Tag: PTSD

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.

ADHD And Struggling

Design and Illustrations by Maya Chastain

I found much of this discussion helpful and so I am sharing it for today’s blog.

The original comment –

My 17 year old son adopted from foster care at 15, after 8 years in care. 2 failed adoptive placements before and he was living in residential treatment for 15 months before he transitioned to my home. He’s been with me for 2 years in total. He has not had contact with any biological family in 5+ years and did not have consistent care givers for the first 7 years of his life. He expresses hate towards his biological family and will not discuss with me.

He’s dealing with depression, anxiety, and ADHD. Although I believe the depression is very long term, today is the first day he has ever said it out loud. He had actively denied it previously. I also deal with depression and the sentiment he described of feeling like nothing even matters is something I’m very familiar with. He’s been let down so many times and I often tell him he’s had a very normal reaction to abnormal circumstances. He is so afraid to hope. He is in weekly therapy and working with psychiatrist. I feel like tonight him acknowledging his depression was a really big step forward. I am trying to help him navigate depression and be more hopeful. He is incredibly intelligent and capable and could really pursue so many opportunities and be well supported in whatever he chooses. He’s sabotaging himself instead. He is an older teenager navigating the transition to adulthood. Thank you for sharing any thoughts.

Response from an Adoptee with Depression and ADHD –

Just to translate some of what you’re saying here and how it may come across. You may not say these things out loud but “could really pursue so many opportunities and be well supported” tells me you probably imply these things:

“You could do so much more if you’d just apply yourself.”

*I’m never going to be good enough*

“Why are you struggling with something this basic”

*I’m stupid and can’t do basic things*

“You self-sabotage a lot”

*Push past burnout and ignore self-care*

My support network lets me move at my own pace. Also learning that I can’t brute force my way past ADHD by being “Intelligent” has helped.

No one really figures shit out until their 20s. Heck – I didn’t figure out anything until my 30s. Gen Z just has more pressure because you can’t live off the salary from an entry level job anymore.

The original commenter replied –

I definitely think this is something I’m struggling with and I appreciate your translation. I think what’s hard for me is that he is 17 but in many way operating as someone much younger. However he has the expectation the he be treated like every other 17 year old. We are fighting regularly because I won’t let him get a driver’s permit or I set structures around bedtime and Internet and he wants freedom. I’m very comfortable trying to meet him where he is and help him grow at whatever rate he grows. But he wants adult freedom and responsibility – he’s simply not ready for and it feels negligent on my part to just give him that because of his age. So I’m trying to help him set meaningful goals for himself, so that he can work towards the things he says he wants but it seems that his depression is a major barrier to working towards those goals.

I’m not rushing him to figure it out or trying to prescribe specific goals. I’m trying to support him in doing what he says he wants to do and having the freedom he wants to have. As a single parent, I’d love for him to have a driver’s license, just as much as he wants it. But how do I help him be ready for that, when the depression he’s experiencing seems to suck any motivation to do the work ?

Response from an Adoptee with Depression and ADHD –

Why can’t he have a learner’s, if you don’t mind me asking ?

People with ADHD (and often undiagnosed co-morbidities) struggle with being infantilized.

You’re talking about controlling bed time when ADHD can come with delayed circadian rhythm and insomnia.

Yes – ADHD often means you have issues keeping up with organizational skills, goal management, emotional regulation and peer relationships. That doesn’t mean you treat that person like a young child. In an environment where controlled exploration is allowed, you develop coping skills.

ADHD – ESPECIALLY as a teenager – means you’re fighting yourself for control of a brain that seems constantly against you. Emotions are hard to regulate. Your rewards system is fucked. Object permanence is a myth. Time is an abstract concept I’ve yet to grasp.

How can you expect a 17 year old to be motivated to control things that are hard and wield an intangible reward like “opportunities,” if he can’t have any control over what’s in front of him that matters.

“Opportunities” offers no tangible reward. My ADHD/PTSD/Depression brain looks at basic chores and goes, “I don’t get why that matters.”

