ATN ~ Blog

In case you haven’t heard, ATN is in the running for a $50,000 grant through the Pepsi Refresh Project.  To learn more about how to vote and help the cause through Power Votes, visit this webpage.

While we have remained consistently in the top 25% of the field from the very first day of voting in August, there are those who ask, “Will ATN really win?” YES! How do I know?  Because the Pepsi Refresh Project is so much like Parenting Traumatized Children.

Here are the top ten reasons I’m sure that ATN has what it takes to win Pepsi Refresh:

#10:  ATN Members are Fast Learners. When we entered the contest in July, we had no idea what would happen next.  When we hadn’t heard anything toward the end of July, we mistakenly believed that our project was not in the August vote.  Then on August 1 we found out “We’re In!”  Even though we has researched the project, and talked to others who have entered and won in the past, it wasn’t until we were actually in the running that we began to understand how much we didn’t know about the Pepsi Refresh contest (sounds like parenting traumatized children, doesn’t it?).  Fortunately ATN parents are adaptable and quick to figure out what they need to know.  We have our children’s challenging behaviors to thank for that!

#9:  ATN Members are Comfortable in Uncomfortable Situations. If you’re monitoring the contest at all, you know that while we know ATN’s rank, we have no idea how many votes that equals.  We don’t know how far others are ahead of us or how many votes we get in a given day.  It’s a bit like parenting “in the dark”, never knowing exactly where you stand or how much of an effort will be necessary to get to the next level.  Yet, we’re used to parenting with these uncertainties, so we’re hardly daunted by this challenge!  We keep doing what we know to do…and learning.

#8:  ATN Members are Good At Networking. The response was instantaneous.  Once we found out ATN was in the August voting round, emails, Facebook messages and tweets went out immediately.  ATN members forwarded this information across the country.  Since we’re used to networking in cyberspace, ATNers  wasted no time contacting everyone they knew through technology.

#7: We Adapt and Move On. When we entered this contest we didn’t recognize how important the Power Vote codes on specially marked Pepsi, Diet Pepsi and Pepsi Now are to winning in August & September.  Now we know that in addition to the hundreds of votes we’re receiving daily, it will take thousands of codes to put us into the winning positions.  So, we’ve adapted and we’re moving on strategies to acquire these codes anywhere and everywhere.  If each of us collects 75-100 codes…we’re winners for sure!

#6: We Do Whatever it Takes! I’ve never met a group more up to the challenge than ATN members.  We’ve face huge obstacles daily as we parent or provide therapy to traumatized children, and our hope for their healing remains.  It’s not hard to transfer that hope to the Pepsi Refresh project.  So I’m not surprised when I hear ATN members are dumpster diving, posting messages on Craigslist and asking perfect strangers for their Pepsi bottle caps!  We’re nothing if not resourceful!

#5:  We’re Good At Routines. By now, most of us have bookmarked (www.refresheverything.com/attachtrauma)  and have the texting number programmed into our phones (text 108042 to 73774).  Just do it…everyday…and remind everyone in your household 13 and over.

#4:  We Share! ATN members are quick to share encouragement and support with each other.  So, as part of the Good Dreams Team, we’re also quick to share our votes. Click here for direct links to all Good Dreams Team members. Please vote for all 5 of these projects daily; their groups are voting for ATN.  Tip: Once you vote for each of these projects, they will automatically show up in the “Ideas You’ve Voted For” tab on the bottom of the Pepsi Refresh window…making it even easier/faster to vote for the whole Good Dreams Team every day.

#3:  We’re Not Alone. Although Pepsi doesn’t print the actual vote tallies, we are obviously receiving daily votes from hundreds and hundreds of friends and family!  Often parenting children with challenging behaviors can feel very isolating, and we think our friends and family don’t understand.  But it’s heartwarming to realize that even though they may not understand what it is like for our children and families, they care enough to support us in our ATN efforts.

#2:  We’re Used to Running Marathons. We know when healing traumatized children, it’s a marathon, not a sprint.  The same is true for Pepsi Refresh.  So we’re in it to WIN IT!  ATN has applied to be selected again in September (and the contest will include Pepsi Codes – so keep saving).  We will continue to apply for October and beyond, if we need to.  But we know running this marathon will pay off!

And the Number One reason I know we’ll win Pepsi Refresh:

#1:  Healing Traumatized Kids is the Best Cause! I can’t imagine a better use of Pepsi’s money than helping some of the most vulnerable children in society get the therapies and parenting support they need to find emotional health, put hope back in their lives and attach to their families.  We know that children who are able to form healthy relationships are less likely to drop out of school, end up in jail, or become abusers or victims as adults.  They are also much more likely to get married and successfully parent children themselves.   Healthy relationships for the future generation…definitely a worthy cause!

