Showing posts with label PTSD. Show all posts
Showing posts with label PTSD. Show all posts

Thursday, January 10, 2013

All's Well That Ends Well . . .

. . . but there's always trauma drama. 

The GOOD NEWS for me is through all the tests and procedures, my heart was proven healthy.  This is great news, since my Dad and all of my brothers have heart issues.  And since I am older than my brothers, I feel it a particular blessing.  I had a dangerous blood clot in my neck and a few in my right arm, but they are gone!  (Yay!)  I have some follow up stuff to do and some meds I still need to take for a while.  I'll always need to be checked for PVD (peripheral vascular disease), but for now, I'm good to go.  I'm almost healed from the access site, too.  Still moving a little slowly, but getting around the house okay.

So, that's all great, good, normal stuff -- except for if you're raising traumatized kids with attachment issues and anxiety.  To say my illness has thrown things off a bit around here is putting it mildly.  Things haven't been TOO bad -- no reverting to criminal activity or full-blown rages (at least not as of this morning), but we've had some issues to deal with along the way.  And yes, I am always waiting for the other shoe to drop.

Youngest Son has gone into full withdrawal mode the last several weeks.  I wrote about this earlier.  For the most part, we let him live there.  If he gets too belligerent when spoken to, or if he seems he's sinking in depression, we pull him out of his room for some time in.  We play a board game or put a movie on Netflix we know he'll enjoy.  Most of the time, though, he stays in his room and draws the same sports car over and over again, making only minute changes to the color or angle so that he can say, "It's a totally different car."

One of thousands of sports car drawings by Youngest Son.  I've copyrighted this, so that means you can't use it without my permission.  Just sayin'.

For some kids with PTSD and attachment issues, repetitive movement or sound-making is soothing.  For my Youngest Son, it's repetitive car drawing.

Still, I worry so much he will be stuck where he is.  He's done some significant healing.  He's been an exemplary community member and his grades aren't great but they're not horrible either.  He just doesn't seem to have any initiative or drive.  I believe he'd be content to live in our basement the rest of his life, whether he got a job or not -- and I wonder if he'll ever get a job.

Hubby took Youngest Son around to just about every fast food restaurant and store in walking distance over the holiday break.  He picked up applications, filled them out at home, and hubby took him back to deliver them.  Around here, applicants are expected to follow up on their own applications.  If you wait for the phone to ring, you're going to be waiting a long time.  So that's what we're doing.  NOTHING.

Oh, I "made him" call one pizza place, but they were just hiring for drivers.  Youngest Son has had no real motivation to work on getting his driver's license, though he's had the permit since spring 2012.  See, we don't have any cool cars and we're not buying him one.  Why bother?  Right?

As for any overt reaction to my illness, it's been all about not listening.  Even the day I went for my surgery, he was surprised.  "What?  Wait?  Surgery?  What's that?"  Sigh.  Yeah, really.  These are the kinds of things I deal with all. the. time. with my 17 year old son.  The cluelessness is huge.  To the outside world, it looks like we don't include him in anything, or like we don't teach him, don't like him, don't pity him, don't - whatever.  If they spent more than a week of having to actually DEAL WITH this kid 24/7, they might begin to get a clue.  But I realize now, the only ones who understand are other parents living similar lives.

Two days after my surgery, in an accusatory tone, he asked, "Did you not make any BREAD for dinner?"  Um.  No, dear.  I did not make bread for dinner.  I did not make DINNER!  There is plenty of food.  You are a big boy.  You are fine.  And before you ask, I did not do your laundry.  I did not clean the floor.  I did not feed the dogs.  And I did not wipe your butt when you got home from school.  These are all things I am sure you are capable of handling for YOURSELF.  Any more questions?  (Sometimes, I am so not in the mood to be therapeutic, but then I wonder if maybe these kinds of questions back at him aren't just a different KIND of therapeutic parenting.)

As for The Princess, she's been mostly amazing through this whole thing.  There have been a few times when she's stomped off to her room and hidden under her bed, but mostly she's been "too good."  She's done far more than her share around the house and she's done everything for me from make me toast to help me up out of the Lazy Boy.  Yes, there are times she's been too hyper, too immature and too disrespectful to Hubby, but most of the time she's been great.

Quite frankly, she makes a better cup of tea than anyone in the family.

Some really good, caring, and amazing ladies have made meals for us the last few nights and that's been a blessing, too.  If you're one of those ladies, thank you!

I'm getting there.  We're getting there.

Wednesday, May 2, 2012

I Have PTSD


You will keep in perfect peace 
those whose minds are steadfast, because they trust in you. – Isaiah 26:3

 I do not rest in “perfect peace” for very long, or very often.  My mind whirls around “what if’s” more than it is ever steadfast.  I would like to believe I do indeed trust in God.  However, I’m sure there are some who would tell me the PTSD I’ve developed these last five years or so, and the hyper-vigilance in which I live much of my life, proves otherwise.  It is what it is.  I am who I am.  Some people love me.  Some aren’t so fond of me.  I am learning to be okay with that.