I’m an adult. With therapy and support, I’ve found ways around that. But I also found it after I started having my own boundaries and stopped infantilizing myself.

Meaningful goals don’t work with ADHD. They just put things behind a glass wall you’ll never break. You get frustrated and give up easier.

You need to give him simple goals he can succeed at to build self confidence.

Don’t make freedom a “reward”. It breeds resentment. Work with him to set personal boundaries and schedules. Those won’t look like what works for a neurotypical.

I like “How to ADHD” for life hacks. I also really recommend Domestic Blisters but she’s more aimed at 20 somethings. Catieosaurus is great. She does talk about sexual health on occasion but nothing a 17 year old with Google hasn’t seen.

Always The Question

From The Huffington Post – I Was Adopted Before Roe v. Wade. I Wish My Mother Had Been Given A Choice by Andrea Ross.

“Would you rather have been aborted?” This is the question some people asked me when I publicly expressed horror at the June 24 overturning of Roe v. Wade.

This question is not only mean-spirited and presumptuous, it’s a logical fallacy. The notion that adopted people should not or cannot be pro-choice simply because we were born ignores the possibility that we can value being alive at the same time we value the right to make decisions about our bodies, our lives and our futures.

My birth mother was 18 years old and partway through her first year of college when she discovered she was pregnant. Her parents arranged for her to go away to a home for unwed mothers once she started showing. My birth mother had limited choices; abortion was illegal, so her options were to keep or to relinquish her baby. And maybe it wasn’t she who decided; perhaps her parents made that decision for her. Maybe she had no choice at all.

Either way, the right to choose to have an abortion has nothing to do with what the Centers for Disease Control and Prevention crudely referred to in 2008 as the need to maintain a “domestic supply of infants” available for adoption, a notion that Supreme Court Justice Samuel Alito referred to in the opinion that overturned Roe v. Wade.

I was born in the home for unwed mothers, whisked away into foster care within a day, then adopted by yet another family three weeks later. I was shuffled between three families in my first three weeks of life.

The logic of the anti-choice, pro-adoption crowd is that I should be grateful for the fact I wasn’t aborted. After all, I didn’t languish in foster care for 18 years. And my birth mother got to finish college and pursue a career, to have kids when she was ready. It was a win-win, right?

Not by a long shot. Psychology research shows that women who relinquish their children frequently exhibit signs of post-traumatic stress disorder. And children who have been relinquished frequently develop relinquishment trauma ― a kind of trauma that “changes an individual’s brain chemistry and functioning … and can elevate adrenaline and cortisol and lower serotonin resulting in adoptees feeling hypervigilant, anxious, and depressed.”

What’s more, the institution of adoption denied me the right to know anything about my heritage, ethnicity or medical history. My birth certificate was whitewashed, amended to say I was born to my adoptive parents, in “Hospital,” delivered by “Doctor.” As a kid, I agonized over what I had done wrong, and worse, how as a baby, I could have been considered so intrinsically deficient as to be unworthy of being kept by my original parents. My life has been marked by self-doubt. I also have a constant and abiding fear of abandonment. I struggle with depression and anxiety. I’ve spent countless hours and many thousands of dollars on psychotherapy.

Supreme Court Justice Amy Coney Barrett argues that “safe haven” laws allowing women to relinquish parental rights after birth are adequate to relieve the burdens of parenthood discussed in Roe v. Wade, implying that providing a ready avenue for adoption substitutes for the need for safe and legal abortion. Her claim is also a logical fallacy. Adoption is not a substitute for choice.

I’m now past childbearing age, and I don’t have daughters, so the overturning of Roe v. Wade will not affect me directly. But I think of my beloved nieces and female students at the large university where I teach. I am furious that they no longer have the constitutional right to bodily sovereignty, and I’m terrified by the possibility their lives might change for the worse if they are forced to carry unwanted pregnancies to term. I do have a young-adult son, and if he impregnated his partner, I would want them both to be able to decide which option made the most sense for them. The circumstances that dictated my birth have no bearing on their rights.