I’ve been saying that word a lot over the past year.  The first big WOW! came April 2010, as I heard the heart-breaking news of Tori Hansen sending her internationally adopted son back to Russia.  While the public looked on in disbelief (and judgment), we watched fully understanding the heartache that led to such a drastic move.  There probably wasn’t a group of people on the planet who “got it” the way the parents of traumatized children at ATN understood the dynamics of what untreated trauma was doing to that family.

We held our collective breath; wondering if now was the time when someone finally “heard” our families’ plights.

The next WOW! was last October, when the Evan B. Donaldson Adoption Institute published their Keeping the Promise policy report.  Someone WAS listening, researching, and recognizing that there’s so much more to adoption that just placing a child in a home.  This report acknowledged there are significant numbers of adoptive families struggling with attachment, trauma, behaviors and mental health issues.  For years we’ve been told that RAD and trauma impacts in our children were “rare”, that disruptions were few, resources were adequate and inept parenting was the likely culprit.  But this report concluded otherwise…

The next WOWs! have come because of ATN members’ responses.  Let’s face it; we’re a rag-tag bunch.  Most of us are parents of children with very severe challenges.  Finding time, energy and ability to advocate and speak out can be nearly impossible.  Some of us have trouble finding time to go to the bathroom alone.  Yet:

• In March, 35 families and therapists showed up to my church’s fellowship hall (on very short notice) to participate in one of the three filming events for a documentary to accompany the upcoming feature film, The Boarder, about a family dealing with RAD.  These dedicated folks came from as far away as Mississippi and Missouri to Georgia to share their stories and meet Jane Ryan, author, parent and filmmaker.  WOW!
• In conjunction with the National Children’s Mental Health Awareness Day (which this year highlighted Childhood Trauma), an ATN member, Marc Deprey, filmed a short video to accompany ATN’s Letter from Parents of Traumatized Children.  Both are on our website for viewing, downloading and your use to help others understand what it’s like to parent traumatized children.  Many of you have called and emailed to say that you’re sharing the video and letter with friends, families, schools and more.  WOW!
• Earlier in May, parents representing ATN joined a coalition of over 40 organizations at the Capitol Hill Briefing on Post-Adoptive Services led by the Congressional Coalition on Adoption Institute, Evan B Donaldson Adoption Institute and Voice of Adoption.  ATN contributed to the creation of the national policy recommendations put forth at that briefing.  ATN members made comments during the briefing.  We are being heard.  WOW!

 But having the voices of traumatized children and their families heard shouldn’t be so surprising.  Statistically there are hundreds of thousands of us.  Consider this data from the Keeping the Promise report.

• In the last 15 years about 1 million U.S. children have been adopted through foster care or international adoption.
• Conservatively, it is estimated that 15% have severe behavioral issues, related to attachment and trauma.  That equals 150,000 children.
• However, surveys show another 30% of adopted children have “some” attachment issues and behavioral problems, equivalent to the level that requires clinical treatment.  So it could be stated that the “significant minority” of adopted children in need of treatment and specialized parenting is closer to 45% or 450,000.
• Other studies have shown that 46% of children, ages 6-17, adopted through foster care are receiving mental health services, compared with 35% internationally, 33% adopted privately and 10% of the general population.

So, as we’re fond of reminding our ATN families – We’re Not Alone – there are literally hundreds of thousands of us out here – searching for services, scrambling for resources, struggling to find the parenting tools and support to keep our families together!

I’m  WOWed that the message is moving mainstream.  And I’m WOWed at the enthusiastic way ATNers are answering the call to advocacy.  BUT, there are so many more families out there!  We are just the tip of the iceberg.

It’s time to mobilize the iceberg.  If you’re not an ATN member, join us.  ATN members, make sure the adoptive families, therapists and others you come in contact with know about ATN and our efforts.  Point others to this website, this blog, our online support, our Facebook page.  There are many, many ways to connect with ATN!

 Help us:  donate—join – volunteer.  There are hundreds of thousands of families who need Hope & Healing!  There’s room for you!

Photo Credit: http://www.freedigitalphotos.net/images/view_photog.php?photogid=2280

I had actually forgotten.  My spring has been so busy with ATN advocacy events, preparing my daughter for her standardized testing and moving the college girl from one apartment to another that I hadn’t made note of the “dreaded” day.  But my daughter had not forgotten.

I vaguely recollect a time when Mother’s Day held great meaning for me.  It embodied all of the idealistic beliefs I had about the joys of Motherhood.  May 1991, with swollen ankles and excited expectations of giving birth just three weeks later, Mother’s Day was perfect.  I was pampered and lavished with gifts…with none of the demands placed on even “typical” mothers…and so many EXPECTATIONS.

Fast forward to May 1998, holding a tiny postage stamp-sized photo of an Asian beauty who we had dreamed of for nearly two years, Mother’s Day was once again full of excited anticipation.  But in the 13 years that have passed since that precious Mother’s Day, so much has transpired, and none of it has matched my pre-motherhood expectations.  In fact, the day has brought so many challenges that I try not to be reminded of its approaching, only reminding myself of the need to get my own mother a gift and get it mailed on time.