I wish so much that my hurt kids – your hurt kids – could learn to be okay with it, too.  I guess if I’m still learning to "be okay with it," then it is a bit much to expect it out of someone so much younger than I, who has been through so much more than I.

“Wait a minute, TMT.  You’re saying YOU have PTSD?  I thought it was your kids that were dealing with complex trauma and attachment issues.”

source
Yes, Grasshopper.  I have developed my own full-blown case of PTSD.  Going through what I went through in Eastern Europe to get my two youngest children home was enough to develop the disorder.  (Just ask my friend, Diana who had a similar experience.  Like her, “I’d rather shave my legs with a spoon than go through THAT again.”  However, it is the 4.5 years that have followed, parenting two hurt tweens into their teens, that have brought me to my own very real state of not-so-perfect peace. 

For anyone reading who may be a pre-adoptive parent or a newly adoptive parent, PLEASE understand this:  It is still worth it and I’d still do it all again if it meant having The Princess and Youngest Son as MY children.  Heck, I’d go through that and more.  Well, now I would.  (Being honest here.)  Now that I love them and they are fully mine.  But it took time.  We didn’t bond instantly.  I didn’t feel as though they were “mine” for a very long time after they were home, and even that came in stages and is still a process because attachment is a two-way street.  It is worth it.  But it’s not for everyone.  Don’t do it because adoption is the call of the Church, or because all your friends are doing it and are having an okay time through it.  Don’t do it because the kids are cute.  Don’t do it because you want to make a difference.  Do it because you are called and it is your life to do it.  Do it because you know these kids are yours, even if they don’t FEEL like they’re yours and it takes a long time.  It’s worth it.  But it’s not for everyone.  And it’s stinkin’ hard sometimes.  It’s frightening.  It’s not easy to dwell in perfect peace.  Trust is not a steadfast understanding here all the time.  Trust is sometimes hanging on by the fingernails for dear life because you’re completely spent and there’s nothing else to do but hang on.  Sometimes, trust is letting go. 
Trust in the Lord with all your heart
 and lean not on your own understanding; 
in all your ways submit to him,
 and he will make your paths straight.  – Proverbs 3:5-6

 Whenever I begin to try and understand what it really means to raise two teenagers from another culture who have been through the abuse and neglect my kids have been through and yet, are still standing, still thriving the best they know how, still trying hard – really, really HARD – to make it in this world, and that I get to be a part of that with all my faults and failures, I am blown away.  Words don’t come.  Still, the path is far from straight.  So I hang onto the promise that He will make it straight in His time.

“For my thoughts are not your thoughts,
 neither are your ways my ways,”
declares the Lord
As the heavens are higher than the earth,
 so are my ways higher than your ways 
and my thoughts than your thoughts. – Isaiah 55:8-9

 I definitely have PTSD.  I have been through things with my youngest children that I never really believed I’d be through when I was in the process of adopting them.  They have had reactions to things that have triggered them into post-trauma that took me a long time to understand.  Their actions and words, the fear of “what if,” and the times they did things like “disappear” on me leave me with my own sense of hyper-vigilance.  I am triggered by things I never imagined.  I know am not alone.  You are not alone.  People who parent hurt kids with RAD, PTSD, ADHD, etc. often end up with their own PTSD and even depression sometimes.  Here’s an article to read:  Post Traumatic Stress Disorder in Parents of Reactive Attachment Disordered Children.  If you really want to dig in, here is a Google link with several scholarly articles on the subject.

source

Back to PTSD and my own triggers.  I know of more than one girl with PTSD and RAD my daughter’s age that is expecting a baby.  We’re talking 13 and 14 year old girls.  Granted, I know that even girls raised from the womb in stable families sometimes get pregnant at very young ages.  However, I imagine kids from hurt backgrounds have a much higher chance of it.  The girls I know about who are pregnant are from hurt backgrounds.  Am I afraid The Princess could make me a Gramma before my adult sons ever do?  Yes!  I’m scared spitless.  I actually lose sleep over it.  I am not at perfect peace.  I don’t want to raise a baby at the age of 50+.

Am I afraid The Princess will go off with “a friend” and get into Lord-knows-what kinds of trouble?  Yes.  She was at an orchestra competition today and the teachers let the kids roam the school, unsupervised while they waited for their events.  She met some boys and “made friends” with them.  Oh, but don’t ask her their names.  She doesn’t know.  She has no clue how much this kind of behavior triggers my fear for her.  She really doesn't see why I'd be upset by knowing she did this.  

For those of you who’ve lived through this, or are living through it right now, know I am praying for you.  I admire you.  You are awesome. 