No, I don’t wish I had been aborted, but I do wish that all those years ago, my birth mother had possessed the right to make her own decisions about what to do with her own body, the same right we all deserve.

Is Infertility A Disability ?

Sunshine, Angel, Rainbow

This morning has been a learning experience for me. Infertility is a leading cause of adoption. One adoptee wrote – I find it hard to sympathize with infertility and I’m aware it’s because that was the only reason I was adopted by my adoptive parents. I’m angry because of the abuse I’ve suffered because of that issue. In the adoption community, women are counseled that they must deal with their mental and emotional issues related to infertility before choosing to adopt a child. An adopted child will never be a replacement for a baby you lost or failed to conceive. An adopted child was conceived and birthed by another woman who will always be that child’s first mother.

Is infertility a disability ? – turns out that legally it is.

In 1998, the US Supreme Court found in Bragdon v Abbott that reproduction is a “major life activity.” And the Court held that the risks of passing the disease to offspring constituted a “substantial limitation” on reproduction. Consequently, infertility met the ADA’s criteria as a disability.

According to the World Health Organization – Infertility has significant negative social impacts on the lives of infertile couples and particularly women, who frequently experience violence, divorce, social stigma, emotional stress, depression, anxiety and low self-esteem. A diagnosis of infertility is determined as the inability to get pregnant after a year or more of trying. Infertility can trigger feelings of shame and a sense of failing to live up to traditional gender expectations. Infertility can strain romantic relationships that included the expectation of shared parenthood. (We watched the 2020 movie Ammonite last night which dramatizes that strain.)

The National Institutes of Health notes that – infertility could be a source of social and psychological suffering for women in particular. In some communities, the childbearing inability is only attributed to women, hence there is a gender related bias when it comes to a couple’s infertility.

Psychologists also must understand that infertility is a kind of trauma, often a complex trauma. Anxiety, depression, grief and loss are part of the psychological impact of infertility. There may even be more to the experience when defined by the individual. At the extreme, the process can be so stressful that a woman who undergoes fertility treatments may develop a form of post-traumatic stress disorder (PTSD).

While defining infertility as a disability may have legal and medical applications, most women do not see their infertility as a disability. When I experienced secondary infertility, I never thought of myself as disabled. I simply had reached an age where my own fertility (I gave birth to a daughter at 19 and had a pregnancy aborted at age 22 or 23) naturally had ended. While it did make me sad that my husband now desired fatherhood after I was too old to gift him with that, I still did not think of myself as disabled. Women in my adoption community who have experienced infertility do not consider themselves disabled either.

Part of my learning experience today was learning about all the “baby” symbolic concepts that I didn’t know before. Angel baby always was understood by my heart. I find it interesting that a mom’s group that I have been part of for over 18 years initially gave our group the name Sunshine Babies because our babies were all born between April and August. Later, we simply changed that to Sunshine Moms. We knew nothing of the use of such words when we chose that concept as our group symbol. We never knew that word “sunshine” had a larger meaning outside of our group.. We all conceived via assisted reproduction. Therefore, a sunshine baby can have different meanings for different families.

My own daughter experienced a still birth prior to giving birth to my grandson and later my granddaughter. It was a sad and traumatic event to be certain. The terms acknowledge the complexity of pregnancy and infant loss as well as any pregnancies that follow such a loss. For those as clueless as I was before this morning – here are some commonly used phrases related to pregnancy outcomes.

The term rainbow baby refers to a baby born to a family after a miscarriage, stillbirth or neonatal death. The concept of a rainbow baby relates to the concept of a beautiful rainbow appearing after a turbulent storm. The concept symbolizes hope and healing. I always have loved rainbows. After every storm there is a rainbow. A rainbow baby brings an unimaginable amount of joy and a sense of peace, knowing that you now have a beautiful, precious little baby.