If you are a foster or adoptive mother, you understand that Mother’s Day brings a flood of emotions for your child.  If you are the mother of a traumatized child or one with attachment disorder you know that anything that brings a flood of emotion for an emotionally healthy child can bring a flood of destruction to your household.   It hurts to have your motherly love totally, absolutely, continuously rejected.  But you feel especially targeted when the escalation of rejection happens on, or around, Mother’s Day.

So, if you’ve been at this for a while, like me, you’ve garnered your own coping mechanisms.  You likely downplay the holiday, perhaps celebrating it without your child, perhaps not celebrating at all.  Perhaps you just put on your asbestos suit and get ready for the firestorm.  Your child’s emotional turmoil becomes your own.

Last week at my daughter’s weekly social skills therapy I didn’t think much of it when the therapist told me that she’d gotten quite a bit of opposition from my daughter on an activity that required “thinking of others first”.  While I was disappointed, I was not surprised.  My daughter has been making many strides in this area, but it’s not uncommon for her to still struggle with reciprocity and showing kindness to others.  So, I didn’t ask what the activity was.

Once in the car, my daughter turned to me, “I had a rough day in social skills.”

“I heard.”

“I hate Mother’s Day.”  I was still struggling to make the correlation when she added, “I love you Mom, but Mother’s Day is awful.”  My brain was whirling, trying to process.

“You talked about Mother’s Day in social skills today?”

“Yes, we were supposed to make you something.  I didn’t want to.  I HATE it!”  Then the tears started to flow.  Tears are a major accomplishment for my daughter.  For the first five years she was home with us we NEVER saw tears.  And only recently has she been able to cry about anything without then becoming angry at allowing her vulnerability to show.

“I don’t know why I feel so awful about this,” she lamented.

So I pushed it.  “Maybe because you’re thinking about your birth mom?”

The floodgates opened and she started sobbing.  I was tempted to pull the car over and offer physical comfort, but realizing that both of us could better maintain what thin thread of emotional stability we had if I didn’t, I kept driving.

“That’s it,” she admitted.  “I miss her so much.”

For the next 15 minutes she verbalized how sad (and angry) she was at losing her mom.  But then she slipped into the self-pity of “No one else feels this awful on Mother’s Day.”  It was then that I introduced the idea that everyone who loses their mother feels this sense of loss and grief, especially on Mother’s Day.  We talked about how many adoptive children undoubtedly feel this way.  We talked about how even my husband feels this way since his mother has died.  One of my daughter’s continuous fears is believing she is different from everyone else and is alone in her misery.

Isn’t that everyone’s fear?  So, this Mother’s Day, if you’re parenting a child who has been traumatized…put on your armor.  You’ll need it.  You will undoubtedly need to change your expectations or be wounded in the process.  But my lesson this year was that my child is suiting up too.  As dysfunctional as their armor may be…all that destruction, rejection and anger directed squarely at you…on YOUR day…is protecting their hearts.

Mother’s Day 2011—the year I got my gift early.  The gift was to see my daughter let down her guard and recognize why she HATES Mother’s Day.  She was crystal clear that it isn’t ME that she hates.  But she now knows  that it’s ok to feel pain and grief about the mother she’s lost — she can survive those enormous feelings.  And she can still love the mother she has without betraying her first mom.  And she’s not alone in grieving on Mother’s Day.

And isn’t that the greatest gift that any of us can receive…knowing we’re not alone!

BALANCE. After reading, listening, talking, listening, attending countless workshops for the last 12+ years, I have to say that at the crux of all therapeutic parenting theories (whether you call them old school or new age) is balance. Our kids need high nurture; high structure – both in MEGA doses. And I believe that if you look at any of those “experts” offering therapeutic parenting advise to us that high structure/high nurture is espoused in their approach, but called a variety of things.

Ok – easy said. Problem is that we can never keep nurture/structure in perfect balance – but we can try every day to get closer. I can only speak for myself on this one, but I find myself always a little heavy on one over the other. Sometimes this is due to my own upbringing and background; sometimes it’s due to my feeling sorry for my daughter; sometimes it’s due to being tired myself and taking the easy way out. Therapeutic parenting is the most exhausting work any of us will do. But if your child is like mine, an emotional barometer – you won’t be able to get too far out of balance before things start to spiral out of control.

If I’m too structured, too much in control, to the point of becoming punitive, it trips my daughter’s trauma triggers. I’m angry and she’s angry & scared. I need to check myself on that one – decide what’s important (my daughter or what I want her to do – my daughter, of course). If I’m too nurturing though, it can be just as harmful. First off, our children often get just as scared by a situation that is nurturing to the point that the structure becomes lax. They are scared of their own angers and rages.