As for my purpose here with this blog, all I can do is share my own struggles.  I can let you know you're not alone.  I can encourage you to hang onto the promise that our paths will become straight.  I can suggest that, perhaps, "perfect peace" is manifested in the ability to just keep going -- to just keep loving -- to find people that can "be there" for you when things are the toughest, people who will not leave when you need them most -- and to hang on by the fingernails when there's nothing else you can do.  When those times do come, please let me know.  I'll pray for you and I'll be a loyal ear.  We trauma mamas need to stick together. 


Wednesday, April 18, 2012

An Eventful Week


Tornado that passed by Salina, Kansas
April 14, 2012
Apologies for the rather long silence here these last nine days.  We’ve had an interesting week in the TMT household.  Our schedule has included trips to the doctor, a college son’s play, a rage/meltdown by The Princess, a tornado out break, a trip to the ER, a bad reaction to pain meds, and visits with social workers.  Yes, life is never boring for very long around here.  (This statement is rather ironic because right before all these things happened, I posted in a private Facebook group of trauma mamas that things were quite calm at that time and I was wondering if I’d forgotten how to live in calm.  ‘Didn’t need to wonder for long.)

The trips to the doctor were because I tore the meniscus in one of my knees.  I’ve done it before.  I’ve also had surgery twice before to clean it up.  My family physician ordered an MRI and was sure I would need surgery again.  However, when the orthopedic surgeon read my MRI, he ordered additional x-rays.  He said surgery would only give me a 50/50 chance of relief at this point because my arthritis was already too bad in that knee.  A total knee replacement is likely somewhere down the road, but not yet.  The doctor asked me if I was afraid of falling.  I said no, that I didn’t really feel wobbly at all.  So, I got a cortisone shot.  I can get one every three months.  It helped a lot, but the day I got it was the opening night of my son's college play.  My knee hurt and was unstable for about 24 hours after the shot, so we didn’t make it to the play that night.  Whether it was me being hurt, or missing the play we planned to attend and having to wait until the next night, or a combination of both, The Princess was triggered over the top and went into a rage.  It was loads of fun.  I want to spare you some of the detail, but will share a lot of what happened so I can tell you how Hubby and I therapeutically parented our usually very sweet girl that evening.  

Our very talkative daughter would not speak.  She hid under her bed and made “G-R-R-R” sounds to express her anger.  She sat in the dark.  She would not take her shower or brush her teeth.  She wrote angry notes and threw them down the hall between the bedrooms, assuming we’d run to pick those notes up and read them.

At first, Hubby went to her room and tried to reason with her.  She has absolutely no respect for Hubby when she is triggered, so this did not work.  We knew it would not work, but Hubby tried anyway.  After that, we simply sat and watched TV, and we waited.  We waited for her to come out from under the bed.  We waited for her to pick up the notes (she handed one to me).  We waited for her to speak.

The note contained content I’ve read many times before when The Princess is angry.  She equates our love for her to the things we buy for her.  The note said we hated her, but loved the boys.  It told us how mean we were for not allowing her to have a cell phone.  It told me I was a bad mother because I would not buy her a certain pair of very short shorts.  It went on and on. 

I did not respond.  I read the note, folded it back up the way she'd given it to me, and put it down on the coffee table.

Eventually, she came out of her room, arms folded, scowl on her face, stomping down the hall and barked, “Don’t you want to talk to me?”  I said, “I will listen to whatever it is you want to say.”  She asked again if I wanted to say anything to her and I replied again that I would listen to her.  She blurted out several things.  I didn’t respond.  I just listened.  She got tired and said, “Why aren’t you arguing with me?”  I asked if it would make a difference.  She thought for a moment and said, “No.  Probably not.”

I explained I did not want to argue.  I told her there was no argument.  I told her she did not really believe the things she was saying to me – not when she was calm.  She knew I loved her and she knew I didn't give 13 year-olds cell phones.  I told her she lashes out at me whenever she’s afraid that I'm sick or worried that something may be wrong with me.  (She also does it whenever I leave for more than a day, but we didn’t go into that.)  I told her she was disappointed that she had to wait to see the play, but that she was especially frightened about my knee.  BINGO.  She ended up talking with us calmly and apologized to me the next day.

On Saturday, the entire Midwest plains experienced an out break of over 120 tornados.  This was scary, too.  The Princess and Youngest Son seemed to handle this well, however.  They participated in our precautions and preparations.  We talked about what to do if the sirens went off here.  We cleaned up the garage to get my car inside in case we got large hail (my family uses the garage as a big junk room – I’ve given up on trying to get them to keep it clean)That’s when I fell.

I experienced the worst pain I can ever remember – even worse than childbirth.  On a scale of 1 to 10, it was a 12.  I broke my ankle – same leg as the “bad” knee.  So, off we went to the emergency room.  Thankfully, the ER was fully staffed in preparation for a tornado, and the waiting room was pretty empty because everyone was home, preparing for that possibility.  I was examined, x-rayed, wrapped and “booted” rather quickly with instructions to get to the pharmacy quickly for my pain meds, because they were closing early.  Those pain meds made me very sleepy at first.  The next day, however, they made me very sick.  This also scared The Princess.  I sure was putting her through the ringer.  Thankfully, the tornados went around us and our town saw no damage.