The sunshine symbol is often used to refer to calm moments before a storm. Therefore, a sunshine baby is the child who was born before you encountered a loss. Your loss could be the result of a miscarriage which is defined as the loss of a pregnancy in the first 20 to 24 weeks. A sunshine baby represents hope. Their presence allows you to believe that you can conceive a baby successfully. Your sunshine baby is a reminder that you are fully capable of maintaining a pregnancy and delivering a healthy baby.

There are even more terms as well – a Golden baby: a baby born after a rainbow baby, a Sunset baby: a twin who dies in the womb (I did experience a “vanishing” twin in my first son’s pregnancy), a Sunrise baby: the surviving twin of a baby who dies in the womb.

If you have a biological child, you are simply lucky. Some people will never have that chance or will have had the opportunity to parent taken away from them by miscarriage or infant death. When an intractable infertility may become an awareness after a first pregnancy results in a loss. Some women will mourn that loss all the more, realizing that they will never, ever experience having a child of their own genetic biology. This can be extended as well to a birth mother who loses her child to adoption for whatever reason, especially if that mother never experiences a reunion with her child (as happened to both my maternal and paternal original grandmothers).

The truth is, when you lose a baby from any cause, you develop a permanent psychological scar. In some women, it is difficult to imagine that they will ever have another baby. Losing a baby can change a person’s dreams and hopes of any future that includes being a parent. Some people will tell you that you should just “get over it.” This is not helpful advice to extend to a bereaved parent. The overwhelming feelings experienced following a loss are normal. Usually with grief and sorrow, the intensity does lessen as time passes.

Losing Mom to Domestic Femicide

Not my usual adoption related story but adoption does come in at the end. Definitely a “Missing Mom” story. It isn’t a blog I really feel good about writing and yet, I believe this cautionary tale is important. Andy Borowitz, who generally writes satire, brought my attention to this story his wife has been investigating – The Murderer’s Little Boy by Olivia Gentile. <– You can read the sad details at this link. As a woman (as I am sure is not unusual for many women), I have been afraid at times due to some response by my romantic partner or spouse (I’ve been married more than once). It is a dangerous world and very dangerous for women, who have been described as the “weaker” sex and not without reason. I grew up in Texas and I apologize for feeling at this point like I have to say – “because Texas”. The state seems to me today to hate women in general – to be very misogynistic.

Losing a mother to domestic femicide is “the most horrific trauma that children can experience,” said Peter Jaffe, the child psychologist. Afterward, they are vulnerable to post-traumatic stress disorder, depression, dissociation, attachment difficulties, behavioral problems, and many other issues. To heal, Jaffe said, they need a caregiver who engages with them appropriately and truthfully about the murder, helps them mourn and honor their mother, and enrolls them in long-term trauma therapy. 

This is very much like the trauma and behavioral impacts that a lot of adoptees suffer from.

Far more children whose fathers kill their mothers are placed with maternal than with paternal kin, research suggests, though exact numbers aren’t known. No laws specify which side of the family is preferable, but in all custody cases, judges are supposed to address the child’s “best interest.” Paternal relatives must be carefully screened, Jaffe said. Since abuse is often intergenerational, the family’s entire history should be reviewed. Furthermore, anyone who enabled the killer’s abuse, remains aligned with him, intends to keep him in the child’s life, or “tries to wipe out the maternal family in the same way the perpetrator wiped out the mother” is presumptively unfit.

His maternal grandmother was forced to file a lawsuit to get visitation rights from the paternal side. Filed on March 15, 2017, she argued that as R.’s grandmother, she had standing to seek custody because the child’s present circumstances could “significantly impair” his emotional development. Her suit failed but she appealed.

Finally, in April 2018, 15 months after she last saw R., a panel from the First Court of Appeals convened a hearing on the maternal grandmother’s pleas. In their questions, the three judges seemed to convey concern for the boy’s welfare. Wasn’t it potentially harmful for R. to be raised by a man whose son had confessed to killing his mother? Wasn’t it worrisome that his father could see R. whenever the grandfather allowed him to? 

