Better Than Punishment

From an editorial by Dr Ruchi Fitzgerald in LINK>The Hill – It is unimaginable to think that seeking medical care could lead to losing custody of their children, yet this devastating predicament is all too real for pregnant women with addiction in the United States.

In our nation, the systems that aim to protect children from the negative effects of parental substance use often prioritize punitive approaches over proven public health strategies. Fear of being imprisoned, stigmatized, or having their children removed makes many pregnant women with substance use disorder (SUD) afraid to seek medical care, contributing to poor maternal health outcomes. Some state laws, including the law in Illinois where I practice medicine, even mandate that health care professionals report cases of detected controlled substances in a newborn infant as evidence of child neglect. While the federal Child Abuse Prevention and Treatment Act (CAPTA) has no such requirement, CAPTA’s overall approach has led to significant variation in how states, counties, and health care institutions implement its reporting requirements when substance use is involved during pregnancy.

Threatening child removal from a birthing parent with SUD without a risk assessment or evidence of danger to the child is not ultimately improving outcomes for children. Research has long shown that children affected by the trauma of family separation tend to experience worse long-term outcomes on a wide variety of indicators, including education, health, housing, employment, substance use, and involvement with the criminal legal system. With over 400,000 children in foster care across the US, the trauma of separation is widespread.

Forced separation also brings unimaginable pain to new families – triggering in some parents such despair that it deters them from seeking or continuing medical care, including treatment for their SUD. Study after study shows child removal is associated with parental overdose, mental illness, post-traumatic stress disorder, and return to substance use. Public health-oriented policies that can result in better outcomes for families are part of the solution.

As an addiction specialist physician, I am involved with the medical care of pregnant people with SUD, and I have seen counterproductive child welfare and criminal investigations launched after a newborn infant tests positive for a controlled substance. Too often, parents become hopeless about recovery once their children are gone.

Current policies and practices related to substance use during pregnancy also result in serious health inequities. Pregnant and parenting people of color are much more likely to be impacted by forced separation than their white counterparts. Black parents are more likely than white parents to be reported for substance use to the child protection system at their child’s delivery despite similar rates of drug use, while Black and Native American children are overrepresented in foster care relative to white children in the setting of parental substance use.

Meanwhile, health outcomes are unnecessarily worse for mothers of color. Since 80% of maternal deaths are due to overdose or suicide, we can save lives with policies and practices that encourage treatment, not punish pregnant women with SUD for seeking it. Policymakers need to remove controlled substance reporting requirements that overreach and contribute to the current punitive approach.

The American Society of Addiction Medicine (ASAM) encourages child protective services agencies not to use evidence of substance use, alone, to sanction parents—especially with child removal; supports eliminating in-utero substance exposure language in child abuse and neglect statutes, and supports policies that extend social services benefits and financial support to families in need.

The US Senate will contemplate reauthorizing and reforming CAPTA this year. Health care professionals who treat pregnant people with medications for addiction, like methadone or buprenorphine for opioid use disorder, do not need to involve child protective services for that reason.

Recovery is possible with the right medical care and support. A pregnant person with addiction seeking medical care deserves a chance to heal and recover with her children. If we want pregnant and parenting people with addiction to access the evidence-based treatment they need, our decision-makers must embrace public health over punitive policies.

Childhood Disrupted

Short on time with a crazy week but I saw this book recommended in an all things adoption group thread and so I went looking. LINK> Aces Too High is a website related to Adverse Childhood Experiences often abbreviated simply to ACE. There is a review there which I am using to quickly dash out today’s blog.

This book explains how the problems that you’ve been grappling with in your adult life have their roots in childhood events that you probably didn’t even consider had any bearing on what you’re dealing with now. Childhood trauma is very common — two-thirds of us have experienced at least one type — and how that can lead to adult onset of chronic disease, mental illness, violence and being a victim of violence. It also showed that the more types of trauma you experience, the greater the risk of alcoholism, heart disease, cancer, suicide, etc.

Donna Jackson Nakazawa is a science journalist specializing in the intersection of neurobiology, immunology and the inner workings of the human heart. She says, “If you put enough stress on the immune system, there can be that last drop of water that it can’t hold, causing the barrel to spill over, and havoc ensues. What causes the immune system to be overwhelmed is different for every person – including infections, stress, toxins, a poor diet.”