I went back to the orthopedic surgeon after the ankle break.  I’ll be on crutches for three weeks, wearing a boot.  Then the three weeks after that, I’ll just be in the boot.  I broke the tip of my fibula.  The surgeon gave me a different kind of pain pill, too.  It makes me very sleepy, but I don’t get sick from it.

Yesterday, I informed The Princess’ caseworker about the events of the week, so she’d know we were still working on some things.  I also wanted her to know how we’d handled things the night of the rage.  I knew she would pass this along to our therapist, who we don’t get to see until next week.  So, a different social worker is stopping by today at 1 p.m. to check in on me.  It’s okay.  She knows me.  She’s just doing her job.  It’s actually kind of nice to have someone local stop by.  Today is the first day I’m home alone since my fall.

Really though, I’d just like to go take a pain pill and get a nap.

Tuesday, February 28, 2012

Trauma Triggers


The ministry team at our church asked me to share a list of things I observe as trauma triggers in The Princess and Youngest Son, and to also list things I’ve observed as trauma triggers in other adopted children.  Below is the list I gave them.  (I didn’t want to overwhelm them with too many things all at once.)

I'm posting the list here so others can refer to it.  You may want to share this with a teacher friend, or youth ministry team leader you know.  Perhaps, you’ll add some things of your own to this list in the comment section for this post.  I will add some myself with an (*) after the list I gave our ministry team.

Universal Trauma Triggers (things I’ve seen most internationally adopted kids, and many foster/adopt kids react to on some level)

Blood, gore, dead babies, dead animals, dying people, people starving in Africa (pretty much any topic you THINK they SHOULD know about should really be discussed with the parents of traumatized kids first).

Orphan care ministry (triggers survivor’s guilt).

Talk about the “blessing” of adoption (triggers guilt for caring about bio family).

Movies about adoption, movies where adoptive parents are portrayed as evil or mean, movies about orphanages, child trafficking, sex trafficking, child abandonment.  (Parent permission before showing movies might be a good standard practice in children’s and youth ministry.)

Talk about a child being adopted – even if everyone already knows it.  Adopted kids don’t want to be the topic of discussion; they just want to fit in

Loud noises, alarms, sudden changes, changes in routine, new teachers/leadership can also be triggers for many adopted kids.

Do not assume adopted kids, especially older, internationally adopted kids that lived in orphanages, know what you’re talking about.  Their world knowledge is VERY limited and it will take significant time to “catch up” on things most people would think “everyone” knows.

*Holidays, especially Halloween and Christmas.  Birthdays, pretty much any celebration, especially if it isn’t all about them.

*Too much “stuff.”  Our kids are overwhelmed with too many choices – everything from a full menu at a restaurant, to too many clothing choices, and too many toys.

*Affection from people other than family members.

*Gifts – even little gifts like a piece of candy.

*Rewards – especially if they’re for doing something any well-behaved kid SHOULD be doing anyway.

Triggers more specific to Youngest Son and The Princess (but can also be triggers for other adopted kids, too):

Talk about suicide, especially suicide by hanging.

Talk about alcoholism, prostitution, divorce.

Talk about their birth country.

When people ask them what their “actual name” is – yes, this has happened in youth group.  Their “actual” names are the names they have now.

Questions about their orphanage or their life in Eastern Europe, including questions about their birth family.  (Youth group members need to learn this is inappropriate conversation.)

Certain smells can be triggers, including fish, fried potatoes, and anything burned.

Questions about therapy or medications.

People assuming they know what is being talked about – for example, The Princess became very upset about hearing one of the youth leaders had a miscarriage – not because she understood what that was, but because she felt stupid, and like “everyone was talking in jibberish.” 

*When one of our older boys comes home to visit.  (It messes with routine, territory, and attention issues.)

*Any new recipes Mama T tries for supper.

*Painting the house, or moving the furniture.

*Other kids not having coats on when it’s cold outside.

*People leaving their animals outdoors.

*When a child is being publicly disrespectful – like in a store.

Other ideas?  Please do share below.  I love on-topic comments!

Monday, January 23, 2012

Black & White Thinking


Riding in the car on the way to school this morning, my daughter asked, “Mom, what is human trafficking?”  Talk about a sucker punch. 

My daughter is processing SO MUCH lately.  Hard topics such as human trafficking are not something I was prepared to deal with today, alongside known trauma triggers such as bio-family stuff like I wrote about on Friday, bad dreams like I wrote about HERE recently, or acting out behaviors like at the zoo over the holidays.  Heck, I wasn’t even fully awake yet.  I am NOT a morning person.  So, what did I do?  I took a big breath.  I let it out.  Then, I answered her with a question of my own.  “Honey, were you talking about human trafficking in youth group last night?” 

Well, yes.  It was THE topic of discussion last night.

