for us.  She is also on Focalin XR before school and a generic (not slow release) Focalin after school.  Abilify is usually added to an anti-depressant.  She is not on one of those now, but the Abilify seems to be helping anyway.  (Maybe tomorrow, I should do a post on medications?  I could list those I know and what they’re used for and let you know how effective they’ve been when we’ve used them.  The thing is, there are on-going adjustments that are made as the kids’ systems get used to the medications and they become less effective over time.)

I’m proud of my girl.  She’s working.  It’s hard.  She’s not always conscious of what she’s doing or how she’s behaving, but she wants to be.  She responds well when she’s approached in a manner that displays teaching rather than irritation or condemnation.  She just wants the freedom to be who she is, but she needs to learn the tools to help her mature and navigate the world.  Today, she was willing to start working on that again.

I feel like we’re stepping back into the light.

Mental Health Day

Things have been rough at school for The Princess this week.  I wrote yesterday about “Frenemies.”  If you need to catch up on things, read that post first.

The Princess and I had therapy this morning.  If you’ve been reading, you also know she’s refused to participate in therapy the last couple of times.  Today, she worked.  It was hard.  Really.  Really.  HARD.  But she did it.  When we got out to the car, I asked her if she was okay.  She wasn’t really.  I asked her if she wanted to stay home from school today.  Usually, that question would get a, “Um, NO!” answer.  She loves school.  Today, a wash of relief came over her face, and her body, and she enthusiastically said, “YES!”

We ran an errand.  (I’m going to be teaching a parenting class at our county jail and we’re doing the initial set up of that.)

We went out to breakfast.  I hadn’t eaten.  She had cereal, but she could eat again.  We’re skipping lunch since we had the late breakfast.  She talked some more about the girl who’s been hurting her.  We talked about some things she could do.  I reminded her she agreed with me yesterday that if something else happened, I was intervening and calling the counselor at school.  She is ready for me to do that.

Right now, she’s watching a movie – just a few feet away from me.  We’re taking a mental health day.  This is a good thing.  Besides, I had tummy trouble last night and I shouldn’t have eaten breakfast at a diner this morning.  ‘Nough said.

I have never taken a day off with The Princess to just stay home before.  She’s never needed it.  She did today.

It Is SO Worth It

I’ve written a lot about The Princess’ struggles of late.  Until recently, I considered her the “easier” of my two youngest children.  The truth is, both The Princess and Youngest Son have good times, as well as not-so-good times.  Sometimes, one of them is struggling with a particular trauma trigger.  Most of the time, issues can be dealt with immediately, using therapeutic parenting techniques.  The trigger is calmed.  The child becomes regulated again, and we move on.  Sometimes, the struggles last a while.  That’s what’s going on with The Princess right now.  However, Youngest Son is doing very well – the best he’s ever done since coming home 4.5 years ago.

This time last year, we were dealing with a ton of “stuff.”  Youngest Son destroyed property at church, and at home.  He stole expensive electronics.  He lied constantly.  He sneaked around behind our backs, and he thought it a grand challenge to defy us at every turn.  He was very hurtful to me, as well as to his sister, and he was in constant, CRAZY competition with the men in our home.  We received increased mental health services, and he had changes in meds.  There were many tearful times of frustration for me, as I wondered if this boy would ever “get it” – get it that he was loved, cared for, and worthy.  We plodded along, doing the things we know to do with kids who are terrified – and that’s just what he was – so very afraid and unable to trust.  He was afraid we could not take care of him.  He didn’t like the limits on his world, because he did not understand how those limits are the care he needed.  He thought he needed to do, and to get for himself, just as he had as a young child.  He didn’t trust us.  He didn’t know how.  And yes, he wanted to test us to see if we, and our love, were real.

It was very hard.  In our lowest moments of our own fear, we wondered if we’d made a mistake bringing him home.  We stuck with what we knew we were supposed to do – what we knew was our only real chance for change.  With struggle, we passed that test.  Our son learned there were natural consequences to behavior and that he was old enough to have to deal with those consequences.  We would stand behind him, but we would not stand in front of him and shield him from those consequences.  He learned we still loved him, even if he lied and stole property.  He learned that in our family, we make things right when we’ve hurt someone else (whether or not we meant to do so).  He learned relationships matter, because we required that he make things right with those he’d harmed.  Then, last summer at youth camp, he stood to give his testimony at a campfire.  He told everyone he was glad he’d been adopted and that he’d gotten a second chance in life.  He apologized to his brothers and his sister, who were also there. 