The judges ordered the parties into mediation, specifying that the mediator be from Houston, not Galveston County where the paternal kin were prominent. The resulting agreement, signed in July 2018, affirmed the maternal grandmother’s standing to pursue custody and gave her two mornings a month with R. as the case continued. Yet the deal stipulated that the visits be supervised by the paternal grandfather or by someone he chose, and it barred the grandmother from discussing R.’s mother or half-brother with him or showing him their pictures. 

Fearing an acquittal due to complicating circumstances, prosecutors made a deal with the murderer. At trial, he would have faced up to 99 years in prison for murder. Under his plea agreement, signed on November 25, 2019, he received 30 years for murder and 20 for tampering, with the sentences running concurrently. He’ll be eligible for parole in 2033.

The custody trial was scheduled for April 2020. But in a new twist to this story, in March, the paternal grandfather obtained another delay: he wanted to adopt R. and had obtained his murderer son’s willingness to cede his own parental rights. The maternal grandmother asked the court to stop the adoption. Her luck now was that there is a new Judge Kerri Foley. She appointed an attorney, Genevieve McGarvey, as a neutral assistant in the adoption case. Later, Foley added McGarvey to the custody case, too. For the first time in four years, an official was tasked with helping the court advance R.’s best interest. 

At a hearing in September 2020, McGarvey testified that R. wasn’t in trauma therapy and needed it “desperately.” She added, “[H]e’s got to talk about his mother more.” And he appeared to miss his half-brother profoundly. “The first thing he ever says when I see him is, ‘How’s J.?’ ‘Do you know J.?’”

Foley halted the adoption case until after the custody trial. But the trial has been repeatedly delayed and won’t happen until this summer at the earliest. Tired of waiting, his maternal grandmother filed a motion on February 2 demanding temporary joint custody in the meantime. A hearing is scheduled for March 21.

Judge Foley recently granted the grandmother longer visits with R., and she’s now allowed to bring his half-brother. But she wants the standard access granted to Texans who don’t reside with their kids: two to three weekends per month, alternating holidays and school breaks, and 30 days in summer.

Understandably the grandmother wants to protect R. She wants to get him into trauma therapy, and she wants to participate in decisions about his medical care and education. Recently, he has bounced from school to school and struggled. She wants to talk freely with him about his mother, whom he remembers and misses. And she wants to terminate his father’s rights and bar him from contacting R.—either from prison or upon his release. 

Even if the grandmother prevails at trial, her struggle won’t be over, since joint custody could be meaningless if the paternal grandfather’s adoption goes through. The grandmother is determined to continue to fight for her grandson.  “R. has never wavered in his desire to see us or just surrendered to the horror of circumstances,” she said. If he won’t give up, how could she? 

Some organizations with links also mentioned in the article –

National Safe Parents Coalition who advocates for evidence-based policies which put child safety and risks at the forefront of child custody decisions.

Kayden’s Law – requires an evidentiary hearing during child custody proceedings to vet allegations—new or old—of abuse. Though ACLU opposed it but it has now been included in the Federal Violence Against Women Act Reauthorization Act which President Joe Biden signed on Wednesday, March 16, 2022.

Respond Against Violence providing “The Strangulation Supplement,” a tool for first responders and investigators to better guide them in investigations and to help capture cases involving strangulation that may have otherwise gone unnoticed. These tools are available upon request to law enforcement, forensic nurses, and EMS, as well as tools for pediatric cases and bathtub fatality cases.

Valentine’s Day for Adoptees

Searching for a topic for a day like this related to adoptees, I found this Huffington Post blog – Roses Are Red, Violets Are Blue, Adoptees’ Worst Fear Will Likely Come True – by Ben Acheson. The image I chose seemed to fit the sentiments of some adoptees that I have encountered. The subtitle of Ben’s essay notes – What if Valentine’s Day, or relationships in general, were a stark reminder of the most painful and distressing events that you ever experienced? What if they triggered a trauma so terrifically challenging that it forever altered your approach to life? Welcome to Valentine’s Day, and relationships, for adoptees.