Another deep breath in.  Another deep breath out.

I kept driving.  I gave her a broad definition of what human trafficking meant.  She asked a few more questions.  She told me some more things her small group leader told her about the topic.  I told her that yes, those things were sadly true.  Then I said I wished the youth leaders told parents when they were going to be dealing with such hard topics.  She said, “Me, too.” 

Then she asked, “What about alcoholics?”  I asked in return, “What about them?”  She rolled her eyes and told me that she is probably going to be an alcoholic, as well as poor, when she grows up.  I asked her why she thought that and she said it was because they discussed it in Sunday School yesterday.  She said that “people who grow up with alcoholic parents become alcoholics, and people who grow up poor stay poor.”  Whether it was discussed QUITE that way or not, I don’t know, but I do know she was triggered by the discussion.  So was Youngest Son.  He confirmed that this was the discussion.

Unfortunately, not enough people working with traumatized kids know enough about them or their needs.  More training is needed – really needed – for anyone working with children.  This education should be part of any teacher training, youth & children’s ministry training, or sports/recreation training.  We trauma mamas need to figure out a way to make this happen!

Traumatized kids tend to see things as black and white.  There are no gray areas.  It doesn’t matter if they’re 6 or 16.  Something either is, or it isn’t.  They think, “If I had alcoholic parents, I will be an alcoholic.”  That’s a traumatized brain.  There are no gray areas that say, “I HAD alcoholic parents, but now I’m being raised in a safe, functional family and I can overcome my past.  I can learn skills that will help me navigate life in a more healthy way.”  Likewise, even though they’ve been told many times, there is no ability to remember that God is in the business of redemption when our kids are triggered.

Black and white, or “all or nothing” thinking, is tied to the most primitive of human responses:  flight or fight.  Kids dealing with complex trauma, when triggered, are transported back to that primitive state of being in flight or fight mode, just as they were when the trauma first occurred.  It is an automatic response on a very basic level.  There is no rationalization.  The brain in flight or fight mode cannot rationalize.  It reacts.  Because traumatized kids are triggered to believe their lives are in danger – that they may actually DIE -- there is no time for “if this” or “maybe that.”  There is no room for gray.  While a youth worker discussing social problems with the youth group may also discuss the redemption of God, or the ability to overcome hard beginnings with good nurturing, the brain of a traumatized kid already in flight or fight mode simply will not process this.  There is no time for uncertainty when your life is threatened.  You need to decide whether to run, or to stay and fight.

The amygdala, which is in the middle part of the brain, and the center for the fight/flight/freeze response, is fully functional at birth.  That means that even a tiny baby is capable of a full blown trauma response.  Even children who do not cognitively remember a traumatic event can still have that full blown trauma response stored in their amygdala.  It “rewires” the brain for life.  It does not go away with love and time.  It can be triggered by events, actions, discussions, sights, smells, touches, and sensory experiences in the future.

The hippocampuses, where the brain assesses stimuli and tells us whether or not it is threatening, is not fully functional until a child is about five years old.  The cortex – the front part of the brain where we can think and figure things out and rationalize -- is not fully mature until around age 12, sometimes even older. This means that when a baby or young child is hurt and frightened, they have no way of understanding what is going on around them. The front part of their brain can’t rationalize what’s happening, so the middle part of their brain simply stores the trauma.  That trauma causes black and white thinking (a flight or fight response), because they do not have the developmental capability to process levels of threat, nor the cognitive capability to even understand what’s happening.

Kids dealing with complex trauma CANNOT simply “get over it.”

The result of trauma triggers such as hearing, “people who grew up with alcoholic parents become alcoholics” is too often a self-fulfilling prophecy.  In traumatized kids’ all or nothing thinking, they believe they are doomed to repeat their biological parents mistakes.  They believe they are destined to BE their biological parents.  Their already too well-established sense of being “damaged goods” is reinforced.  In their black and white thinking, their beliefs about themselves are affirmed.  The instruction of a well-meaning teacher or youth worker is twisted to a belief that is exactly opposite of what any caring adult would intend.

In addition to education for people working with youth and children, parent notification is also essential when hard topics will be presented in the classroom or the youth meeting.  Youth leaders and teachers should notify parents IN ADVANCE that they will be discussing hard topics with youth.  Parents raising hurt children can then decide how best to prepare their child for the topic – or even whether or not to allow their child to participate in that discussion at all.  Some parents may decide to prepare their child and also attend the session with the child.  Still, the decision on how to best approach these topics with a traumatized child should be left up to the parent.  Communication is the key.  Teachers and youth workers should not depend upon children to communicate to parents that a hard topic is to be discussed, or that a documentary on a hard topic will be shown.  One of the greatest challenges for parents of traumatized children is getting them to tell us anything!  Adults need to communicate with adults.  As parents, we are the ones who need to take the initiative.