This year, he’s going back to camp as a volunteer junior counselor and will be working with junior high kids.  He’s come a long way.

I am not going to say Youngest Son is completely healed.  He still has trust issues.  He still has to take meds and may need to do so all his life.  In therapy, he’s still working out what’s real versus what are fantasies about his past.  He still has nightmares.  He is still learning the things we are trying so very hard to teach him:  to be responsible, respectful, appropriately resourceful, and reciprocal in relationships.  He has become a young man who cares about other people, but not just for what he himself can get out of the relationship.  In fact, he has become very interested in “being there” for other former orphans.  He cares deeply for the families we know in the process of adopting children, and he wants to be a good role model for their kids when they come home.  He is still a teenager.  He still has snarky moments.  So do I. 

High school is also good for Youngest Son.  His grades are good.  He’s engaged.  He’s a good example.  He does his work, even when he doesn’t like it.  His teachers like him.  And, he WANTS to please them (this is HUGE!).  I’ll admit, however, I feared his going to high school very, very much.  He’s surprised me. 

Youngest Son is learning to trust, because we are parenting him in the way he needs to be parented (for the most part – no one is perfect).  We still keep his world relatively small.  There is a routine to his life, so he knows what to expect, and what is expected of him.  He has shown responsibility in the care of his possessions, and the respect for other people’s possessions.  He does his chores (often without being asked).  He even has real conversations with me.  He jokes around with me.  I have much more hope for this boy, today than I did one year ago, when I did not know for sure if anything we were doing was ever going to make a difference – if we were ever going to break through and start to see some healing.  Yet, he is gaining knowledge, skill, self-control, and good judgment.

Youngest Son is growing up.  Yes, his traumatic past will always be a variable for his life, but I really do think he’s going to make his (very good) way in this world.

Options: When to Limit Them

The Princess hasn’t cooperated in therapy her last two sessions.  Both times, we’ve wasted our therapist’s time and our money.  She is going through a lot and has decided she must seize control of all situations in whatever ways she can.  We’ve tried all the therapeutic techniques we can, but little seems to be helping lately.  After her therapy session last week, I talked with our therapist.  I knew we couldn’t make The Princess participate.  I also knew the therapist wasn’t going to keep seeing her if she didn’t start working again.

Because we’ve been struggling, and because some of The Princess’ struggles have been public, community-based services were ramped up for her and for me this month.  She is considered “at risk.”  This means a couple of social workers are involved in our lives.  One of them saw her for an hour yesterday.  This social worker told The Princess that if she didn’t start cooperating in therapy, she wouldn’t be able to go to therapy any more.  (Yeah.  I heard you say, “UGH” just like I said it when she GLEEFULLY told me last night that she wouldn't have to go to therapy anymore, looking at me with a face that screamed, “Ha!”)

You know, there is a reason I didn’t tell The Princess about this option.  She NEEDS to work on some things.  I need help for her.  And I limit options I know are not good for her.

So, I talked.  I explained that her behavior lately was very concerning to me, her Dad, her brothers, and to our therapist and the social workers.  I explained that is why these people want to see her more often right now.  I explained why we have a medicine check appointment next week.  I explained that working through these things now, while she was young, was much better than trying to work through them later when she’s older.  I reminded her how adults behave who have unresolved issues.  I reminded her that she’s been hurt and that we can’t just bury that hurt inside – that it comes out in places like at the restaurant the other night and at the zoo last month.  I told her we all loved her and wanted the best for her.  I told her God loved her and had given us both some pretty specific instructions about how to behave with one another.  I also told her that I would not allow quitting therapy to be an option.  We would still do it, one way or another.

If you happen think of us, would you say a prayer for us from time-to-time?  Pray for The Princess' therapy appointment next week, as well as her med check appointment.  Pray she cooperates.  Pray for wisdom for me on how best to handle things with her.  I still have much to learn. 

Need to Control = Fear

The Princess and I had family therapy yesterday morning.  It wasn’t fun.  This is the second session in a row she has refused to participate.  She just sits there, with her arms folded, and won’t say anything other than, “I don’t know,” or “I don’t want to talk about it.”  There’s a lot going on, but for her, if she doesn’t think about it, then it’s not really happening.  For her, if she doesn’t deal with it, she doesn’t have to feel it.  For her, those big feelings are still there whether she wants to feel them or not.  So, because she will not deal with “it,” she is easily triggered and then explodes, (like she did at the zoo), or she’s constantly talking, bouncing off the walls, and using her baby voice.  You see, she MUST be in control.  If she lets go, if her control goes, then there’s no telling what feelings will come to the service!  She’s crazy scared of what those things REALLY feel like.  The fear is HUGE!

