Saturday, August 4, 2018

Surprised by Attachment: Compassionate Nurture

Over the years I’ve taken care of many, many children whose number one fear seemed to be the fear of being nurtured by a mother figure. The most obvious instance was a child who was only four-years-old. He seemed securely attached to me and more “normal” than the most average child I’d ever met, until he realized he was stuck with me for a bit.

Once he realized he was stuck with me, he began refusing to do anything I asked of him. He wouldn’t put shoes on. He wouldn’t use the bathroom before leaving the house. He had to pee the second it was inconvenient for me- especially if I’d just asked him to go minutes before.  He wouldn’t eat food I prepared. He’d wait until he got to school, convince the teachers I didn’t feed him, and beg for food there. For two consecutive weeks, he didn’t eat one meal at home. He ate breakfast and lunch at school, Monday through Friday, and then fasted until snack time at Sunday school. I started only fixing his favorite meals and that scared him even more! His response when I baked him a treasured treat was to defecate on himself.

Any “good mom” move I tried to make was either thwarted by him in a way that seemed manipulative to me or refused by him altogether.

I had heard the phrase “Connect before you correct,” when interacting with kids from hard places, but this child would wet his pants if I made eye contact with him!

He was horror-stricken in my presence.

I was fairly unnerved in his.

For months, I was at a loss as to how to live in the same house with this truly precious and hurting child. Connection seemed impossible. I began to wonder if it always would be.

I began to wonder if the trauma everyone in the household was enduring in this child’s presence was going to destroy us all.

If I was ever going to connect with this child, I had to make some changes because he was terrified, and I knew that a terrified child is not building his tolerance for the thing he’s scared of.

Eventually, I had to embrace the fact that in order to love and nurture him well (and in order to love the rest of the family well), I might have to appear to be a bad parent to parents, teachers, and neighbors who had no context to understand his enormous fear.

I couldn’t let it bother me when people saw me care for only his very basic needs while using few words and no eye contact. It was all the connection he could handle from me. He was petrified with any more nurture from me.

I had to consider the definition of nurture: to care for and encourage the growth or development of.

And I had to remember that if the ways I nurtured my child was not encouraging his growth or development (or, in fact, doing quite the opposite), it was technically not nurture, and it had to be modified.

In order to connect with my most hurting children, I’ve had to acknowledge that more foundational than discipline, correction, or control are peacefulness, acceptance, and the willingness to take myself less seriously.

In order to nurture my hurting children with compassion, I’ve had to learn how to respond to each individual child’s need to feel safe and in control. I had to be willing to forfeit all I once expected from the parent/child relationship including the entitlement to “warm and fuzzy” feelings. While I understand correction is important in the long run, I had to learn that correction was impossible until my children felt safe with me. It was more important to create safe spaces, plan safe activities (they could succeed at), tighten boundaries and provide a predictable routine for the months or years to limit dysregulation during times that correction was only inducing shame in them.

I’ve had to learn from each interaction with each individual child how to help him feel safer so his anxiety and stress could be lower and so that he could function higher behaviorally. When this was done successfully, over time, my children began gaining the confidence they needed to build trusting relationships.

Before my children began feeling safe with me, they felt safest with chaos - because that was what was most most familiar. They delighted in “making me angry.” They had to test the limits of my love to believe it existed and know they could trust me and to rest in the knowledge that, with me, they are safe.

In order to help my children feel safe so I could eventually do more to nurture them, I had to consistently offer them an alternative to the chaos. Until I could be consistently calm- despite being surrounded by the chaos my children needed to stir up (to feel safe due to their early life experiences)- they couldn’t feel safe with me. For as long as I let chaos reign, our most hurting children depended on the familiar feeling that chaos provided for them.

Practically speaking, we created safe spaces in our house for individuals who needed them. We built in routine. We began to mantra anytime there’s an interruption from our typical family routine, it’s going to be a surprise and will be fun planned by Mom and Dad. Otherwise our hurting children were prone to sabotage the impending fun out of anxiety and fear. We had to learn to provide our children with only activities they could handle so they had chances to succeed behaviorally and so we could avoid attempting to discipline them before they felt safe enough to appropriately respond to our discipline. Before our children could trust us, we had to let go of the expectation that they would respect us. How could they? We have no evidence that anyone in their history ever respected them. We had to simplify our possessions, our schedule, our commitments, our careers, our meals, and even our wardrobes. For example, for the better part of two years, we were raising older children who bathed at night and changed into comfy clothes they would sleep in and then wear the following day! If we hadn’t, the morning routine would have been too overwhelming for a portion of our children and, therefore, torturous for the rest of us.