She goes on to note – People who have experienced childhood adversity undergo an epigenetic shift in childhood, meaning that their stress-response genes are altered by those experiences, and that results in a high stress level for life. Stress promotes inflammation. These experiences are tied to depression, autoimmune disease, heart disease, and cancer during adulthood. She says, “. . . no other area of medicine would we ignore such a strong genetic link to disease.”

She has much more to say and I do encourage you to read her interview at the link. My apologies for not having more time today.

In A System Haunted

DeJarnette Sanitarium

It doesn’t take long if spending time among adoptees to learn about the strong link between foster care and adoption. Foster care is often the first step in that direction as children are removed from their parents and placed with strangers. The official goal is reunification of the family when it is deemed safe for the children to be returned to their parents. That does happen in many cases after an emotionally damaging experience for all concerned. Other times the parent’s rights are terminated and in the case of infants and young children, often these are adopted by the foster parents or some other hopeful adoptive parent. And in too many cases, these young children “age out” in the system and are thrown out into the world as young adults with few supports, though that situation has improved somewhat in recent years.

Yesterday, I learned about the link between the building pictured above and foster care. Dr Joseph DeJarnette was a proponent of racial segregation and eugenics, specifically the compulsory sterilization of the mentally ill. He was known to idolize Nazi Germany and took the facility under his management from a resort-like treatment center to an apocalyptic prison nightmare. His determined efforts resulted in the passage of the “Eugenical Sterilization Act of 1924” (a.k.a Racial Integrity Act). This new act reinforced racial segregation by preventing interracial marriages and classifying “white” as being pure 100% Caucasian. Men and women who were admitted to his hospital were involuntarily sterilized to prevent the conception of mixed race human beings. DeJarnette also forcibly sterilized single mothers, alcoholics, those with mental conditions and epilepsy, the poor, and the incarcerated. Dr DeJarnette not only performed countless sterilizations but also medical procedures on his patients like electroshock therapy and lobotomies.

He died in 1957. DeJarnette became a state institution with a focus on children’s behavioral health issues. It is at that point in the history of this place that my interest today became awareness. If you believe emotional energy leaves traces of residual energy in a place, then in that sense DeJarnette is believed haunted. A young woman writing an op-ed for LINK> The Huffington Post brought that awareness to me.

At the age of 14, the author was relatively new to the foster care system and waiting for a bed to open up at a long-term facility. The author walked those halls, recognizes the once-grand arches that frame the doorways, the bedrooms with graffitied walls. She says, “Dr. Joe’s evil spirit is said to walk the halls. Some say they’ve heard children’s voices in the darkness or moans and other noises from the former patients reported to have perished due to medical experiments. I doubt the teens who once lived there were aware of Dr DeJarnette by name. I wasn’t. However, the building’s ties to eugenics were among the first things new kids learned about the center.”

She goes on to note that she asked – “Why did they do it?” And the answer she got was – “They think your kids are gonna end up like you. If we don’t have babies, they’ll be less of us and more of them.” She says – “I wasn’t totally sure what more of them meant but I understood less of us. Less of me.” She also shares that she lived in DeJarnette during the winter with the holidays were approaching. It was her first Christmas in the system. Her expectations were perpetually low back then. She fixated on the phrase anything you want when asked to provide a Christmas wish list with one condition – as long as it’s less than 10 dollars. She remembers asking for a Def Leppard tape even though she no longer had her boom box. Receiving the tape symbolized hope and the belief that someday, she would have a tape player again.

We don’t often consider what it is like for a teen living in foster care. That they don’t have typical teenage memories like going to the homecoming dance, having their first date, a sweet 16 party or getting a driver’s license. What she did get was a strong sense of her ability to survive. She made it through the system and didn’t become a statistic. She says that she is thriving today. She says of that residual energy – “when you consider the collective traumas and experiences of all those who spent time in that cavernous, state-run institution, there was plenty of haunting going on. It wasn’t ghosts, though. It was us.”