There is nothing we can do to MAKE her participate in therapy or in other community based services.  Nothing.  We can be there.  We can offer her support and help, but if she doesn’t want to participate, we’re (therapist, social worker, SRS case manager, parents) just spinning our wheels.  She’s just not ready for talk therapy right now.  She’s 13 and has the shape of a young woman, but she is still about as emotionally capable as a preschooler.  So, backwards we go.  In therapy, we’ll deal with the preschooler.

After the $140 waste of time yesterday morning, the Princess’ therapist called to talk with me privately.  We had two choices:  quit for now (not an option to me) or revert back to play therapy with puppets, sand trays, play dough, and other toys (like you’d use with a much younger child).  I asked the therapist to try taking her backwards and working with her as though she were in preschool.  When she started therapy two years ago, these are the kinds of tools we used in our attachment therapy.  She responded well then.  She revealed her thoughts and feelings through play and responded well to receiving ideas for helping her to deal with situations.  So now, in going back there, I am hoping she responds well again.  Things have been so hard with her the last several months.  I cannot imagine her (nor I) not having our therapist and HCBS (home & community-based services).  I don’t want to imagine it.  (I know some of you, dear readers, do not have a mental health facility near you like we do.  Please forgive my whining.  I know a lot of you do this on your own.  I am a wuss, and God knew that when He plunked us down here.  Believe it or not, I just “lucked into” finding our therapist.  I didn’t even know we had a MH facility in our community when we moved here.) 

When I picked The Princess up after school yesterday, I told her the therapist called me, and that we talked about adding a community-based service (someone who’d work with The Princess in the community and talk with her about family and social skills).  We also talked about the need to cooperate and work in therapy.  I explained we’d be going back to doing play therapy more so than talk therapy, but that she needed to do the work of dealing with the big feelings that have been bubbling up inside of her.  I did not tell her about the possibility of being “fired” from therapy for not cooperating.  She would seize CONTROL of THAT like a drowning man grabbing a life ring!  I did tell her if she did not cooperate, we would be facing a lot more years of therapy and interventions than we could begin to imagine.  (I did not elaborate.)

The Princess is not afraid of me, nor of her therapist.  That’s not where her need for control rests.  She trusts us.  The person she doesn’t trust is herself.  She doesn’t trust she’s strong enough to handle those big feelings that are festering under the surface.  She’s afraid of peeling off the emotional scab and letting whatever poison out that is there, so the healing can begin.  Alas, we plod on.  We try to help her feel safe enough to “go there,” assuring her that developing coping tools now, while she’s young, will help her out much more effectively than waiting till she’s older to deal with things and does not have us “right there” to catch her, and help her back up.

That’s what therapeutic parenting is, you know.  Plodding on.

Trauma sucks.  Big time.

In Therapy

My son and I had family therapy this morning.  Usually, our therapist sees me for a few minutes, and then sees my son for the remainder of the 50 minute “hour.”  Usually, she asks me how it’s going, I tell her, and then I sit in the waiting room while my son has his session.  I’m lucky to have found a therapist that respects me, and that I can trust.  We’ve been with her for three years now.  I have no plans to stop seeing her with my son.  It works for us, and we’re blessed to have insurance that covers our need very well.  In the beginning, I was in the room for the entire session with my son (or daughter).  Traumatized kids can cause parents a lot of grief if they’re left alone with a professional who does not yet know the family or the kid.  They often tell tales of abuse, but those tales are often lies – or memories of past abuse.  Therapists have to report suspected abuse.  Parents of traumatized kids often experience their own trauma by having to go through “the system.”  This system most often suspects the parent first without taking into account the background of the child.  After all, there have been enough horror stories for caseworkers to be suspicious.  Who wouldn’t be?

Trust takes time to build.  So, I insisted I be part of the entire session while we were getting to know our therapist and she was getting to know us.  I took about a year doing things this way.  Eventually, after the therapist and I had both learned even more about older, internationally adopted kids, more about RAD, and more about trauma (PTSD), we understood it would be good for my son to spend at least SOME time alone with the therapist.  He was holding back, and was saying things he thought I wanted to hear rather than work through the hard stuff so he could start to heal.  Eventually, we were able to get to the point where the therapist knew what was “real,” versus what was our son was saying as part of his working through past trauma.  She knew when he was using us to personify the evil he’d experienced as a young child.  Because she “got it,” I knew I would not be investigated by children’s services due to my son's lies, or because he was processing something his biological family did.  However, it took time. 