I found that the most “compassionate” way to nurture was not my most “natural” way to nurture. In fact, my “natural” approach to nurturing was both unfamiliar and terrorizing to my child. Compassionate nurture doesn’t always look like a picture of good parenting in the eyes of the world. Compassionate nurture is seeing our child’s fear and tolerance level for relationships and offering predictable nurture at that level - until he can handle more. Compassionate nurture begs us to ask forgiveness for the times we’ve overwhelmed our children by attempting to nurture them beyond that tolerance level. Compassionate nurture reminds the child consistently that we’re doing what we can now to care for him well, and we really look forward to a time when we can enjoy a deeper connection. Compassionate nurture is faithful and patient- hoping for the day true connection happens, without being resentful if it never does.

Once I began nurturing the aforementioned child compassionately, the rest of our household could begin to breathe.

As I’ve attempted to nurture my children compassionately, I’ve made a ton of mistakes and I’ve had to apologize often. I’ve had to continually attempt to discern the difference between what I can and cannot control. I’ve had to do some intense problem solving to determine what I can do to nurture my individual children in ways they can accept, while patiently hoping for our family’s healing.

It hasn’t been easy to let go of every expectation of the parent/child relationship. It hasn’t been easy to parent in a way that constantly elicited judgment. It hasn’t been easy to structure our lives in such a way that has often isolated us from our physical community.

In fact, it’s been excruciating. At times I thought I’d sacrificed a life worth living to nobody’s benefit and our entire family’s demise. I wondered if I’d lost myself completely as I often could barely recognize the person I stared at in the mirror.

However, I can now say a child who was once so terrorized in my presence that he defecated on himself as I offered him his favorite meal, now enjoys healthy, trusting relationships. He knows himself, loves justice, and is confident enough to explore his individual interests. He smiles, laughs, and loves others well.

Was the extent of what I see in him today ever a promise? No.

But, knowing that how I learned to care for him was paving the way for his relational freedom, I can finally say that all the pain and problem solving was worth it.

Saturday, March 10, 2018

Six Thoughts as Oprah Tackles Childhood Trauma

Learning about developmental trauma has changed the way I see most people. At one point I thought of the relationship that’s most stressful for me and I decided to measure that person’s Adverse Childhood Experiences (ACE) score and I wasn’t surprised that her score (from what I knew of her experiences) was unusually high.

No wonder she treated me so poorly!

For the first time since I’d known this person I began to look at her with compassion rather than being angered by her unfair treatment of me.

Parenting children from hard places, I have to understand how trauma impacts development, and, the more I learn, the more I realize childhood trauma is a pervasive problem that needs to be better addressed in our society.

Like many of you, I’m looking forward to hearing the conversation between Oprah and Dr. Bruce Perry tomorrow on 60 Minutes and I’m thankful Oprah is using her platform to join and initiate such a crucial discussion.

In preparation for tomorrow’s segment, I began gathering some of my often-too-scattered-to-share thoughts regarding developmental trauma, and they are summarized in the following six ways.

1. Language Matters

For the past twenty years I’ve worked with children in residential care and the diagnosis for those struggling the most from their early life experiences has always been “Reactive Attachment Disorder,” often shortened to “RAD.” The label is still used, although it seems many professionals are beginning to question the diagnosis. There’s been a movement to change the diagnosis to “Developmental Trauma.”

When a child has suffered from trauma that has interrupted his development, the ability to attach with a caregiver is impacted. However, “attachment” is a two-way street. If all a child knows from primary caregivers is neglect and/or abuse, he has to do what he needs to do to survive.

Labeling him with an attachment disorder insinuates that he must change when he does not have that ability. The only way for his attachment experience to change is for a loving caregiver to monitor his relational tolerance and consistently nurture him in ways he can handle until he can handle more. Then, his caregiver has to adjust nurture to match the child’s increased tolerance for nurture.