Inside DeJarnette Today

I Am Now My Own Parent

My Dad and Mom

I’ve told some version of this story before and can’t promise I won’t again, though with evolving perspectives, these likely do change over time. My dad died only 4 months after my mom. She died first in September 2015 and he followed in February 2016. It was a profound event in my own life as I am certain it is in many lives. After my dad died, my youngest sister said, “We are now orphans.” I remain estranged from her. The cruelty she expresses towards me when we are in contact with one another causes me not to want to be involved with her. Not long ago, the state of Missouri informed me that they held some abandoned asset of my mom’s and I jumped through hoops and ended up with a whopping check for $20. Because I needed to provide my sisters names and addresses, so they could receive their own shares, I contacted my youngest sister’s conservator, who had been appointed to manage her funds. Turns out, he has been free of her for 2-1/2 years and no longer has that responsibility. The judge turned him loose and I understand. My sister is difficult and uncooperative and so, she is on her own now. So be it. I never wanted to take her freedom away from her. It was her own lawyers and the need for a family member to ask the court to look at her circumstances that forced my own involvement.

The topic today was inspired by a Daily Guide for Sunday, July 10 2022 in the Science of Mind magazine written by Rev Dr Jim Lockard. That phrase that is my title today comes from an affirmation he put at the end of his essay. He mentions that some people have never known their family of origin. That was certainly true for BOTH of my parents – as each of them was adopted and they died knowing next to nothing about their origins. I was conceived out of wedlock by a teenage mom. I could have so easily been given up for adoption but thankfully, I was not. It seems that one of my purposes in this life was to reconnect the threads of my parents own origins and I have now made it as far as is necessary for my own peace of mind. I know who all 4 genetic grandparents were, something of their stories and am aware of quite a few living, genetic relatives now that I am in contact with.

After my mom died, I came into contact again with an aunt. She is the widowed wife of my dad’s brother (my uncle was also adopted). A profound experience for me in high school was witnessing my uncle’s slow decline from Lou Gehrig’s disease. She is a nurse who met him when he was a Marine and hospitalized due to an auto accident. I had been thinking about this aunt for several days. It seems we do have a “spiritual heart connection” and so, she had been thinking about me and called me recently. It has been true since my mom died that she still calls me to check in from time to time – mostly to hear the latest for me and adds a few insights into her own life. Mostly, she just listens. I find her easy to talk to, honestly, though she is much more conventionally religious than I am. She usually asks about my sisters and how are they doing. She used to tell me she was praying for my estranged sister and I but she no longer tries to reach me that way. She had only one child with my uncle and he died a few years ago, too young and somewhat unexpectedly. She lives with an elderly sibling and that sibling’s spouse. My aunt is now 90 years old and I never know how much longer she will be in my life but she is totally lucid and I am always happy to hear from her.

Mine is a strange reality to live. Learning who my genetic relatives were and are, has to some extent, distanced me from the ones I grew up with. Even so, I remain fond of the adoptive grandparents I grew up with (now deceased) and with the aunt just mentioned and one other (my dad’s step-sister, who he acquired when his adoptive mother remarried after a divorce). My mom also had a brother who was adopted through the Tennessee Children’s Home before her. I am not all that close to him but did see him at my mom’s memorial service. It was his daughter’s receipt of his adoption file that had her call to tell me – I could get my mom’s. That opened the door for me to become genetically whole again and fulfill an intended life purpose.

Abandoned Babies

Will there be more with Roe v Wade being overturned ?

A story making national news recently is about a baby found, wrapped in a towel in a stroller outside of an apartment complex, by a Coeur d’Alene Idaho resident when they left for work around 6 am.

A woman, identified as an adoptee named Webster, in this youtube news story, is quoted saying “We are living in a time where people feel like they are alone and they don’t have a support system or a net under them.”

If you are considering abandoning your baby, you likely are experiencing many different thoughts and emotions as well as being faced with one of the toughest decisions of your life. You might have one or more of these factors occurring in your life –

  • Have a history of substance use and are afraid to share that information
  • Not have proper documentation to live in the United States and fear being deported  
  • Be living with a mental illness or facing postpartum depression  
  • Be afraid of the baby’s father or worried about what your loved ones might say   

If you are desperate for help, you may see no other option but to abandon your baby. Perhaps, you even wonder what happens to abandoned babies after they’re found?    

