A Lot Of Anger

Today’s story – She is 13 years old. She has reactive attachment disorder (RAD) and takes it out on the whole family. She is my cousin’s child, so also my cousin. She is placed here along with her 2 other sisters. She is triggered by her younger sister’s happiness in being here and how we are one big happy family but she doesn’t feel a part of that.

An interesting suggestion was this one – Therapeutic Boxing. This is a style of depth psychotherapy using boxing skills to bring subconscious and unconscious material to the conscious mind, an unconventional style of mindfulness to look beneath the surface of behaviors. Also contact sports to help channel the anger into a positive. Some recommendations included kickboxing and Krav Maga (an Israeli martial art developed for the defense forces, it is derived from a combination of techniques used in aikido, judo, karate, boxing, savate and wrestling. It is known for its focus on real-world situations and its extreme efficiency) and rugby.

With adoptees – it is a given to seek out an adoption trauma informed therapist. Managing how an adoptee navigates trauma is a life-long road with peaks and valleys. Another type – Dialectical Behavioral Therapy (DBT) – a type of talk therapy for people who experience emotions very intensely. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation, as well as for changing behavioral patterns such as self-harm and substance use. There is also Cognitive Behavioral Therapy (CBT) – a structured, goal-oriented type of talk therapy. There are also rage rooms, also known as smash rooms or anger rooms, where people can vent their rage by destroying objects. Results according to experts appear mixed. One suggested that her oldest (age 10) loves to break large blocks of ice. There’s a lot of sensory input with that activity and it works wonders! One had a high school art teacher that always had old clay projects she could smash into the dumpster. She found that a very satisfying and helpful release. Another suggests group therapy because having other people who can relate makes some feel less alone with their situation. There are so many forms, yet another is Dyadic Developmental Psychotherapy (DDP). Some target difficulties in attachment and some difficulties in intersubjectivity, finding it hard to give and take in relationships.

There are activities one can apply to develop coping skills and emotional regulation skills. Some examples include – Relaxation techniques: deep breathing, meditation, progressive muscle technique. Also taking a quiet bath in the dark, being alone but intentional about where and how one spends that time, eliminating all other distractions. Exercise; dancing, talking a walk, lifting weights. Talking with someone you trust. Engaging in art; drawing, coloring, painting, photography, playing a musical instrument. Journal, then later burn it into ashes. Also, scream into a pillow.

For the time being validate her anger. Acknowledge that you couldn’t even imagine what she is going through and apologize to her. Tell her that she’s welcome to be a part of that family bond, whenever she’s ready, and to take her time. And tell her until then, you can be a friend – if she let’s you. Some adoptees find only adulthood brings the freedom they need to cease being so angry.

Please Be Mindful

Please be mindful of what you say about an adoptee’s birth parents and extended birth family – regardless the circumstances or how you personally feel. Remember that this person shares genes and inheritable aspects with that family of origin.

From an adoptee – As a child I internalized the messages about how I was so much better off adopted, that I was convinced my mother must have been a very evil person. I thought perhaps a witch or a prostitute and would tell everyone this. I was secretly petrified I would be just like her. (Note: she’s not, she was a vulnerable woman who was not supported to keep me.)

Of course, it is known that children have no filters or sense of decorum and will often repeat the perspectives of adults around them – thus comes this sad recollection. One of my earliest memories is from when I was 5 years old and a classmate told me I was adopted because my biological mom didn’t love me. It was so hurtful and it took me a long time to get past it.

The same advice applies to one parent or family bashing the other parent or family. Regardless of whether these are biological, foster families, adoptive family. All of these are part of a child’s history and life experience and when you do this, you are saying in effect that a part of the child is equally bad.

Dialectical Behavior Therapy

I came across the letters DBT in an adoption discussion group and as I had no idea what it stood for, I do what I often do in such cases, google it. It started with this comment by an adoptive parent –

“I just had it click in a deeper way yesterday that I put a lot of thought and effort and will into trying to heal my kids. As if I’m a savior. As if I can. But in DBT, it talks about creating a change ready environment for your kids. By the way, if you can find a child DBT therapist, do it! Its expensive and it involves individual and parent and group sessions, and its work and learning, but its SUPER effective. All kinds of stuff prove its effective. Back to my point, if I’m trying to create a change ready environment, a calm and consistent environment where mean words can roll off my back, and I’m working on me setting the example that self care is important and I’m working on me so that I can hold all the pain they send my way, that’s where I make the most beneficial impact for all of the family and that’s where I love my kids the best.”