As parents, we need to be the ones talking to our kids’ teachers, youth leaders, and coaches.  We need to be proactive, and not reactive (often the “fight” of flight or fight response) ourselves.  Communicate with the adults in your child’s life.  Perhaps offer some training.  The FACT SHEETS I posted on this blog are a good tool and can be adjusted to help youth leaders outside the classroom as well as for teachers.  There are also some good resources posted HERE.  Feel free to share in the comments section additional resources or links to sites you have found helpful.



Thursday, January 19, 2012

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.

Tuesday, January 17, 2012

UPDATED! - Fact Sheets for the Classroom

Educating teachers about PTSD, RAD, ADHD/ADD, FASD/FAE, PDD, anxiety, depression, and even Aspergers is a chore each year for me.  It is a necessary chore, however.  Unfortunately, our teachers are overworked and underpaid and frankly, clueless about what it REALLY means to deal with all these things, or how to best educate a child with complex trauma.  (Let's face it, we were all clueless, too until we had to deal with it face-to-face ourselves.)

I wish I'd found these Fact Sheets back in 2007.  They are posted on the Kansas State Department of Education website and are designed to give teachers an overview of the challenges our kids face every single day.  They are not comprehensive, but they provide the basics.  (Besides, I've learned most teachers don't bother reading much of the information given to them even by their own administrators.  Even if they WANTED to, there just aren't enough hours in the day to read everything they're told is "essential.")  

I've developed a lot of presentations and materials of my own through the years and I promise to share more of those over time on the blog.  But my best piece of advice for communicating your child's needs to his or her teachers is to develop a relationship with them.  Be prepared to advocate (a.k.a. "fight") when you need to, but work with your child's teacher to show them you appreciate their professionalism.  Hopefully, they in turn will respect your expertise as a therapeutic parent, raising a hurt child.  

Do not expect a teacher to work like a therapist.  Their job is to educate your child.  Give them tools that support them in their job, even as you ask them to support your job as a therapeutic parent.  Hopefully, they'll appreciate your efforts to make their job easier, and thus make your job easier by avoiding those triggers which set your kids off on behaviors most teachers never get to see.




     *Anxiety

     *Depression



     *Asperger Syndrome

Additional resources for the classroom here:  Child Mental Health Resources

Friday, January 6, 2012

Dear Teacher: About My Child in Your Classroom


Dear Teacher,

Thank you for your willingness to spend your days inside a classroom with two to three dozen energetic children.  You must certainly be an exceptional person.  While each of your students is exceptional as well, a child who has suffered from significant, complex past traumatic stress (C-PTSD) and reactive attachment disorder issues (RAD) is enrolled in your class this year.  This child is indeed “exceptional.”

Children suffering from C-PTSD and RAD, or “RADish” issues, can come from various walks of life and live in different family structures.  My child was adopted in 2007 at the age of 12.  Until his adoption, my son lived in an orphanage for special needs children located in a former Soviet state.  His birth country is now its own independent and proud nation, but its child welfare system is still much as it was decades ago throughout Eastern Europe.  Specific details of my son’s story are private, but in order for you to understand what this child has been through, there are some specific things you need to know.  These things are to be discussed only with me, or with professionals you work with at school, and on a confidential basis only.  These things are never to be discussed in the classroom.  There is never a need to announce to your class that my child was adopted.  (Yes, there are teachers who’ve made that mistake.)  Don’t do it.  Not ever.  It’s common knowledge for many, but it is not a topic for classroom discussion.

In the orphanage, my son slept in a room with a few dozen other boys ages 7 to 16.  He saw things that boys do who are unsupervised during much of their time.  These things would put children into rehab programs for child predators here in the states.  Some of those things he may have seen – he probably did see – they may have happened to him, too.  We will never know the full story.  Our son was abused and neglected by orphanage workers.  He had belongings stolen from him.  He stole (and sometimes still steals) things, too.  He learned to lie and to act as well as any award winning movie actor.  He was beat often by both adults and other children.  The scars you see on his body were not put there because of normal childhood accidents.  Those scars are from things that happened to him both in the orphanage and in his first family, years before we ever knew him.

My son may seem pretty “normal” to you most of the time.  He wants very much to “just be normal.”  The fact is, the trauma of his past and the abuse and neglect he suffered during the first 12 years of his life have altered the way he thinks and the way he functions in the world.  These are not things that are healed with time or love.  C-PTSD and RAD are not curable.  They are not miracles just waiting for God to heal.  They are life-long challenges for which my son needs to learn skills in order to navigate this life and be productive in society.  He has the potential to lead a life far different than the life he knew as a young child, but please understand his brain is FOREVER changed because of those early years.

The Association for Treatment and Training in the Attachment of Children (www.ATTACh.org) defines attachment as a “reciprocal process by which an emotional connection develops between a baby and its parent.”  Attachment influences the child’s physical, neurological, cognitive, and psychological development.  It is the foundation of the development of basic trust and shapes how the child relates to the world, how he learns, and how he forms relationships throughout life.