They are scared that we’re not strong enough to take their big negative emotions. They feel internally out of control – so if we don’t impose structure, they wonder if we are strong enough to keep our households from spinning into chaos. It can become a vicious cycle. If you give the child limits he rages. The rages are dangerous and exhausting. So, you get scared and relax the limits to calm the storm. Only it doesn’t calm the storm in the long run because the child feels internally even more chaotic. So the child demands more, attempts to control more and rages. And his behaviors continue to escalate because he craves the structure and is terrified of allowing the nurture.

The other thing about structure is that it is necessary for our children to experience so they can then learn self-regulation; self-control. They can’t learn this without first feeling safe (which requires the high nurturing). But if the structure isn’t also high, as the child moves on to a more toddler-level of emotional development, they cannot learn self-control and delayed gratification. My daughter exhibits much of this in her ODD behaviors.

Here’s an example: In February, she was not feeling well (discovered a sinus infection). She’s 14 y.o. and I thought was in better touch with her body to be able to tell me this –sigh. Anyway, her opposition to everything increased. And I recognized she was not feeling well. Going to total nurture of her while she’s feeling sick worked, but only for the first few minutes. Then she was overly demanding, and angry with me for tending to her needs – fearful of her internal feeling of weakness when allowing me to nurture her.

My therapeutic mom assessment was that three possible things were going on in her brain (probably all at once) – first she knew she should be controlling her behaviors better (but felt sick and wasn’t able to express that), second she felt shame, and third her physical weakness illicits fear.

Shame is an interesting byproduct of our children’s angers and behaviors. If we’re punitive, we can contribute to the shame. But if we’re not structured enough, we can contribute to it as well. Our children have a highly tuned emotional barometer. They know if we’re overdoing praise. They have an overly skewed negative view of themselves – so too much positive talk about them makes them suspicious that the person giving them this praise is either — a) naïve/stupid (and therefore not safe) or b) giving the praise with ulterior motives – wants something in return. Neither helps attachment.

Knowing that my daughter needs a near-perfect balance of high structure/high nurture and knowing that I cannot (no one can, to my knowledge) maintain a PERFECT balance of these things, I listen for clues about which side I’m erring on.

Note: ATN has an Essentials Webinar Series, starting April 12 that discusses many basics that therapeutic parents need to know. Join us!

A year and a half ago I was about to go crazy. My son with RAD was extremely violent towards me and my daughter; his stealing was in high gear; his ODD was always on; and my husband was about to depart to Iraq for a one year tour. Thanks to a lot of things, including God and Grace Boys Ranch, I thought I was healing and leaning more towards my normal self. That was until teen angst reared its ugly head (from a healthy teenager) and I found myself back in the war zone. Instead of seeing my healthy exchange student’s usually pleasant and cheerful (although sometimes moody) personality, I was triggered into the memory of my 8-year-old son who consistently told me how he wished I were dead or at least not his mother. His greatest pleasure in life was to pee on anything that would mean I would have to clean it. My exchange student’s half truths and teenage avoidance became my son’s bold faced lies. His tone, tempered with exasperation, became my son’s blatant disrespect. Oh how to keep my mind in the here and now! Oh how do I know what is reality or my perception of reality based on my past negative experience?
My first maternal rejection with my son with RAD was his first Mother’s Day with us. He was three years old and his preschool had a Mother’s Day Tea where the staff and students prepared a beautiful lunch and there was a photographer there to take pictures of all the happy students with their mothers. My beautiful toddler boy had to literally be peeled off of his teacher because he could not stand for me to touch his hand or be in his space. Circle back to today, where my exchange student seems so nervous and anxious to spend any time with me. So much so that he always seems to leave the room when I enter it. His rejection of me is such that he will call around to see where he can spend the day as opposed to being home interacting with me. Flashback….. I see , feel, smell and hear that angry, crying three year old clinging to anybody, holding onto anything , looking to run into a busy street with cars coming rather than holding my hand or being close to me. I’m hurt. The pain is so real in this moment because I’m back there instead of right here in the present. I feel a weight on my chest called anxiety and the sting of unshed tears .
As I write these words, the feelings become intense, the tears flow, and I understand so vividly how the actions and trauma of parenting a traumatized child – a child who would reject a mother’s love because of his life’s circumstances– colors and forever changes the way you make your own way in the world.

Sheri is ATN’s Support Director.

Happy New Year!

It all seems so easy, as one year changes over into another, doesn’t it? We see one day as the magical end to all our hardships and troubles of the past year, and as the clock strikes midnight we suddenly get the chance to start anew with a fresh, clean slate! We even spend that first, magical day celebrating with parades and parties, and a lot of arm chair quarterbacking, all of it designed to take our minds away from what we have been through, and create renewed hope for the days to come.

If only starting fresh with our traumatized kids could be as easy!