Ultimately, Valentine’s Day is about relationships, or the lack thereof. It may evoke unpleasant memories of lost loves, but the nostalgia is normally forgotten by the time the flowers wither and the chocolates disappear. Or does it ?

Take a moment to balk at such a provocative, nonsensical claim; that saving a child through adoption could lead to a life of relationship problems. It is ungrateful and even accusatory to altruistic adopters. It is insulting to those battling depression, Post-Traumatic Stress Disorder and other psychological issues associated with adoption.

The development of intimate relationships can be a major challenge for adoptees. Their first and most important relationship was irreparably destroyed. The person supposed to love them most disappeared inexplicably. Then they were passed to strangers and expected to pretend that nothing happened.

The impact of that severed relationship is colossal. It permanently alters everything they were destined for. It alters how they attach to people. It causes bonding problems. It leaves them angry, sad and helpless. It interferes with emotional development and instils a persistent fear of abandonment within them.

This fear impacts future relationships. Many adoptees fear that what happened once might happen again. They fear that each new relationship, like the very first one, will not last. If their own mother abandoned them, then why won’t others?

It affects their ability to trust. Their trust in adults was shattered when they were most vulnerable. The idea that their mother loved them so deeply that she gave them away is a confusing paradox. Connection, intimacy and love are forever intertwined with rejection, loneliness and abandonment. Being unable to remember the traumatic events only compounds the problem.

Adoptees are sensitive to criticism and have difficulty expressing long-suppressed emotions. They have hair-triggers and lack impulse control, frequently overreacting to minor stresses. They can be manipulative, intimidating, combative and argumentative. Total absence of control over childhood decisions gives them an unrelenting need for control in adulthood. A counterphobic reaction of ‘reject before being rejected’ is a classic sign of stunted emotional development and unresolved trauma. That is not to say that adoptees do not want intimacy. They often want to ‘give everything’. They yearn for a close, trusting connection. They want to let someone ‘in’, but the openness and vulnerability is petrifying. Letting someone ‘in’ also opens the door to rejection.

Even if partners recognize that deep, sensitive wounds exist, they tire of walking on eggshells. The emotional rollercoaster is exhausting. They become sick of the ‘parent-role’ they often assume. Even if the adoptee matures and gains insight into their behavior, the damage may have been done. Partners may reach the breaking point and leave. But who is to say that failed relationships cannot be a blessing in disguise? For adoptees, the important lesson might be that you sometimes need to fail in order to truly succeed.

A Huge Disappointment

The author of this book has completed Day 1 of a 2 Day conference on trauma. His book had previously been recommended in my all things adoption (which includes foster care) group. It is impossible to accurately convey how disappointed those who view the first day’s live event are with this man’s perspectives. I just signed up for free as there is still Day 2 to go this day and then, there are supposed to be recordings, if one misses the live event. Here is the link – The Body Keeps Score.

From the registration site –

Dr Bessel van der Kolk presents his signature presentation on treating the imprints of trauma on the body, mind, and soul.

He claims – “I’m presenting this training to serve as both a guide and an invitation—an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it.”

Dr van der Kolk shows you how to apply proven methods and approaches like neurofeedback, EMDR, meditation, yoga, mindfulness, and sensory integration in your clinical practice — so you can experience the satisfaction of helping even your toughest client heal from deep-rooted trauma.

Some comments from my all things adoption group after watching Day 1 –

There were some horrific comments about foster children being dangerous and difficult and burning houses down. Not as specific cases. Foster children in general.

Of the 8 or so hours, I can probably boil the helpful info down to about 3 sentences and none of them are new.

Assumptions that all adopters are very nice and that any problems with adoption trauma must be due to the first mom drinking during pregnancy. I’m exaggerating. But not by much.