When a child’s needs are not met, or if his needs are only met on a sporadic basis, his brain is forever changed.  He operates from a systemic need to fight or flee.  Fear and shame are his base emotions.  Survival is his base motivation.  He must gain control.  Otherwise, he feels, quite literally, like he will die.  This is the nuts and bolts of C-PTSD and RAD.

His reactions can appear in several ways.  Unless you know what to look for, you might even miss a reaction to something that has triggered his trauma and caused him to go into that “flight or fight” mode.  Kids who deal with C-PTSD and RAD are often either very inhibited (withdrawn, passive/aggressive, sneaky) or very dis-inhibited (hyper-active, talkative/argumentative, superficially charming).  And sometimes, a kid who is usually inhibited, can display himself as very disinhibited, or visa versa.

You can read about things to look for in traumatized and attachment disordered children at this blog post:  If It Walks Like a Duck

You probably learned in your Child Psychology class in college that babies learn to regulate themselves emotionally and behaviorally in the arms of loving parents.  When a baby cries, the attentive parent soothes the child through rocking, feeding, singing, touching, and lovingly gazing into that baby’s eyes.  This helps the child learn to self-sooth in an emotionally healthy way and to cope with strong emotions such as rage.  Children who are not held or comforted when distressed learn to self-sooth in other ways, some of them very destructive.  Rage is not something that they can cope with easily and for this reason, many children with RAD or C-PTSD have difficulty regulating their emotions and behavior.  They’ve learned to survive.  Some of the behaviors they employ to survive do not serve them well in society or at school.  However, hurt kids are not “bad.”  They are not acting out because they are “spoiled.” 

Another thing to understand as my child’s teacher is this:  I did not cause this hurt for my children.  My children came to me deeply hurt.  I need to parent my hurt children with methods that are very different than the traditional parenting methods I used to raise four healthy, well-adjusted and productive biological sons.  I am not coddling my hurt children.  I am not spoiling them.  They are not “getting away with murder.”  Any behaviors you see or report you may hear (true or false), you would see or hear no matter in what good family my child was placed.  My child is a resilient survivor.  His survivor instinct is well-ingrained into his very psyche and he continues to use strategies that enabled him to cope through multiple traumatic events including his mother’s abuse and prostitution, his father’s neglect and suicide, his parents’ and extended family’s drinking, and his placement into a very corrupt and abusive orphanage system.  There is no glossing over the trauma of his past.  I will not make it “pretty” to protect you because it will serve neither you nor him to do so.  Please don’t pity my child.  Understand he’s been through much more than we will ever fully imagine.  But, his survival strategies are no longer effective.  We are working hard as a family, together with our child’s therapist and other support services, to help our child learn how to have his best life now that he is safe.  We also need your help and cooperation.

I am one of those parents that teachers are always saying they wished there were more of, but then complain about as “helicopter parents” soon after.  It is true that I am intensely involved in my child’s therapy and healing.  My child is not – cannot – be parented by the traditional parenting methods that helped me before I adopted.  I have spent a graduate degree’s worth of time researching, learning, writing about, counseling, teaching, and practicing methods to help my child and other hurt children.  I am not naïve.  I know what you have to deal with in the classroom every single day.  I’ve been there.  I know now, however, I am not meant to be in a classroom every day.  But I also know my child is not your only student.  In fact, I know on average, you have five attachment disordered and traumatized children in your class, though you may not be fully aware of it, as they may be undiagnosed.  Helping a child who has suffered the kind of trauma my child has suffered is hard.  REALLY hard.  It’s hard as his teacher.  It’s many times more hard as his parent.

There are some VERY IMPORTANT things you can remember to do in your classroom in order to help my child:

1.  Remain calm.  Even when you feel like letting my child really have “it,” stay calm.  A child who manages to upset or anger you is in control of the situation.  Model and verbalize desired behaviors:  calm voice, open and relaxed arms and stance, attentive eye contact, friendly face.

2.       Stay in contact with us – the child’s parents/family.  We are excellent sources of information about our children’s strengths and current challenges.  Many of us are very well educated and can provide you with resources that will help you better understand our children, as well as other children with traumatic backgrounds.  And this is really IMPORTANT:  Remember children with RADish issues often attempt to maintain control by creating chaos with triangulation.  “Crazy” is what feels “normal” to them.  Triangulating all individuals – especially the adults – is a favored way to create chaos.  (For example a child trying to triangulate adults may tell his teacher, “My mom said I didn’t need to do my homework at all.” Or “My mom wouldn’t let me study for the test; she was too busy making me clean the bathroom/give her a backrub/cook her dinner/pick up dog poop in the yard.”)  CHECK WITH the child’s parents, other educators, youth ministers, coaches, etc. before believing what a traumatized child says.  Maintain a respectful and professional relationship with the child.  Remember you are not their primary caregiver.  Parents are to be where the child receives hugs, cuddles, food, and treats.  Don’t buy into the “poor me” or “poor orphan” mentality.