It makes sense that we as parents of traumatized children, often become frustrated and burnt out through our experiences. The daily struggles seem overwhelming, and the treatments, therapies and ‘solutions’ do not seem to magically provide us with any fresh start. We focus on getting the right medication, finding the best support in the school setting, seeking out a therapist who ‘gets it’, and teaching our family and friends what support from them really means for us, but are we forgetting something? If we are limiting ourselves to a sudden deluge of hope at year end (or with a new therapy, teacher, or intervention) we are truly missing the change that happens for our kids, not all at once, but in tiny bits every day.

The truth is that this hope for a fresh start does not magically transform our children or our circumstances, any more than December 31st changing into January 1st instantly dissolves the past and guarantees a smooth future. There are already moments of real progress and joy buried in every day, and our goal should be to shift through the stuff to find them. As parents of traumatized kids, we are treasure hunters, not miracle workers! So rather than waiting for that one thing or moment that will instantly transform us and our lives with our kids, shouldn’t we begin hunting for the seconds and instants in every day that are already golden?

I know that I don’t.

When my daughter has a ‘golden moment’ I tend to say, “That’s more like it, now let’s see this every day.” Note the lack of emphasis? Now I am asking myself why when I see her have a healthy moment, I don’t drop everything and have a party or lead a parade to celebrate! Ok, that might be too much stimulation for both of us, but my point is, I need to give those fleeting moments a real chance, and real attention. Those moments actually ARE the transformation that I am hoping for, albeit just a fragment at a time.

We also need to cut ourselves a break here as parent too. Our kids golden moments come a bit here or there, and our ability to be in a place to process that information properly also comes and goes. For that reason I will not be making any ‘resolution’ to notice them all this year, in 2011, any better than I did in 2010, but I AM going to try right now, for today. My kids can’t promise to be golden for all of 2011, and neither can I! As a Mom I believe it will go a long way toward my child’s healing, for me to acknowledge the little moments as they arrive, rather than holding out that highest of expectations for one single day (therapy, medication, or intervention).

I am not sure what the new year will bring for my friends at ATN, but I do have hope that at least  you will find something to treasure today. Today is actually 1/1/11, an abundance of 1′s! The first does signify a begining, and a new chance to appreciate what you have, but don’t forget that all the days that follow will have their small moments as well.
Let’s go find them!!

While a few million children are out buying cards, flowers, chocolates and making dinner plans with their mothers…there are a few thousand families (maybe more) for whom Mother’s Day is not exactly the Norman Rockwell version.

I’m not talking about those whose mothers have passed away, or those who have never become a mother.  I’m not even talking about those whose mothers are ill or who live far away from their mothers.  I’m talking about those who love a traumatized child.  Mother’s Day for us is…well…very different from what society tells us it should be.

Our child’s early trauma has altered so many things in their world, but the most significant is their ability to build healthy emotionally attached relationships.  And who is the person to which you are supposed to have the most attachment?  Your Mom.  A day devoted to celebrating the Mother/Child bond is fraught with danger for those parenting traumatized children with attachment problems. 

Many traumatized children have found their way to our families and into our hearts through adoption.  Adoption itself symbolizes loss – the child lost his original birthmother, and we often have experienced loss through infertility that has made adoption the option for parenting.  So the set up for problems starts there.  Many adoptive and foster children find Mother’s Day particularly rough because they feel a divided loyalty.  But for traumatized children, it’s even more precarious than that.

The suggested intimacy of giving your Mom a Hallmark card, focusing your attention on Mom, cooking for her, nurturing her, showing your appreciation is TOO MUCH!  Many of our children “lose it” around Mother’s Day (and to a lesser degree around Father’s Day). 

In turn, many of us moms lose it too!  All we ask for is one day!  One day of peace, no rages, no sneaky behaviors, no opposition, no passive-aggressive reactions, no rejection.  But no, we get a day where we end up hurt.

I have no magic solution for making it a truly HAPPY Mother’s Day.  I do know that part of the hurt comes from our own expectations and desires.  And while it’s next to impossible to deny all that and set the bar really low on Mother’s Day of all days, if you can do it, it does help to lessen the resentment and grief we can feel.

But, Mom, please do not beat yourself up if those feelings of grief and resentment start to build.  That is the ultimate Catch-22 for mothers of traumatized children.  We “get it” about why our children act the way we do, but we can’t always “take it” when what they do is so emotionally wounding and directed so clearly toward us because we are, after all, the Mother (and we represent all they’ve lost). 

So my fellow “sisters” – Happy (?) Mother’s Day!!!  Whether I’ve met you or not, I know you are a hero.  I know that not many people call you one.  And I also know you cringe when people do declare you as such!  I know you live in a situation where your child does things that few would believe, understand or be able to figure out how to handle.  Yet, you get up every day and somehow do it again!  And while it feels like a war is raging in your house daily, you rise above that and do battle for your beloved traumatized child with all the schools, social services, medical professionals and whomever else doesn’t understand what you and your child are going through.