A friend of mine used to say that “Reactive Attachment Disorder” was a natural response to a very unnatural problem. When we label the child as “disordered,” it’s easy to forget that the caregivers must do whatever is in their power to create both real and felt safety so they can build their mutual attachment.

Once I made the shift away from using the term “Reactive Attachment Disorder,” to speaking more generally of trauma, it was easier to see that the behaviors I was so frightened by were survival strategies. It didn’t take long for me to drop the words “manipulation” and “control” once I realized these were tools my child used to survive and they weren’t premeditated. Again, it was all he knew to do to survive.

Once I began seeing my child as a survivor who was constantly in a battle, I began to have compassion on him rather than fearing him. Once my compassion grew, I had more clarity on how to specifically support my child.

2. The Behaviors often Associated with those Labeled with RAD are Real

As I’ve mentioned before, the behaviors of children who don’t feel safe and can’t regulate their emotions can be terrifying and, for years, I remember reading information that labeled these children with RAD and said there was little possibility of them ever developing a conscience.

The fear I had as a result of my reading led me to believe our children were doomed. Our family was doomed. When I first heard Bruce Perry MD speak about trauma and how children can make progress, I began to make a shift. Eventually, rather than being scared of my children, I began to notice their fears. Once I began to see their fears more clearly, I had the ability to begin protecting them from those fears. Once our children were less scared, their behaviors became a ton less scary.

I finally realized that the place I needed to begin was to be safe and create safety and routine for my children. After time, my children were calm enough around me to hear some of my words. It seemed to take forever before I could begin helping them problem solve verbally, but, in a way that seemed to make our relationship more natural. The parents of a newborn are constantly watching for signs and patterns so they know how to provide for their child’s needs. I had the opportunity to mirror this process with my adopted children until they felt safe and confident enough to verbally process with me.

3. Parents often Feel Isolated, Judged, and Hopeless

Our families need help that is rarely available to us. Before our children feel safe with their primary caregivers, they often need frequent, long, and predictable breaks from their caregivers because, for many of them, primary caregivers are their number one fear- for good reason. Their caregivers also need predictable breaks from their lovely children.

Getting these breaks is nearly impossible though. Even school rarely seems like a break. In fact, until babysitters, camps, and schools understand some trauma basics, the time our children spend with them does more harm than good- leaving the entire family feeling overwhelmed and hopeless.

Those supporting our family need to know that it isn’t cute when a child they’ve never met jumps into their arms and starts kissing them on the cheek- it’s survival. They need to know how to respond kindly to that survival. [For example:  Hi. What’s your name? We don’t know each other yet, but I hope you’ll still like me on Friday. If so, maybe you can give me a hug then. It’s not safe to hug strangers.]

When our friends see our families, our children often present their best behavior. Our friends see this behavior and don’t understand that being around strangers brings our children’s stress levels down and they are able to function higher as a result. They also don’t understand that our children have often depended on strangers to safely meet their needs when the adults in their lives have been untrustworthy or that they’ve often learned to charm strangers as a defense mechanism.

As a result of friends seeing only charming behavior from our hurting children, the parents in our families are often dismissed as having gone crazy post adoption and the result is often painful isolation from healthy community.

4. The Support our Families Need

I’m going to limit this bullet to education, childcare, and therapy for brevity.

The first years our children were home it seemed their education was nearly impossible. Their schools weren’t trauma informed. The information we shared with schools was rarely considered. Our children suffered. Our family suffered.

Even when children who have experienced developmental trauma seem to function high, there are often gaps in their education, sensory needs, language, and social skills that need more attention than I had ever imagined. Our children had to spend so much of their effort surviving the way they knew how that they often missed opportunities to develop skills necessary to thrive in a healthy environment.

Our children need years to work on those skills in a setting that is low stress. Most of the children in care I’ve worked with over the years would have benefited greatly if they’d been provided with tutoring, speech therapy, occupational therapy, in a low stress environment- rather than in a traditional classroom- to develop skills they are lacking. The classroom is swarming with relationships that are often overwhelming for our children during the years they are building their general relational tolerance.