None of that happened without the process of building trust.  In addition to spending time in the therapist’s office, we got children’s services involved.  My son has gotten into trouble more than a few times over the years.  He even “disappeared” on us the night before my oldest son’s wedding, leaving the rehearsal dinner with an aunt.  (He told her we said he should ride back to the hotel in her car.  Why she didn’t check with us to see if that was true, or why she thought we’d tell one of our kids to go with her without us asking her first if that was okay, I still don’t understand.)  When we realized we did not know where our son was, we called the police.  We frantically looked “everywhere” for him.  We were sure the stress of the wedding had triggered feelings of abandonment for him.

After what seemed like an eternity, I got a call on my cell phone, and we learned he was back at the hotel with my husband’s sisters.  We were in another state for the wedding, but when we got home, children’s services showed up at my front door.  The police in that community had reported the incident to authorities in our state.  It wasn’t the first time I’d been visited by children’s services, though.  The caseworker already knew me.  She’d visited with me many times before, as there was a period of time when our son was in trouble quite often.  I told her what happened.  She patted me on the back and told me to “hang in there.”  She said I should call if I needed anything.  It was like having a friend stop by.  Again, a relationship was already there.  Trust was already established.

I think one of THE most important things a parent of traumatized kids can do for their family is build relationships in advance of a crisis with people and agencies that may become a part of that family’s life eventually, anyway.  Some people think this is akin to “looking for trouble.”  My experience is different.  Being pro-active has saved me a lot of hassle.  Being honest about everything, including my own struggles with parenting my children, and reaching out to our therapist, to the school psychologists and principals, the student resource officers (police), and to our state children’s services department, has afforded me the support and the help I need to best parent my kids.  I’ve received services and aid I would not receive otherwise.  I’ve avoided messy investigations because people acting in good faith have reported me as not having control over my child.  I’ve gained respect from people working “on the ground” with hurt kids, and they’ve even called me for advice.  I think that’s more about looking OUT for trouble – stopping it before it ever starts – than it is about looking FOR trouble.

Things are going fairly well in therapy with my son.  There are days however, like today, when my son doesn’t want to cooperate.  He shuts down.  He pretends he’s not awake.  He stares and he withdraws.  There are also days when I am still part of the whole 50 minute hour, like today.  Most of the time, my son works well with the therapist.  He is conscious of the tools he’s worked to develop with her in order to help him navigate the world.  He’s matured – a lot – this school year.  I’m still looking OUT for trouble, though.  I’m still working to stop it before it ever starts.  Things are going well BECAUSE we are in therapy, and because we have a support system.  I never dreamed I’d need it before I adopted, or even during the first year or so of our adoption.  It was only when I’d gotten to the point of considering disruption that I knew I NEEDED this support, and so did my kids. 

Not everyone is lucky enough to have a good behavioral mental health facility in their community.  I totally lucked into ours.  I didn’t even know it existed when we moved here.  However, I highly encourage parents to look OUT for trouble and to seek out support BEFORE it’s needed.  Even if things seem to be going okay those first several months home, or that first year home, build relationships with people you may need in a crisis.  Our son did not steal anything until he’d been home nearly three years.  Apart from the expected adjustment period of having an older internationally adopted child enter the family, things went fairly well the first couple of years home.  Any problems were contained to outbursts at home, shutting down, or occasionally getting into a minor scuffle at school – all things seen as “normal” for a kid adjusting to a new family, new language, and new culture.  At three years home, things changed for both kids.  Suddenly, we had to figure a lot of things out we’d never had to deal with before.  Thankfully, I’d been building relationships with our therapist, the schools, and with children’s services before the poo-poo hit the fan.

Even if you do not have a mental health facility in your community, you can do the work to develop relationships with people you will need at some point, for some reason or another.  It’s not always easy.  I’ve had to educate educators.  I even had to teach our young family physician what “RAD” meant, and then guide him to resources where he could learn about it.  (They just don’t teach this stuff in medical school.)  You need to educate yourself before you can educate others, of course.  The good news is there are a lot of resources available that weren’t available even four years ago when I got home with my kids.  There are a lot of great blogs written by very wise (though sometimes very worn) therapeutic parents.  There are relationships you can build with people who have walked in your shoes.  Don’t be afraid to share with someone who’s already walking this road.  Don’t be afraid to try some things, even if those things seem “weird.”  And if you’re in therapy, don’t give up too quickly.  If things are going well, it might just be because of what you’re doing – not because you don’t need to do it anymore.