You are NOT alone!  ATN understands the chaos and stress that Mother’s Day brings with it and all the feelings you have as you attempt to survive the day.  We know you are doing important, life-changing work.  And as much as it doesn’t feel like it, you are making a huge difference.  Stay strong, take time for yourself.

I wish you a day of peace and simple joys.

Hugs

Julie

P.S. If you’re an ATN member, join us Tuesday, May 11 at 8:30 pm Eastern in the online classroom for an “I survived Mother’s Day” support chat.  If you need more information about logging on, email me: julieb@attachtrauma.org.

As I promised ATN members in this month’s Hoofbeats, below is posted the letter sent by ATN to the American Psychiatric Association as public comment to the proposed changes to the diagnosis of Reactive Attachment Disorder.  ATN encourages anyone and everyone to comment on these changes at www.dsm5.org.

April 20, 2010

American Psychiatric Association

DSM-5 Task Force

Dear Sirs:

The Attachment & Trauma Network (ATN), a non-profit, parent-led organization dedicated to support, education and advocacy for traumatized children and their families, has grave concerns over the proposed changes in the DSM-5 to 313.89, Reactive Attachment Disorder of Infancy or Early Childhood. We have further concerns that the DSM-5 Task Force did not include Developmental Trauma Disorder in the proposed revision. Our specific concerns are detailed below.

The children of our member families have been diagnosed with an entire constellation of disorders (often RAD and PTSD in combination among many other things), and clinicians repeatedly express that there are not adequate diagnostic categories to capture the pervasive impairments caused by the trauma of early pathogenic care. Some have proposed that “attachment disorders” are on a “spectrum”. But currently there is no one disorder that captures the whole range of symptoms and behaviors that traumatized children exhibit. The lack of such a diagnosis complicates our families’ lives, as clinicians have no guidance on how to treat, and support systems (such as schools, child welfare agencies, medical professionals and juvenile justice) who rely on these diagnoses to assign services and develop policies are unable to address/unaware of the pervasive impact trauma has on our children’s early lives. The proposal of Developmental Trauma Disorder was an appropriate attempt to capture these complexities.

Instead of identifying this disorder in a more global way, splitting the current Reactive Attachment Disorder diagnosis into two distinct disorders, and the proposed criteria for the new Disinhibited Social Engagement Disorder, bring up the following specific concerns:

1. Significant numbers of children exhibit both inhibited and disinhibited symptoms (currently classified as mixed types of RAD) and will now have to be diagnosed with two disorders. Because these disorders are believed by many to be exceedingly rare, it means that children manifesting both types of behaviors will have to be seen by a professional that truly understands the differences to be “correctly” diagnosed with two exceedingly rare disorders.

2. The new definition of RAD narrows the developmentally inappropriate attachment behaviors to rarely seeking caregiver for comfort or responding to the caregiver’s comfort. It removes all mention of hypervigilance or highly ambivalent or contradictory responses as part of the definition of RAD. This removes a key component of what we believe to be the very cornerstone of RAD, its relationship to trauma due to early childhood abuse, neglect, maltreatment or medical trauma.

3. The criterion C.3. “Persistent harsh punishment or other types of grossly inept parenting” for the proposed Disinhibited Social Engagement Disorder, is alarming. This criterion isn’t proposed for RAD. There’s no mention in Dr. Zeanah’s summary of the need to include this criterion. In fact, Dr. Zeanah’s work says that the pathogenic criterion for the two disorders is the same and that the role pathogenic care plays in these disorders is yet unknown. The danger of using “grossly inept parenting” as a criterion is the blame it places on whoever is currently parenting the child. Grossly inept parenting is difficult to define and the words are emotionally loaded. This criterion could actually make it harder for children to be correctly treated, served or diagnosed because of the stigma of bad parenting. It could lead to the removal of children from safe, loving homes where they are exhibiting these symptoms with their new, appropriate caregivers.

4. The act of splitting a diagnosis such as RAD will only increase the lack of awareness about this already misunderstood disorder, not to mention the lack of therapeutic resources and interventions, the lack of guidance on treatment, and of the lack of education to the families and professionals working with these children.

Finally, the lack of research of RAD and the related trauma caused by pathogenic care has resulted in the belief that this disorder is “exceedingly rare”, which in practice causes great difficulty for children needing treatment, support and other resources within the systems that rely on diagnoses and the research behind them. More research has long been needed in the area of attachment and trauma. We ask that the DSM Task Force reconsider the inclusion of Developmental Trauma Disorder and consider combining it with the current definition of Reactive Attachment Disorder in such a way as to provide a more comprehensive identification and diagnosis of the countless traumatized children and their families who need interventions and support.

Sincerely,

ATTACHMENT & TRAUMA NETWORK, Inc.