As I mentioned, school was an unhealthy place for our children during their first years at home. During that time, we only saw our children thrive in one setting: nature camp.They loved the wide open space. The nature was calming to them. Their sensory needs were met as they explored. The only problem we ever had was one of my children refusing to return to the building for lunch!

If I could develop a program to help families heal and build healthy attachments, it would begin with nature. There would be a wide open natural space to explore, clean portable restrooms, outdoor sinks, and picnic tables. Children would not need to go through any unnecessary transitions as transitions are often felt as threats/losses. The staff would be trauma informed and would work closely with families to be sure they were encouraging rather than hindering healthy attachments.

Beyond what our children need, their parents need excellent, trauma-informed coaching. In my experience, during our earliest days, this was far more valuable than sending our children to therapy. We’ve had great experiences with a trauma-informed therapist, but excellent therapists who understand our children are challenging to find. Our experience is that any therapy that isn’t helping is hurting. Finding parent coaches can be far less stressful. Parents can choose coaches from all over the world and meet with them via Skype when their children are sleeping. Our family needed coaching to know how to help our children feel safe and how to lower their stress so we could eventually build trust and enjoy being in a trusting relationship.

5. There is Hope

Seven years ago, I imagined by this time our family would have at least one child living in a residential treatment center. While it’s possible that’s still in our future and we do not see residential treatment as a failure, we’re in a much brighter place than we ever imagined. One of our children wants to go to a small, private school so he can develop and nurture closer friendships. Another child spent a couple of unexpected months home from school this year and he jumped right into the homeschool community without reservation. He knew it was a safe community because I brought him there and because I was present.

6. Our Families Need to be Heard

While those of us parenting children who have a history of trauma need to be heard and understood, even greater is the need for our children to be heard and understood. Like Oprah said, “The question that we should be asking is not ‘What’s wrong with that child,’ it’s ‘What happened to that child?’”

Our children speak loudly through their behavior before they feel safe enough in a trusting relationship to communicate using their voices.

They don’t need to be judged. They need to be heard.

Monday, February 19, 2018

One of Those Days...

Last week, I had one of those days....

As I abruptly and unwillingly awoke to the blasting of a neighbor's car stereo at 5:30 am, I didn't have opportunity to assess the situation before answering an urgent call from a disoriented five-year-old. After getting him settled in our room, I realized the reason I was experiencing the neighbor's car stereo to the fullest was because there was a neighborhood blackout. This explained the loss of the faithful sound machines and nightlights which led to our child waking at such an unreasonable hour. It also explained why I ran into no less than three walls on my way to rescue him from his perils. I rose an hour later to wake two of my sons for school and our youngest (still wide awake) jumped out of bed eager to begin his day. Our two older sons were extra groggy and eventually admitted to being awakened by the blackout. [This is a thing when you live in the city. We aren't used to the dark, and we trust our sound machines and/or window unit air conditioners to block out the sounds of our neighbors’ lives during the hours we choose to sleep.]

That evening, chaos abounded with the usual needs and requests for water, stories, and my perpetual presence (in at least three places at one time). The evening was also sprinkled with requests that tend to happen rarely (and, typically, not all at once): a thermometer, Vicks, and for the neighbor to fix their security light that was apparently impacted by the blackout and had not (much to my child's demise) yet been restored. [Who knew  the sliver of light produced by an obnoxiously bright lamp fifteen feet away and ninety-five percent blocked by a blackout shade would be an irreplaceable comfort?]

It would be depressing for me to even record the above if it weren't for the middle of my day. Two of my sons and I ran errands together and then took the long way to visit Matt at a fundraising event for his work. Our ten-year-old son stayed to help and was later delighted to recount all he learned at the event, about his fundraising success, and about the joys of getting to know his colleagues better. It turns out his exuberance for preventing homelessness far outweighs his fear of asking total strangers for money.