There are really only three ways a woman can abandon her baby:  

  • A prospective birth mother can work with an adoption agency to make an adoption plan for her baby. This is one legal way a woman can release her baby from her responsibility to care for it.
  • With Safe Haven laws, women have the option to safely, legally, and anonymously leave their baby, unharmed, at a safe haven location — like a hospital, fire station, or a church.   
  • Even so, some women, feeling completely overwhelmed and unaware of the first two options, will take drastic measures, such as the case with this abandoned baby, leaving them in an unsafe condition.  

The way a baby is surrendered will affect what happens to the infant afterwards. Babies who are abandoned in an unsafe location often have tragic outcomes because help comes too late. Babies that are found safely, after they’ve been abandoned or surrendered to a safe haven location, become a ward of the state.

Safe Haven babies are typically checked out by a doctor and, if necessary, given medical care. Afterward, the state’s social services department is contacted. Once that happens, the baby will be placed into foster care and become a ward of the state. In some situations, a private adoption agency might be contacted.  

When a woman does not contact an adoption agency for assistance or use the Safe Haven law locations, if she can be located and identified, criminal charges will be filed against her. That is why the police in Coeur d’Alene Idaho are actively seeking information about who the woman may have been.

Marilyn Monroe

From Norma Jeane to Marilyn Monroe

Marilyn Monroe’s mother went into a mental hospital and left her to orphanages and foster care. In My Story, Monroe wrote that she recalled seeing her mother “screaming and laughing” as she was forcibly taken to a State Hospital.

At age 11, Norma Jeane was declared a ward of the state. She lived in a total of 11 foster homes throughout her youth; when there was no foster home available, she sometimes ended up at the Hollygrove Orphanage in Los Angeles. As if moving from one foster home to another wasn’t difficult enough, Norma Jeane recalled being treated harshly in several of them. Even worse, she was abused including sexually in at least three of her foster care placements.

Norma Jeane in Red Sweater

Here is one story from the Daily Mail, “The magic red sweater that turned ‘Norma Jeane, string bean’ into Marilyn Monroe” –

She told of being whipped by one foster mother for having touched ‘the bad part’ of her body. Another more serious incident occurred when she was eight. One evening a lodger she called Mr. Kimmel (Marilyn said later that this was not his real name) asked her to come into his room and locked the door behind her. He put his arms around her. She kicked and struggled. He did what he wanted, telling her to be a good girl. (In a later interview Marilyn stated that the abuse involved fondling). When he let her out, he handed her a coin and told her to buy herself an ice cream. She threw the coin in his face and ran to tell her foster mother what happened, but the woman wouldn’t listen.

“Shame on you,” her foster mother said. “Mr. Kimmel’s my star boarder.” Norma Jeane went to her room and cried all night. Marilyn said she felt dirty and took baths for days after it happened to feel clean. Such repeated attempts to feel clean through showers or baths are typical behavior for victims of assault. Marilyn also said she began to stutter after the incident and reverted to it at times of stress. When she told one interviewer about the abuse, she began stuttering. The evidence points to the fact that she was an abused child whose early sexualization led to her inappropriate behavior as an adult.

One of the reasons she chose to marry at 16 was simply to escape her foster care takers. She never knew who her father was. After getting married at 16, she later divorced and became a new persona. She went from Norma Jeane Baker to Marilyn Monroe in order to fit in, be accepted, and wanted…what she never wanted was to become a sex object.

Not many seem to have recognized that she was dealing with abandonment trauma her entire life. She overdosed at the age of 36. According to an article at a site called Vigilant Citizen, behind Monroe’s photogenic smile was a fragile individual who was exploited and subjected to mind control by powerful handlers. Through trauma and psychological programming, Monroe a became high-level puppet of society’s elite, even becoming JFK’s paramour.

One “conspiracy theory” asserts – “Some children live in foster homes, or with adopted parents, or in orphanages, or with caretakers and guardians. Because these children are at the mercy of the non-related adults, these types of children frequently are sold to become mind-controlled slaves of the intelligence agencies.” ~ Fritz Springmeier, The Illuminati Formula to Create a Mind Control Slave. Not saying that I believe conspiracy theories but often there are some facts that are foundational to them.

Industry insiders convinced Norma Jeane to undergo aesthetic surgery, to change her name to Marilyn Monroe and to change her hair color to platinum blonde. Monroe’s sensual, “dumb blond” persona allowed her to land roles in several movies, which began a clear culture shift in Hollywood.