Julie Beem

Executive Director

julieb@radzebra.org

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So many times others who are parenting adoptive children with significant problems have expressed anger and frustration with their adoption agencies.  Some have written nasty letters, some have spoken out publicly; some have even attempted legal action.  But, I was so overwhelmed trying to figure out how to find help for this child and keep the rest of my family from drowning, that the agency was the last thing on my mind.  And, after all, I was a business woman and this was a business deal.  I didn’t really expect the agency to help me.  Their job was over – get me to China and get me home with a child.

However, I’ve changed my mind about that.  Countless families call ATN in desperation, looking for support and resources.  And especially in international adoption (children adopted domestically are also at high risk for impacts from trauma), the story is the same – “I told them, but our adoption agency did nothing.”  Or worse yet, “They asked us to tone down what we were reporting in the post-placement report because too much negativity could impact future adoptions. “ I’m all for future adoptions, but whose truth gets reported when families in crisis are asked to soft pedal what’s really happening in their homes.

At ATN, we tell families about the resources we know of in their area and offer them membership and placement in our support groups.  We send them newsletters and listen to them in phone calls and emails.  Sometimes it doesn’t feel like much with the need so large, and the workers (a rag-tag group of stressed-out parents) so few.

• Someone needs to prepare pre-adoptive families!  The argument is that pre-adoptive parents are not in any condition to listen.  Agencies say that they tell the pre-adopts that there may be issues with their new child.  Starry-eyed and aching for a baby, these folks will do almost anything, climb almost any mountain, to get to their child.  Still they need to be told, and told and told again.  And even after you’ve told them, they need to be told again.  Later, when the problems are real, many of them will remember what at first they couldn’t fathom.
• Someone needs to insist that the child’s full history be disclosed.  No more typical medical reports and facilitators saying things like “we just don’t know anything about this child”.  There should be comprehensive medical records, orphanage nannies interviews, specific information about what has happened TO the child and behaviors that the caregivers have seen FROM the child.  Countless families tell us that they find out after the adoption so much information that may or may not have swayed their decision, but would have definitely given them clues into the kind of help their child needed to heal. 
• Someone needs to follow up with the family, not just once by phone, but often.  And be ready and able to lead them to resources.

The logical someone to do these things is the adoption agency.

The latest, and almost convincing, argument that adoption agencies are making in defense of not providing this intense level of service is that parents don’t want to share the problems they’re experiencing with the agency.  They are either ashamed or just want to “feel like a normal family” after the adoption.  Perhaps this is because the agency hasn’t told them that it IS “normal” to have negative feelings toward a child that struggles to attach to you.  That being rejected repeatedly by the  person you’ve waited so long for is an emotionally overwhelming experience.  That you’re not a “bad mother” of you don’t immediately “feel” the attachment.  And that not all hope is lost if the child exhibits some alarming behaviors.  Perhaps it’s because the family hasn’t been told about the length of an adjustment period, the behaviors that are frequently associated with trauma and the need for parenting your traumatized child with high structure/high nurture.

Do I think all adoption agencies are bad?  Heck no!  They are made up of good people, trying to do life-changing work.  But even the non-profit ones are businesses.  The decisions they make are business decisions.  It’s expensive and time-consuming to follow up with families once their child is home.  And the fee structure they set may not include any additional payment for all those post-placement services.  These agencies do not usually have mental health professionals on staff.  (And I’m not sure they need to.)

But, I’ll use this analogy to illustrate.  Everyone in America who buys a new car gets seat belts in that car (and air bags now).  Manufacturers are required by law to install them.  Making cars would cost less if manufacturers weren’t required to include seat belts.  And it is the law that Americans wear seat belts.  Most of us never have a car crash, but a significant minority of us will.  Statistics tell us that those wearing seatbelts sustain less injuries.  Do seat belts prevent everyone who wears them from dying in a car crash?  No.  But they definitely are a significant step in making car travel safer.

The same could be said for pre-adoptive and post-adoptive training, support and resources.  Not every adoptive family is about to crash.  But a significant minority is at high risk!  (And pre-adoption we don’t know which ones will crash.)  With a seat belt of training, support and pointing families to resources like therapy, respite, treatment centers, adoption would be much safer.  Will all dissolutions and disruptions stop with more active pre- and post-adoptive services?  No.  But there will be fewer serious injuries with these increased safety features.

And adoptive parents who are struggling to find help, hope and healing for their traumatized children will not feel “thrown under the bus” as so many of us did when JCICS announced this week that they and the majority of families with “successful” adoption ARE THE TRUTH.  Ouch!

As a young adult I grew up in the shadow of the building seen here, the administrative building on the campus of Northwest Missouri State University. Carved over the doorway was the inscription “and the truth shall set you free.” Seeing that inscription daily, I fell in love with the idea of seeking truth and being set free. Oh, the idealism of my college years! It was not long after that when I began to talk about how adoption might be the right way for me to build a family.

Maybe my love for that inscription and fond memory of that building are part of the reason I was enraged this week when the Joint Council on International Children’s Services (JCICS) put out a Call to Action called “We Are the Truth” urging the condemnation and prosecution of parents like Torry Hansen. In fact, adoptive parents were encouraged to blog today about their successful adoptions. The call claimed that the truth about adoption was not in children who were prone to set fires or parents who acted unwisely out of desperation, but in successful adoptions.

