Safety Security and Protection

I was intrigued and drawn in by this graphic image but wasn’t really finding what my heart was calling for from Dr Shaw. However, I did find this – LINK> Attachment Explained by Sarah Mundy. I had previously been exposed to Reactive Attachment Disorder in my all things adoption community. Sarah notes regarding “attachment” that “with different approaches and a number of terms banded around it can feel so confusing.” Sarah is a Clinical Psychologist with over 15 years of experience in the field. She also admits that as the mother of three, she has learned that theory does not always feel that easy to translate into practice.

Attachment theory was developed by Psychiatrist John Bowlby in the 1930s. Shaped by their experiences of being parented, children develop an internal working model, a template of how they see themselves and the world. Humans learn to behave in ways that will help maximize their chances of getting their needs met.

Sarah goes on to describe 4 attachment patterns – Secure, Insecure/Ambivalent, Insecure/Avoidant and Disorganized. It is clear to me now from 5 years of reading the thoughts and experiences of adoptees now that many of these challenges show up in how they were parented.

As a parent, I am well aware of those times when I feel that I did not do as good of a job parenting as I might have wished. Sarah says, “Try to remember that secure attachment relationships may be what we aspire to, but they are not actually that normal! Please try not to worry – nearly half of us lean towards insecure attachment relationships – they are adaptive ways to fit with the parenting that we have experienced.”

It is reassuring to know that a recent study on infant attachment found that parents need to be “in tune” with their babies about 50% of the time in order for them to develop secure attachment relationships. The benefits of developing a secure attachment are multitude – when we are safe in our relationships the world feels more exciting and less frightening. We can be vulnerable and know that others can help us, we can be curious and find joy more easily.

Sarah has more to say at the link.

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.

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

Why Do I Care ?

I was searching my heart for a topic for today’s blog. I’ve been reading a book and recently the topic was treating Borderlines. I once knew someone slightly who lost her children and described her diagnosis with that as the reason. I didn’t think too much about it at the time but due to my reading, I understand her personality better now. I also know that adoptees often suffer from a wide range of mental health issues. So I googled Adoptees and Borderline Personality Traits.

I am going to link this sad article for you because there is so much there. I actually care and have learned a lot more to care about since uncovering my adoptee (both mom and dad) parents origins and adoption stories. While I will be forever grateful I didn’t end up adopted (because it is a minor miracle I did not), I care about all things adoption and an extension of that has been caring about foster care youth and often, foster care does lead to adoption. That is the background of the story I will link for you here.

Dark Enough: When Adoptive Families Struggle

The subject of the story is Rebecca who was removed by Child Protective Services (CPS) from her natural mother when she was 6 years old. CPS did initially try a kinship placement with Rebecca’s maternal grandmother but a few months, it became clear that their grandmother was unable to meet the children’s needs. There were 3 girls. Rebecca went through multiple foster care placements but eventually was reunited with her 15 month old sister Alina, when Rebecca was 7, in that separate foster home. The 3 girls had been sent to separate homes after their stay with the grandmother. Rebecca and Alina were then placed in a foster to adopt situation.

Rebecca’s adjustment has been difficult, to put it mildly. By the middle of eighth grade, her adoptive parents began to suspect that Rebecca was afflicted by Reactive Attachment Disorder (RAD). Though both RAD and Fetal Alcohol Spectrum Disorder were both ruled out, her adoptive mom felt frustrated and defeated. Everyone was telling her this child was normal when she knew something was terribly wrong. CPS referred them to a psychiatrist who found symptoms of PTSD, major depression and anxiety, as well as poor coping skills for stress – and one surprise (which based on behaviors was not surprising at all) – Rebecca displayed an attachment disorder specific to father figures. Rebecca was able to develop an attachment to her maternal grandmother and to her adoptive mother but had severe difficulties with the adoptive father.

Rebecca’s new attachment therapist Cheri diagnosed her with Borderline Personality Disorder (BPD). BPD is not curable, but it can be understood and managed. According to the National Institute of Mental Health, BPD sufferers have an unstable self-image and their actions display that uncertainty about how they see themselves. Unsure of their worth, they will go to extreme lengths to avoid real or imagined abandonment. They also feel victimized by the world and have great difficulty taking responsibility for their actions. Therefore, by the very nature of the disorder, BPD sufferers are blind to their role in the troubles surrounding them.

The article is worth reading in full.

Adoptive Parents Being Bad

This is sad and cruel but this actually happened in a group of adoptive parents. Their answers will stagger you –

hugging a porcupine!

Or Superman holding cryptonite!

Trying to row a boat with one arm

Speaking a different language

Having a root canal with no anesthesia

Talking to a brick wall

Talking to a room of screaming monkeys who throw things at me

Talking to the wall and it doesn’t respond

Panning for gold

Reasoning with a rock

How repulsive. These women shouldn’t have any children in their care.

These comments occurred in what is termed a “safe space” for adoptive parents to vent their frustrations.

An adoptee shares in response to one I didn’t include above – “I dont know (cause thats the only response i get!)” that this is an adoption trauma response. If an adopted child doesn’t feel safe, they learn not to give opinions because that puts them at risk for abuse. To those who thought that whole experience was a lark (or a laugh) – Your adopted child is showing traits of trauma, that isn’t a funny joke.

One women admitted – I’ve joined some of the RAD (Reactive Attachment Disorder) groups. It opened my eyes to how much a large number of Adoptive Parents seem to really hate their children. And have zero clue how the typical child behaves. Always ranting and raving about how bad their “rad” is when half the behaviors are things my neurotypical zero trauma biological kids do. I’m so disgusted by these people but I can’t make myself leave the groups.

So . . . this is just one reason why adoptees are forever scarred by the experience.

Reactive Attachment Disorder

I read this today –

So I have a story that those in adoption fantasy land will call an unpopular opinion.

Story time

So about 2 years ago, my adoptive mother handed me all the paperwork she had on my and my older sister’s adoption. This turned out to be the record of how I ended up with my adoptive family.

I found out that I had been in and out of foster care from 3 months old. I was placed with my adoptive family at 3 yrs and adopted at 5.

This led me to do some digging and sort through the trauma. I came across Reactive Attachment Disorder (RAD). After being in groups and researching for myself I found that it is primarily foster and adoptive children that have it (that was even pointed out in some articles).

So here is my unpopular opinion, children with RAD are really just hurting because you took their whole life away and now you think these should be happy with you. News flash, you’d have RAD too if your whole entire life was tossed aside like trash and you were told to be grateful. These kids don’t know how to process what is happening, teach them how to process these big emotions in a healthy way, don’t assume they think you saved them (sorry – they will never see it that way).

Thank you for coming to my TED Talk.

NOTE – Reactive attachment disorder (RAD) is a condition in which an infant or young child does not form a secure, healthy emotional bond with his or her primary caretakers (parental figures). Children with RAD often have trouble managing their emotions. They struggle to form meaningful connections with other people.