It Is About More Than That

In my all things adoption group, a woman writes –

Let’s talk about “playing the victim”. I see this come up a lot in this group when adoptees and former fostercare youth are talking about their trauma. I can only speak for myself, but I’d like to explain why this is so bothersome.

This is a group about the realities of adoption. Our conversations are often about adoption. I talk about my adoption trauma a lot in this group. Why? Because it’s relevant to the conversation. The conversations I have in this group are not reflective of the conversations I have elsewhere in my life. This group is only a sliver of my life.

I have trauma from being adopted. I suffer from mental illness. I’ve been diagnosed with BPD (* see below). I don’t blame all of my struggles on being adopted. I can’t say for certain that it is the root of all my problems. But I also can’t separate it. I was relinquished as a newborn. This trauma has always been here. It is a part of the other problems. It is a part of me. But it’s not all of me.

* Note – BPD – Borderline Personality Disorder is a condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.

I have trauma from being adopted but I have privilege in other areas of my life. I’m very fortunate to be where I am today. I’ve met many roadblocks as a result of being an adoptee, but I’ve overcome many of them. I’ve made mistakes and suffered the consequences of those mistakes, but I own them. I don’t blame others for my actions.

Being adopted comes with trauma. Being adopted has legal implications that can make things difficult. In a group about facing the realities of adoption, I don’t think it’s “playing the victim” to acknowledge the hard things. You have no idea how anyone has lived their life. We are simply sharing experiences that are relevant to the purpose of this group.

Parentification

This was a new term for me and came out of one of the stories I read recently conveyed by a foster parent. Here’s the story –

I am currently fostering a 14 year old. They were removed because of trauma from a family member who is not their mom but who still lives with their mom. Mom refuses to ask this person to leave or to move into a different apartment, but is otherwise doing what is asked of her to work towards reunification. Today this kid told me they really want to be reunified, which makes perfect sense. I’m worried because this seems unlikely unless mom starts believing them and takes steps to cut their perpetrator out of her life. How do I support them? If you were in their shoes, what would you want from a foster caregiver? I’m also worried because many of the reasons this kid states for wanting to reunify are to care for their mom. It’s not my place to make the judgment calls, but it seems from the outside like a case of parentification. Add to this that I’ve heard this child talk about how much they wish they had been given the opportunity that their peers had to “just be a kid”.

So what is parentification ? Parentification is when the roles are reversed between a child and a parent, a toxic family dynamic that is rarely talked about and is even accepted as the norm in some cultures. However, research has found that it can have far-reaching negative psychological impacts. It is a functional and/or emotional role reversal in which the child sacrifices his or her own needs for attention, comfort, and guidance in order to accommodate and care for the logistical and emotional needs of a parent and/or sibling.

One response was this from experience – my parents put me in foster care briefly when I was suicidal from the pressure of being a “good kid” and experiencing their abuse. I wanted to go back to them to protect my brother. I feel for the teen. I would have this child in therapy now to begin processing those emotions of responsibility. I’m 24 and still struggle with guilt that my brother may have suffered when I was gone or what would have happened if I’d stayed gone. My mom would’ve likely lost her mind. She did – when I went to college. My best advice is therapy for the child while in your care, and perhaps talk to a therapist about how you could best talk to their mom about her removing that person in the home. My mom chose my dad over me often, so I feel for the teen.

Another one shared – Unfortunately this might be something that never fully goes away. I was like this, the eldest child who took care of the family from a very young age and getting rid of that guilt and the “needing to take care of them feeling” has been very very resistant to therapy. I think the best you can do is just try to be empathetic, don’t make them feel like they’re acting too old or whatever (mine did that and it really fucked with my head) just be kind and remind them they can relax and do things for themselves, even if they don’t listen.

This one touched my heart, because I am the oldest as well. I was not in an awful situation but I have always felt a sense of responsibility for my two sisters. Our parents died only 4 months apart (high school sweethearts married for over 50 years). From the first day I returned to my family after my mom died first, I found myself having to take over financial responsibility for my sisters that my mom had been financially providing, making me in effect “the mom”. Then, after our dad died too, I had to ask the court to appoint someone to assist my youngest sister with her finances. She is likely a paranoid schizophrenic with very weird ideas about the way money functions. The court agreed to appoint a conservator. My sister and I have struggled. What had been a really good relationship before was destroyed when our mom died. Our mom had a poor relationship with my sister for over a decade and my sister’s feelings about that transferred to me when my mom died and I had to take over the family finances.