Since I’m relatively sure that my adoption story is not the kind of successful their looking for, I’ll place it here. If you’d like to join me in blogging about your experience, feel free to comment below:

Our daughter was adopted at 20 months from a Chinese orphanage. We used a small international agency that, before we actually traveled to adopt had been acquired by a large, well-known (now Hague accredited) agency. We were not local to either of these agencies, so we did our homestudy locally and all the other communication via email and phone. We were not required to do ANY pre-adoptive training. We were sent a book list, of which I read three books, the most helpful (and scary at the time) was Toddler Adoption: A Weaver’s Craft. The young child in that book scared me, and I quickly shelved it, convincing myself that all that “attachment stuff” wouldn’t happen to us.

Looking back more than 12 years, I realize how truly naïve I was about early childhood development (despite having three other children already) and how I knew NOTHING about the impact of trauma (abuse and neglect) on an infant/toddler. The very first night we were with our daughter was when we found out that at 20 months she likely had never had solid food – she didn’t know how to chew. Her head was flat from lying in the crib, she had only two teeth, she spoke no language and didn’t appear to understand much of what was said to her in her native language. What were we getting into?

Fact is I wasn’t thinking. I was trusting. I’d taken a leap of faith, followed my mother’s heart that had been dreaming of this for so long and somehow (not realizing the significance of the clues) believed what the agency told us about adjustment periods and catching up developmentally, etc. The first two years home are a blur in my memory bank, most likely because of extreme sleep deprivation. Since my daughter only slept a maximum of two hours at a time, so did I. And I still attempted to maintain full-time employment. No one told me that I should cut back on my career, work on bonding, recognize the growing signs of trauma. No one – except a renegade band of adoptive moms on the internet.

If our agency contacted us shortly upon our return home, I don’t remember. I do remember them contacting us the next summer for our 12-month post-placement report back to China. I remember expressing my concern over her sleeplessness, that she was often inconsolable and prone to hurt herself or me (scratching, biting and spitting), and that she was significantly language delayed. I also remember getting the distinct message from the agency (over the phone; they did not visit in person) that I needed to “soften” the message about her issues and sound more appreciative so as not to give the Chinese any reason to restrict future adoptions.

Was I appreciative? Well…yes. Who isn’t thankful to God for each and every one of our children? But that is not really the point, is it? As the years wore on (still sleepless until we started neurofeedback at age 5), I searched for answers to questions like “Why does she curl up into a fetal pattern when she smells ammonia?” or “Why does she rage so violently when someone laughs?” or “Should I let her scratch and bite herself or risk injury or increasing the rage by trying to stop her?”

Our agency contacted me once more, when my daughter was between three and four. They were opening a branch office near us and looking for families to talk to prospective adoptive families. I told them I’d be happy to (and I meant that). They requested that I bring my daughter. I explained that they might not want her to be there as she was easily overwhelmed by unexpected noise and that our therapist (we’d consulted an attachment therapist by then) wanted us to limit her involvement with strangers who might want to hold her, etc, as she was very prone to want to go with anyone but me, still arching away from me, especially in public. The woman from the agency quickly said it sounded like it would be problematic for us to attend, but thanks anyway. That is the last communication I have ever had with our adoption agency.

Life has gone on here. We’ve spent most of the last 12 years in some kind of crisis mode. We’ve experienced events we never dreamed of pre-adoption. Our home has felt like a war zone (with broken possessions, holes in walls, frequent screaming.) Our other children, although significantly older than our adopted daughter, have given up a great deal. I stopped working full time. Then stopped working all together. We’ve lived through several week-long therapy intensives, crossing the country to consult with professionals, psych hospital placements and interviewing RTCs. We battled the local school system in court for nearly 4 years to keep them from placing her in a draconian “kiddie prison” school where restraint and seclusion were a part of the daily lesson plan. We lost, which means that I now school her here, with the help of a charter virtual school. So the child who had fought so hard to not bond with me and still shows remnants of RAD, is with me 24/7. It has also meant that our savings are totally wiped out and that my dear husband will work well past retirement age.

Well, JCICS…that’s our successful adoption story. It’s a truth that I face every day. It doesn’t mean for one second that I don’t love this child (or all my children). I don’t know how this story will end. From where I stand I can’t fathom it will be “happily ever after”, at least not the same “happily ever after” I was sure of pre-adoption. We worry that our daughter may not be able to live independently, hold a job, have a successful adulthood with full relationships. We try not to think about what that means for us and the rest of our family. We prepare as best we can, but now we know the truth…and the truth is that there is much that can go wrong, there are few resources to help, there are plenty of people who will turn you away, and the public is quick to tell us it’s our fault. And that truth is why ATN exists.