5th Christmas: From Where Does Wisdom Come?

This is the fifth Thanksgiving, the fifth Christmas, and the fifth New Year’s home for my two internationally adopted kids.  Our first holiday season home with the kids happened less than six months into our journey as their parents.  We thought we knew so much back then.  We thought we’d “read it all” and “talked through it all.”  We were so naïve.  Even when our second holiday time with the kids came, we were confident we’d already weathered all the storms.  We were secure that we were doing all the right things for our family.  Really.  We were.  Well we were secure in as far as we had the knowledge to be, and as far as we knew our kids’ needs at that point.  We were still doing it on our own though, and “trusting God” for wisdom.  No therapy.  No meds.  We were handling it.  Well, if being so stressed out that I had no time and no desire to do anything but be with my husband and try to keep things going at home is handling it, then we were handling it.  

I didn’t want to pay attention to the signs that screamed we were NOT “handling it.”  For example, our son knew enough language, and enough American culture by then, to take full advantage of our naïve state.  He was sneaky.  He lied.  He was nasty to me and sullen towards his dad.  He had no respect for us or his older brothers.  He hit his sister constantly.  He knew our expectations but he didn’t care about them.  He was a teenager, strong and tall, but without the emotional maturity or world knowledge of his age peers, and our daughter was right behind him.

By our third Christmas, we’d been home just over two years.  I realized, at that point, that God provided wisdom in ways other than just in our personal revelation or self-education.  He provided it most directly in the experience of others, including doctors and therapists, and that He’d never intended for my husband and I to do this alone – or even with just the help of other adoptive parents (though it is truly a treasure to have you, dear friends).  A child who was consistently hyper-vigilant, consistently lying, consistently sneaky, nasty, and  sullen – or hyper-active, constantly talking and asking ridiculous questions, a child who could laugh at someone else’s pain, even while causing that pain -- was a child that needed more than my experience of raising four, really good biological kids who’d never given me any real trouble.  These were children that needed far more than my prayers for personal wisdom.  

God already had plenty of wisdom waiting for me.  While it seems as though there were times we were making little progress, therapy has made a HUGE difference in my children’s lives, as well as my own.  We have all learned SO much!  I can see that it has made a world of difference in our quality of life, looking back these last couple of years.  Medicine also HELPS my kids.  It works to regulate their physical responses – biological responses – to the trauma that forever changed their brains – their psyches.  Medicine is a very, very good thing when it is carefully planned, monitored regularly, and adjusted as needed. 

Wow.  This post is turning into something different than I’d intended when I began to write.  Sometimes, that happens.  Perhaps there is someone reading that needed to hear this?  I know I’ve read blog posts by other trauma mamas that were exactly what I needed to hear at the time.

Maybe I’ll get to a description of holiday triggers and what to do and not to do later – even how triggers feel for our kids and for us.  I’m pretty scattered, and I realize that.  There is just SO MUCH floating around in my brain that I want to put into writing. 

For now, let me just say I know part of taking back the holidays for me has been accepting help from professionals, as well as the wisdom of others who live with a hurt child, or have lived with a hurt child.  If someone else has already walked this path, and they have tried things that work (or don't work), why would I not also give it a go (or avoid that which did not work)?  If someone else is smart enough to clinically research therapy methods, or come up with medicines far better than any we’ve ever seen before, why would I not also check them out for my kids?  Why wouldn’t you? 

Sandspiel (Sand Tray Play Therapy)

Most therapeutic parents I know are not psycho-therapists, nor registered play therapists, nor even social workers.  We’re just moms and dads raising hurt kids with traumatic pasts we will never fully know nor understand.  We’re just people trying to help our children live their best possible lives.  So when I write about sand tray therapy, please remember I’m presenting my experience and whatever knowledge I have as a layman – as “just” a mom.  There are plenty of places on the internet where you can find more scholarly articles and research-based information.  One place you might start to look for that information is sandplay.org.  The purpose of this blog is for sharing parent-to-parent, not to serve as therapist.  So, that’s my not-very-legal-sounding disclaimer before I begin.

Sandspiel (or sand play) therapy was developed by a Swiss therapist named Dora Kalff (1904-1990).  There is some argument about whether or not she is the originator of sand play (or sand tray) therapy.  Some people say H.G. Wells was the inspiration for it because he wrote about his two young sons using miniature toy figures to work out problems with each other and with other family members.  Frankly, I don’t care who originated it.  I know Kalff wrote about it first and then other therapists expanded upon it.  It boils down to using a tray, filled with sand and usually, a bunch of different kinds of small toy figures to make pictures in that sand.  (Sometimes, it’s just drawing in the sand.)