He also said that combat veterans with PTSD don’t benefit from Prozac because they’re too invested in blaming PTSD for all their problems. He also claimed that Prozac always works for everyone who isn’t a combat veteran.

Therapists are victims and powerless, that DSM is “a piece of sh*t”.

He also thinks everyone should take tango lessons and that it would solve their trauma better than therapy.

I hope people only ever access his works thru pirating and only to laugh at him and that his empire crumbles under his feet.

Let me guess he said adoption trauma isn’t real lol Most people think that children when adopted are clean slates, and our minds and bodies can just start over but that’s not even true, even for babies.

He spent AGES showing a video and talking about how traumatic it was for a non adopted child to be away from his mom for a day or two while younger sibling was being born. But oh gosh if it’s adoption, then adopters are very nice people and are absolute saints for putting up with difficult adopted children.

A lot of people are just uneducated and adoption trauma doesn’t exist to a lot of the world.

He also made a comment that assumed all foster children are correctly and justly taken from their families because they’ve all been abused by their first families.

A questioner asked should I skip reading the book ? The answer was – the book itself is great. Just not the adoption aspect, but overall.. worth a read!

His bigotry made me unwilling to financially support his business.

As an adoptee my response to him is: how f***ing dare you assume all adoptees are difficult and dangerous and all adopters are saintly and amazing for putting up with us ? How dare you, you overprivileged white man, one who feels entitled to say that colonizing wasn’t that bad and China is a miserable place to be ?

He is drunk on his own power and has no capacity for critically thinking through his bigoted views.

I have read the book. The book is not all about adoption, in fact, if I was describing the book I wouldn’t even discuss that part. It is about the bodies physiological, neurological and biological response is trauma. It is a very important way of understanding regarding why people respond they way they do. It’s been a while since I read it but I’m sure there are some generalized and probably offensive statements for adoptees but overall it’s extremely helpful in understanding how trauma effects all the multiple systems of the body.

I was told flat out by a Guardian ad Litem that my children needing glasses was due to my drug use during pregnancy. Never mind the fact that I’ve never had a drug problem, never failed a drug test and was drug tested during, before and after my pregnancy… Couldn’t be that every member of mine and my husband’s family needs glasses and sometimes children just have vision problems. It must be drug use (meant sarcastically).

Keep in mind that over 50% of psychological research cannot be replicated. (Over 50% actually according to a top scientific journal – Nature magazine.) While therapists can be beneficial, there are a lot of quacks who present as authorities in the field. Some of the most well-known people in the field can be the most problematic such that their work cannot be replicated, but they ride the coat tails of their notoriety and most people don’t know how to keep them accountable.

Just a note, that 50% number is not quite accurate and most of the psychology quacks aren’t the ones actually doing research. There have been a lot of critiques of that article since, including the kinds of studies they chose to try to replicate and the conditions under which they claimed replication failed. I’m not saying it isn’t a problem, but that article almost certainly overstated it.

I’m a PhD in psychology. We have a giant problem with public communication of our science.

Someone suggested the book – The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Nadine Burke Harris MD. From a review at NIH website – Hans Selye, a Hungarian-born physician, developed the concept of the General Adaptation Syndrome as the first neurohormonal model of physiologic stress implicating pituitary and adrenal function in the etiology of many chronic diseases, and the associated sickly appearance of those suffering. claimed the physiologic life is fundamentally a process of adaptation to the totality of one’s experience, with real health and happiness being the successful adjustment or adaptation to those ever-changing conditions. Failure to adapt to the stress burden resulted in disease and unhappiness. In 1985, Vincent Felitti, MD, Chief of Preventive Medicine at Southern California Permanente Medical Group, San Diego, added mightily to Selye’s work with his findings of the profound, destructive, multi-organ system consequences of adverse childhood experiences. Nadine Burke Harris, MD, discovered Felitti’s pioneering work later, yet immediately understood the potential power of its lessons if implemented in her pediatric practice. She describes well her newfound understanding of the pathogenesis of ACEs (adverse childhood experiences) and the excitement of potential, effective therapeutic interventions. The Deepest Well is the story of how Burke Harris transformed herself into a champion persuader of truths difficult for others to hear, and a better clinician.

