Tag: Anxiety Disorders

Being Infertile While Black

I actually learned about the book in my image while reading another woman’s story of the disappointments and heartbreak of going through failure after failure after failure in assisted reproduction cycles. The essay’s author mentions Emily Bernard’s book Black is the Body, in which she describes her own reproductive struggles, and how she felt like a failure for not being able to conceive. No matter how much she tried, she could not conceive (she ended up adopting). And though my blog today is not about that book, so often, one thing leads to another and there I find adoption. Infertility is a common thread that very often leads to adoption. In my all things adoption group they often counsel women to confront their grief related to infertility before adopting. An adopted child will never be the child you could not conceive naturally and not coming to grips with that will bring a problematic relationship with your adopted child who regardless may never feel like they were good enough to meet your expectations even if you did not go through infertility first.

You can read Edna Bonhomme‘s entire essay in The Guardian about her experience of infertility in search of Black Motherhood. “For women from Black, working-class families like mine, to have children – countering the forces that tried to destroy us – can be a powerful political act.” That perspective really made sense to me but was one I would have never considered, if I had not read Edna’s essay. I will share some other excerpts I jotted down.

“Infertility damages mental health in many ways, and the clinical depression and anxiety disorders that occur after failed IVF attempts can have long term negative consequences. Some people offered unwanted counsel: ‘Why don’t you adopt?’ I had to accept that some people will never get pregnant, no matter how hard they try. (As a writer) It is more challenging to tell a story about fertility treatment that ends in childlessness.”

“One friend and confidante, who struggled for nearly 10 years to conceive, told me how she had been ready to adopt right before she became pregnant. I have to rationalize that my body, like all bodies, is complex, and there is no simple answer for why I cannot get pregnant. In the closing lines of a story such as this, one might assume the denouement brings a child: it doesn’t. Unfortunately, it ends here.”

I had expected this essay to end in an adoption but another thing I often read in my all things adoption group is not everyone has to have children. It would appear that is where Edna ended up – in an acceptance of nature as it is for her Black body.

Developmental Trauma Disorder In An Adoptee

“All diagnoses are wrong, but some are useful.” George Box

The kinds of complex issues that adoptees face can be difficult to treat. A 2013 study found that fewer than 25% of adoptive parents who sought mental health services felt that their mental health professional was adoption-competent. The symptoms and issues that adopted children experience are typically not taught in most graduate school mental health programs. Adding to the challenges faced by adoptive families, insurance companies will not cover what is really going on with these children and their families because it is not correctly conceptualized, coded, and diagnosed.

Some common diagnoses used with adopted children include Pervasive Developmental Disorders, Oppositional Defiant Disorder, Conduct Disorder, Reactive Attachment Disorder, Affective Disorders, Anxiety Disorders, Attention-Deficit Hyperactivity Disorder, Post-Traumatic Stress Disorder, and Borderline Personality Disorder. Each of these may characterize certain symptoms that these children demonstrate, but none of them systemically addresses the developmental aspect of trauma that most (if not all) adopted children experience. None take into account the sad possibility of being traumatized by birth or foster-parents. “There is no diagnosis for children that more than partially addresses the symptoms associated with these impairments in self-regulation” according to Julian Ford, PhD, who is a psychologist with the University of Connecticut.

“Developmental Trauma Disorder” or DTD includes symptoms that differentiate it from Post-Traumatic Stress Disorder PTSD more commonly associated with the “Battle-Fatigue” symptoms of WWI. Children are often traumatized in the context of relationships. Because children’s brains are still developing, this trauma has a much more pervasive and long-range influence on their self-concept, on their sense of the world, and on their ability to regulate themselves.

There are four diagnostic areas involved in DTD – [1] Exposure [2] Triggered pattern of repeated dysregulation in response to trauma cues [3] Persistently Altered Attributions and Expectancies and [4] Functional Impairment. Those who’s work has been focused on adopted children who have suffered various forms of Complex Trauma will recognize the manifestation of these. The American Psychiatric Association failed to include this in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (also known as the DSM-V).

The problem with this oversight is that after experiencing chronic trauma, the current standard of clinical practice often reveals no diagnosis, inaccurate diagnosis or inadequate diagnosis…all of which leads to misguided or complete lack of treatment plans. Further, because there is almost always considerable dysregulation of body (sensory and motor), affect (explosive/irritable or frozen/restricted), cognition (altered perceptions of beliefs, auditory and sensory-perceptual flashbacks and dissociation) and behavior (multiple forms of regression), the diagnoses of bipolar, oppositional defiant disorder/conduct disorder, attention deficit hyperactivity disorder (ADHD) or other anxiety disorders are made. Many of these disorders are co-morbid with developmental trauma disorder, as they tend to cluster in these complex families. But the importance is that the developmental trauma disorder would be primary and thus guide the treatment plan…and further, refine the inclusion (or not) of other co-morbid disorders.

Today’s blog was informed by an article Could My Adopted Teen Have Developmental Trauma Disorder? by Dr Norm Thibault, LMFT