DBT stands for Dialectical Behavior Therapy. Dialectical behavior therapy is an evidence-based psychotherapy that began with efforts to treat borderline personality disorder. There is evidence that DBT can be useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm and substance abuse. Many of these issues are aspects experienced by adoptees due to the trauma of separation from their original mothers.

One woman commented – “DBT absolutely SAVED MY LIFE. The skills helped me stop with SI and I then went on to lose 140 pounds.” I had to google SI too. Introverted sensing (or Si for short) is one of the most misunderstood cognitive functions in the personality community. Introverted sensing is a perceiving (information-gathering) function. It focuses on the subjective, internal world of personal experience and compares and contrasts new experiences to past experiences and memories. Si-users tend to notice patterns repeating themselves and are quick to spot changes or inconsistencies in their environment. They trust personal experience and subjectively explore the impact of current events, choices, and consequences.

So back to DBT . . . .

Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. DBT can help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors (eating disorders and substance use disorders). DBT is sometimes used to treat post-traumatic stress disorder (PTSD).

DBT incorporates a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when there is a “dialogue” between opposing forces. The process makes three basic assumptions:

All things are interconnected.
Change is constant and inevitable.
Opposites can be integrated to form a closer approximation.

Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain. The strategy can also help you stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior. BTW, I am a BIG believer in mindfulness.

Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook. There are 4 techniques – distraction, improving the moment, self-soothing and thinking of the pros and cons of not tolerating distress.

Emotion regulation lets you navigate powerful feelings in a more effective way. The skills you learn will help you to identify, name, and change your emotions. When you are able to recognize and cope with intense negative emotions (for example, anger), it reduces your emotional vulnerability and helps you have more positive emotional experiences.

Interpersonal effectiveness helps you to become more assertive in a relationship (for example, expressing your needs and be able to say “no”) while still keeping a relationship positive and healthy. You will learn to listen and communicate more effectively, deal with challenging people, and respect yourself and others.

Healing Trauma

I’ve only just learned about this book and have not read it but didn’t want to wait for whenever, if ever, that might happen to pass it on to readers here.

Many adoptees and foster children have some degree of trauma. It is said that this is one of the best-known books about trauma, and in particular early life trauma (which especially applies to the topics I cover in this blog).

It is not light weight reading, has almost 500 pages that includes a significant reference section. Someone who did read this (link at bottom of this essay) says – “It’s very in-depth, giving plenty of detail, but it’s not unnecessarily complicated. There’s some technical terminology used, particularly with respect to the functioning of the brain, but I thought this was explained well.”

Van der Kolk is a psychiatrist who initially began working with trauma while treating war veterans. There was a lot that wasn’t known about trauma then. He’s been an active researcher throughout his career and often considered at the forefront of new trauma-related knowledge.

In this book, he repeatedly stresses the importance of recognizing the changes that occur in the brains and nervous systems of people who’ve been through trauma, and targeting treatment accordingly with the goal of getting back the functioning they have lost. He is quoted as saying, “Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think.”

Imaging studies have produced some new understandings about flashbacks. There’s activation of the right brain along with a drop in activity in the brain structure called the thalamus, which prevents the events from being remembered as a coherent narrative, as would be the case with other kinds of memories.

Brain scans have also shown an impaired self-awareness. Van der Kolk explains that this is why it’s important to work on breathing, mindfulness, and recognizing the link between physical sensations and emotions. He writes further: “The body keeps the score: If the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.”

The book pays a lot of attention to early life trauma, including issues like attachment and attunement. The author explains that trauma increases the need for attachment, even when the only attachment figure available to the child is the abuser.

Van der Kolk championed adding complex PTSD as a separate diagnosis from PTSD. He was part of the working group that proposed C-PTSD for inclusion in the DSM-IV, and the group that proposed developmental trauma disorder for inclusion in the DSM-5. American Psychiatric Association did not approve any of these suggestions as new diagnoses.

I am indebted to Ashley of The Mental Health @ Home blog for her review which is the basis of my own blog today. You can read more about this book in her article.