During the event, our youngest and I walked around the city together holding hands. We decided to take public transportation to our favorite cafe for lunch. We played Connect Four while consuming savory crepes and vanilla cream puffs. Since it was just the two of us, I had opportunity to delight in his every expression. We then walked the mile home, and a friendly dog walker asked my five-year-old if he would "help train" her youngest charge (a two-and-a-half month old Chihuahua) by giving him a treat. My heart leapt watching him, donned in his Robin superhero costume, carefully (and seriously) fulfill his responsibility. When we arrived at home, I allowed him to choose a short film and we watched it snuggled together. When the film was over, he took off to play with his Legos, and I had the pleasure of listening to him as he, along with his team of misfit heroes, saved the entire world no less than seven times. Eventually, he moved so he was playing within two feet of me- glowing- basking in the awareness of my delight in him. Later we chatted as we traveled to pick his older brothers up from school. When they saw us, they were all smiles- glad to be going home and glad it was burrito night. They all three cracked jokes that were borderline inappropriate for dinner conversation, collapsing into giggling hysterics several times over the course of the meal.

After breakfast until about an hour into the bedtime routine, our family enjoyed each other during each moment we were together.

It's easy to judge a day by one or two lousy snapshots. At 9:30, that night, when I was rinsing potassium hydroxide out of my eyes because I had finally located the thermometer and opened its battery compartment only to find the batteries had leaked some time ago- in that moment- I wasn’t remembering the joy that should have defined my day.

I do the same thing in years. And in decades.

For seven years our family's challenges have been almost unbearable. There were times we didn't think we would make it.

And we still have excruciating battles. This year has not been a picnic. One of our sons missed over two months of school and endured some major medical setbacks because of gross negligence on the part of his school. The rest of our family walked through that messy trial with him. For much of the year it's seemed we've been engaged in active combat. We have scars. One of our sons couldn't bear the stress of watching his brother's pain and that stress impacted his health dramatically. Another of our children couldn't sleep during a period of about three months. It seemed every hour, all night, he needed to be reminded everything would be okay.

And our other child- he showed more compassion than we expected to see from him. Ever. His thirst for relationships grew. His trust in his parents grew. His love for his brothers grew. His desire to be a part of a positive community grew. He helped carry burdens, wrote encouraging notes, asked the right questions, and listened intently to the answers.

One night Matt was recounting our three current, greatest struggles and I was overwhelmed with sudden gratitude.

While the snapshot is still ugly... I realized that if you had told us seven years ago that the three struggles we're currently facing would be our current struggles, we would have jumped for joy! We would have fallen on our knees thanking our Father for providing in ways we never could have imagined.

So yes. I'm tired. Our house smells like stale burritos and Vicks. If I’m lucky, I smell like stale burritos and Vicks. I wipe every surface before touching it. We are still lacking the ambiance formerly provided by our neighbor's flood light. There isn't enough caffeine in the world to remedy my lack of sleep over the last several months. Our relationship with our child's school is awkward, lonely, and frail. And it seems I’m going to have to go out and buy a new thermometer.

Even more weighty is the fact that we have very little specific direction on how to meet our children's very real and ever-changing needs over the next days, weeks, months, and years.

But the reason we lack direction is because our current struggles are linked to miraculous growth in our family that we could never have anticipated.

So today I refuse to allow my happiness to be determined by the chaotic snapshot and the presence of my current struggle. Rather, I'm going to take a step back and see the miracle behind the snapshot and the challenge.

Because,in our experience, today's struggles are the almost always the result of yesterday's miracles.

Wednesday, January 10, 2018

My Favorite Adoption Resource

Beacon House truly rocked this outstanding resource on the Window of Tolerance and I wanted to share it with all of you. 

This resource could be helpful to share with schools, after-school programs, and extended family members. It's helpful for me as a parent. 

For years, it seemed as if Attachment Therapies had a propensity to focus on bonding. I remember reading books where the suggestions were to carry our child, hold our child, rock our child, and spoon feed him. While those suggestions could be helpful if a child is ready to accept them from his caregiver, they can only cause setbacks if the nurture is being offered outside of the child's Window of Tolerance. Providing "nurture" outside of a child's Window of Tolerance causes the child to experience distress. 

When my children first came home, I realized, for them, structure was nurture- the only nurture they could handle from me at the moment. In the beginning, the only way I could reduce my children's anxiety so we could begin a relationship was to provide structure for them so they could begin to feel safe.  

I wish I had known about the Window of Tolerance before our children came home and I hope this resource is as helpful for you and for your community as it is for our family. 

You can follow this link to a podcast hosted by my friend Melissa. During our conversation we discuss our experiences learning about Regulation and Tolerance. 

You can learn more about our journey toward Regulation here. 

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