Bessel van der Kolk was booted by The Trauma Center (which he helped establish) because of his issues. The Boston Globe from March 7 2018 – Allegations of employee mistreatment roil renowned Brookline trauma center.

This doesn’t surprise me in the slightest (I’ve met Bessel before and my old boss worked under him at the Boston Trauma Center when he was in charge… he went down with Me Too NOT because he’s a sexual predator, but because he’s such an a**hole that he got more or less ousted from the PTSD community). It’s really a shame because his work is SO important and good and foundational in the complex PTSD world but he’s such a horrible person it overshadows it a lot of the time. I didn’t realize his what views were re: adoption etc, but I did know his insane levels of narcissism and his general tendency to bully.

Another one says, I met him at an International Society for Traumatic Stress Studies conference as well, in 2012 or 2013, I remember him being rude, though I had no idea he had any specific views about adoption in particular.

I’m so very disappointed to hear this. I read his book and it was so very eye opening for me. His work seems so foundational to the study of the affect of trauma on people. It is so very disappointing and even more frustrating.

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

Becoming Whole

This is what it is like to relinquish a child and then one day find them again and realize you are coming full circle and putting your pieces back together to become whole again. One birth mother’s story for today.

Summer 2018:

While working with my husband (repo agent) doing research on debtors, I stumble across a Facebook profile pic that makes my heart stop. After years of searching with very limited info, I finally saw a picture of the man my son grew to become. (He happened to be FB friends with a debtor we were looking for). My own eyes were staring back at me.

I chew nervously for days on what to do. Do I reach out? What if he doesn’t want to meet me? My heart is racing almost non-stop, and I’m functioning barely in a constant state of fight or flight.

I bite the bullet and send a message. Crickets for a few days, and then a very guarded/nervous response. I back off because I can’t even imagine what he’s thinking/feeling. And then, I receive a friend request.

I can see his life in posts, pics, and a piece of who he is. It’s such a gift…one I had long ago conceded I’d never receive. We tread carefully back and forth on social media for some time. I immediately put myself into intensive therapy to deal with the unresolved trauma and PTSD issues I had ignored forever. I search for and join multiple groups both for support and adoptee perspective. I, for the first time in my life, focus on self-improvement instead of self-destruction.

February 2019:

We meet face to face for the first time in a neutral location. He hugs me, and I’m shaking externally from all the emotions I’m feeling. I’m trying to absorb everything because I’m so scared this is going to be it. I have gifts for him in the car (a hand written letter, framed pic of me holding him as a newborn, and a watch engraved with

Always loved… Never forgotten…

I wait until our lunch is over and ask if he’d be ok with a couple of gifts. He readily accepts them, and we part ways. I’m terrified that I’ve done too much, but only 30 mins later I receive a message thanking me for everything. He goes on to say that the picture and letter would have been more than enough, but absolutely loves the watch.

Today:

I honestly could write a book on our journey so far. There are so many things that have occurred that aren’t included in this small recap – but I’ll save that for another day.

This is what I want to share –

Less than 2 years after reuniting, he joined us on our annual family vacation. He left his car at my house and endured a 10 hour drive with myself, hubby, his half brother and our dog.

He loves hiking and the outdoors!!! I’ve spent many family vacations dragging my husband and other 2 kiddos hiking only to hear complaints. This year, I had an Ally!!! I listened for hours to my husband and him talk cars, my youngest son and him talk video games, and my daughter and him talk science and politics.

I don’t ever want to forget these moments.

My son asked me during our first meeting…”Does your husband know about me?”… My response was “Of course! I told him about you only 2 weeks after meeting him. I hoped I would find you one day, and I could only be with someone who could accept and support that.”

My husband has done more than just support me….he’s accepted my son, included him and embraced him. I’m still a broken woman, but my pieces are coming together. And my family is finally whole.