Sand tray therapy is a specific kind of play therapy where the therapist (or therapeutic parent) sits close by and seemingly does nothing while the child uses sand to make a picture.  Sometimes, the person observing the play will give some open-ended direction such as, “Make a picture that shows how you’re feeling.”  Other times, the direction may be more pointed, but still rather open-ended.  For example, the first time our therapist pulled out her sand tray, she drew a line down the middle of it with her finger.  She directed my son (then 14) to “Make two pictures in the sand.  One of your life before your adoption, and one of your life with your family now.”  (Notice she left the part “before your adoption” open-ended.  She didn’t tell him to make a picture of his family before adoption, or of his orphanage life before adoption.  She left that up to him.)   Still, other times, there may be no more direction except to “Make a picture in the sand.”


People have been making pictures in the sand throughout history.  The Bible talks about Jesus “drawing (or writing) in the sand” when the Pharisees questioned him about a woman caught in adultery (John 8).  In Navaho Symbols of Healing, Donald Sander writes about sand painting ceremonies.  When the ceremony is over, the painting is wiped away.  Today, Zen Sand Gardens are popular gifts and people of all religions (or no religion) enjoy making designs in the sand as a relaxing “de-stressor.”  The thing that is common for all of these is the non-verbal imagery of the activity.  Jesus was silent as he drew in the sand.  The Navaho ceremony is conducted in silence.  People play in their desk-top sand gardens in quiet solitude.  Thoughts are processed in the silence while the sand provides a tactile experience or outlet for those thoughts.

As a parent, you can discern a lot about what’s going on with your child by watching him work through a sand tray picture.  Does the picture have people?  What about dinosaurs or other monsters?  What about super heroes?  Animals?  Fences?  Houses?  Is there violence in the picture?  (Crashed cars, fights, etc.)  Is there conflict of emotion?  (Domestic scene with mom walking away?)  Granted, as a parent, we might not be able to figure out everything exactly as our child is thinking it, but we can get a good idea.  When he’s done, asking an open-ended question such as, “Tell me about your picture,” will provide him an opportunity to make things more clear for your interpretation.  When he’s finished, if you’d like and if he’s receptive to it, you might add what you see.  For example, “Wow.  It looks to me like these guys are really upset with one another -- like maybe they want to kill each other.”  Or “This mom looks peaceful to me and her kids look like they are happy.”

For our family, the sand tray has provided an opportunity for me to redirect a child,  to stop the crazies so we can focus on something else, and to help my child get the big feelings stored in that center, emotional part of his brain where there are no words (the Amygdala) to the front part of his brain (the Neocortex) where he can process those feelings with words and rationalization.

Well, at least that’s the goal.  Granted, we don't always get to rationalization because hurt kids aren’t always able to process big feeling with words and rationalization.  Still, even when our kids can’t process those big feelings, the sand tray gives us an opportunity to verbalize what we see going on in their picture which is a snapshot of what is going on in their brain.

You might say something like, “This mom looks peaceful to me and her kids look like they're happy.  I know I want to be peaceful and I want my kids to be happy.”  Or, “They look like they want to kill each other.  That makes me wonder if they’re really angry about something that happened, or maybe if something bad already happened and they’re remembering how they were scared.”  When our kids CAN’T tell us about their sand picture, cues from a therapeutic parent can sometimes help them “get there.” Even if they end up saying, “NO!  That’s not what’s happening!,” we've still helped them begin to process.  In that case, we can say, “Oh, okay.  So, tell me what they’re really doing.”

While the child is involved in the work of making the picture, the parent does nothing but observe.  Answer any questions your child has with an open answer.  Ask, “What do you think?,” without giving your own opinion, as a way for your child to explore even more.  For our son, wanting to KNOW THE ANSWER was a big, stress-filled motivator for him.  Open-ended stuff like sand trays drove him batty at first because he needed to know the rules.  If there was any question, he didn’t want to appear as though he didn’t know the answer – the RIGHT answer.  It was freeing for him, though it was not without struggle, to get to a point where he realized that sometimes, there are no “right” answers.  Sometimes, things just “are.”  And sometimes, things can’t be fixed or righted.  However, we can process those things, move on, and try to learn some skills to help us navigate through life, maybe adapting those broken things so that they have a new purpose.