3.  Traditional methods of discipline do not work for traumatized children.  Avoid the use of punishment as a negative motivator for the behavior you’d like to see.  It produces resentment, retaliation, or retreat into sneakiness.  A week of missed recess or a missed activity is meaningless in terms of changing behavior.  It will escalate.  Make consequences natural results of choices.  STAY CALM.  Do not raise your voice.  Say, “Oh, how sad for you that you’ve not done your work on time.  You’re lucky to have an awesome teacher who will give you the chance to practice these skills while the rest of the class is doing computer time.”

4.      Avoid those behavior management plans that everyone at NEA tells you to use.  They’re based on consistency, and that makes them easy targets for manipulation for kids with C-PTSD and RADish behaviors.  These plans also let students know just how much you value certain behaviors.  My hurt kids love to “question” (a.k.a. ARGUE) and get into useless discussions about valued behaviors and rules.  It’s not that they don’t need to know the rules.  They do!  It’s just that children with RAD have difficulty figuring out cause and effect.  Remember, they need to feel in control in order to feel safe.  The “rewards” of behavior management plans (candy, prizes, etc.) mean little to attachment disordered kids.  In fact, little gifts and prizes that are often part of behavior management plans can set them off into really crazy triggers their parents wind up having to deal with at home later.  You may never see it, but your actions caused it.  So don’t go with this old standard when it comes to hurt kids.  It’s harmful, not helpful.

5.      Provide natural consequences the first time.  Do not give the child a second chance.  Keep consequences as logical outcomes to the behavior, but ensure the child “makes things right” the first time.  Otherwise, you give the message that the behavior is “okay.”  (Also, never say, “It’s okay” when it’s not.)  Attachment disordered children are black and white thinkers.  Second chances and warnings are perceived as threats and will force hurt kids into that fight or flight mode of thinking.

6.      Establish eye contact.  Attachment disordered kids – especially those who display inhibited attachment disorder – dissociate from others and from situations when they feel threatened.  Keep them in the here and now – in the moment.  Remind them they are safe.  Say it out loud to them!  “You are safe.  You are not going to be hurt.  You are in Mrs. Smith’s classroom and we work together here.”  Remember to stay calm.  Be matter-of-fact even as you are firm.

7.      Ask “what” questions such as “What are you feeling?”  or “What happened?”  Avoid “why” questions.  Our hurt children mean it when they say, “I don’t know” in answer to a why question.  Why questions are fruitless.  Ignore obvious lies in the heat of the moment.  Remember the child is in survival mode and confronting the lie will only escalate the situation.  If the child is unable to tell you what happened, give yourself and the child a “time in” where the child stays nearby until he is ready to talk.  Do not shame the child with a “time out.”  This will send him further into withdrawal and reinforce the feelings of neglect and worthlessness so ingrained in him due to early neglect and abuse.

8.      Use actions.  Not so much words.  If a child continually tips his chair, remove it.  Let him sit on the floor.  If a child refuses to wear a jacket, don’t force the issue.  Let them experience the natural consequence of being cold.

9.      Use one-liners when you do need to use words.  They make kids think, instead of tuning you out.  They place responsibility on the child.  They let the child know you will not be provoked and are effective tools for you to use to avoid power struggles and additional trauma triggers.  The fewer the words, the better.  Remember to use a CALM, matter-of-fact voice.  Sarcasm and anger counteract the good one-liner.  Some of my favorites:

a.       “Sucks for you.”  (Probably not appropriate in the classroom, but you can modify it.  Besides, I was going for the laugh.  Did you laugh?)
b.       “Bummer, Dude.”
c.      “What do you think about that?”
d.      “What are you going to do about that?”
e.      “How are you going to handle that?”
f.       “How would you handle that next time?”
g.      “Hmm, and how did that work for you?”
h.      “Thanks for your honesty.”
i.       “I respect you and myself too much to argue with you.”
j.       If he/she whines, “Why?”  Say, “If you don’t figure it out by [time], I’ll explain it to you.”
k.      “I listen to one person at a time. . . Thanks.”
l.       “I’ll be glad to listen when your voice is as soft and as calm as mine.”
m.    When a child tells you that “you never do” or that “you don’t do” like another teacher say, “That’s right!”
n.      When the child tries to argue say, “I know.”  (Student:  Math rots!  Teacher:  I know.)
o.     When a student degrades himself and says, “I can’t do this.” Or “I’m too stupid,” you say, “Aren’t you glad I don’t believe that.”  Then walk away.

For more information about post-institutionalized children, RAD, and C-PTSD visit websites such as www.ATTACh.org, www.bgcenter.com, and www.beyondconsequences.com.

Please feel free to contact me with any questions you may have about older child adoption, international adoption, post-institutionalized children, post traumatic stress disorder or attachment disorder.  I look forward to partnering with you this year so that my child learns all he can in your classroom.

Sincerely,
Your Student’s Parent