Also this interesting perspective – I cared for a teen relative of mine last year similar situation. As soon as she could legally, she returned to mom and the abuser to care for her siblings again and her mom. This is what she had been taught was the only way to get attention, love etc from mom. The best way we found to help her was to enroll her in a group for teens about healthy relationships at our local Domestic Violence shelter. She also did therapy with someone she selected and equine psychotherapy which helped her with attachment a lot. While she was here, we focused on just reminding her of our unconditional love and building trust in our relationship. Even though she went back, it didn’t take long for all of that to help her see how to set boundaries with mom, identify unsafe situations with abuser and start to come out of some of the fog. It’s still complicated but she isn’t engrained and I see her setting more healthy boundaries. We (and her dad) are still safe people she can come too and does. It took about 6 months of us just watching from a distance and being supportive regardless. In your situation, maybe focus on staying neutral and asking for a CASA or Guardian ad Litem to help with the other side of the coin. Having a mentor also really helped my relative. It was someone closer to her age that she could confide in and she is still actively talking to that person now. Maybe your foster youth could use a mentor because they aren’t a therapist but can be a sounding board. Also a lifeline if the youth returns and ‘adults’ get cut off from that person. (I say adults because the mentors we have had are usually 25 or younger and parents don’t see them like they do a 40 year old caseworker).

It Really Was That Bad

Today’s story –

I was adopted from foster care when I was 12. I was adopted into the same home as one of my biological sisters. Being adopted was the only way I could stay with my younger sister, so I consented. I knew my first family, as I lived with them to the age of ten. Having to leave them, especially my siblings, destroyed me.

Nearly as bad was the family I ended up with. My adoptive mom berated me constantly, and could be very cruel. I was told that my sister and I weren’t wanted, and that’s why my mother kept her other (three younger) kids but gave us up. That we were lucky that she chose us. The day of the adoption she told me that my life now was between her and Jesus.

I have a good relationship with my biological mom and stepdad, and their kids. I love them, and they love me back with a kind of enthusiasm that I never experienced in my adoptive home. Awhile back, my adoptive mom sent me a message, trying to apologize. It was painful, but it made me know for sure that things were as bad as I thought they were.

From the adoptive mom –

A couple of years ago we sat in the livingroom and I made an attempt at making an amends with you. I thought if I had stopped drinking and stayed sober, then the past was the past.

At the beginning, when you moved into our home, I made a feeble attempt at reaching out to you. You cringed and would not trust me, would not call me mom. You already had a mom and I had not even showed I was a safe person. I couldn’t and didn’t listen to your silent pain.

I know I verbally and emotionally abused you. You went to therapy but it didn’t work and I was glad because I did not want my neglect to be exposed. I knew I was guilty for causing the demons that haunted you.

At the height of your anorexia, you were hospitalized and yet I was jealous of you. I know I was insane. It was my own mental illness more than the alcoholism.

I just wanted to tell you that I am so ashamed of not giving you the childhood you deserved. It was my loss, I never really got to know you. I take none of the credit for your strength.

They Are Not Orphans

If anyone cared about children and adoption, they would be focused on changing the things that lead to a child being taken away from their parent or a parent not feeling adequate to parent their own child.

Things like poverty, addiction, mental illness and abuse.

Most “adoptable” children are NOT actually orphans. That is a myth.

Poverty plays a huge role in how children end up in foster care and through that in the adoption system or end up going straight into adoption without the parent ever trying to raise their own child.

Society needs to focus on the inequities that destroy a stable family unit.

Focus of those aspects that disrupt children’s lives.

At the maternity ward level, every adoption takes place in a tragic situation where the birth mother actually wanted her baby – that is the main reason any woman would devote 9 mos of her life into the creation of a new human being in her own womb. This is a huge sacrifice and commitment on the part of any woman.

Here’s the honest truth – there actually is ENOUGH money in this world to HELP people – instead of jerking their precious children away from them in order to make a profit from another couple who desperately believes that is their only path to parenthood.