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privileging the voice of adoptees

Just over a week ago, the Department of State’s Bureau of Consular Affairs with the support of the U.S. Domestic Policy Council hosted a Symposium on Intercountry Adoption (ICA) in Washington DC. The purpose of the Symposium was to bring together a diverse group of ICA stakeholders in order to strengthen the future practice of intercountry adoption. Such stakeholders included professional adoption practitioners; attorneys; government officials from the U.S. Citizenship and Immigration Services (USCIS) and the Department of State; and Legislators as well as a number of others. Interested adoptive parents also attended, and historically, the Department invited adult adoptees as well as birth parents for the first time, as the Department’s aim was to “create a deeper understanding of the respective views and interests of each stakeholder group.” The Symposium gave a clearer comprehension of the roles of the many different governmental offices in intercountry adoption, and yet there is still much to learn about each entity and their direct roles. It became clear to me that our present system of intercountry adoption and the policies and regulations governing it are far more intricate than I imagined.

All of us care for the safety of children. All of us recognize their vulnerability. All of us want to protect them from those who would do them harm. Bringing all of us together, as this Symposium does, provides us with an opportunity to meet those goals in cooperation rather than in competition.

Carl Rische, Assistant Secretary of State for Consular Affairs

Despite moments of challenge, in the end, all agreed that safety of the children is utmost. For long now, fear, trauma, anger, and disconnect have made it extremely difficult for everyone involved to come together. I believe all members within the adoption constellation, that is birth parents, adoptees, and adoptive parents, have suffered tremendous loss, but those losses and how they are experienced and processed are uniquely individual. However, I’m not the first to say, adoptees have had the least voice and suffered the greatest losses, yet have the most to be learned from because of our lived experience. We all need far greater awareness and acknowledgment of the losses, fears of rejection, feelings of shame and guilt and our own processes of grief for true healing to occur. We have to hear each others’ voices and not be put off by them. I experienced the Symposium as a step towards changing the current environment, an opportunity for all voices to be listened to, despite great disparity at times among different groups. All in all, if intercountry adoption is to exist and we agree that those who should “benefit” the most – the adopted child, youth, adult adoptee – then we must guarantee long-term healing, safety and permanence for the adoptee through adoption practice and policy that provides greater protections.

What Protections?

Citizenship For ALL Adoptees. Today, an estimated thousands of intercountry adoptees who were adopted by U.S. parents are without U.S. citizenship due to a loophole that exists in current legislation. They remain at risk, unable to access critical services and rights. According to 18 Million Rising, 35 intercountry adoptees have been deported with more being targeted. Current legislation (Child Citizenship Act of 2000) granted citizenship to foreign-born adoptees adopted by U.S. citizens; however, the bill did not take effect until February 27, 2001, and as a result, adoptees who were 18-years old or older at the time were not covered unbeknownst to adoptive parents and adoptees. Deportation causes another significant trauma to those adoptees. They are torn away from family and forced to live in a country where they were relinquished, where they do not speak the language, understand the culture, nor have known family. They were guaranteed a “better life,” one of permanence, and yet have been failed. The Citizenship Act of 2019 would fix the loophole in current legislation and grant automatic citizenship to all adoptees; however, the bill remains tied up in Congress. Adoptee activists continue to engage with Congressmen/women and Senators to advance this bill, yet increased and ongoing Adoptee and Ally support is needed. I urge you to support this bill, get involved by donating, volunteering and/or contacting your legislators. Learn more at Adoptees for Justice, Adoptee Rights Campaign, Adoptee Rights Law.

Ethical Adoption Practices. Regulatory oversight is critical to ensuring the safety and protection of children, as we know that those who would cause harm for profit have existed under unethical adoption practices across the history of intercountry adoption. At the Symposium, adoptive parents, Adam and Jessica Davis, shared their story of adopting a five-year old girl, Namata, from Uganda only to learn a year and a half later, as Namata’s English improved, that she had a loving mommy who cared for her back home. Upon further investigation, the family learned that, indeed Namata was not an orphan. Her mother had been tricked into sending her daughter to a family in the U.S. whom she believed would provide for her education and then be later returned home. The Davis’ did a remarkable thing, eventually vacating the adoption and reuniting Namata with her mother in Uganda. This is one family who stood against those who urged them to keep Namata, despite the injustices again her mother and the abhorrent trafficking that occurred. Jessica stated in an interview with CNN,

After unveiling Namata’s true story and doing extensive research, I feel I have gained an awareness of the realities of corruption occurring across the board within international adoption. This complicated yet beautiful act of opening up a home and a heart to a child in need has become heavily corrupted by greed and saviorism.

Jessica Davis, adoptive parent and activist – quote used with permission.

The U.S. adoption agency the Davis family worked with was later debarred. This is only one story, one family, one example of unethical adoption practice, though others exist. And yet, “Harm to even one adopted child is unacceptable.” (Carl Rische, opening statement). Unregulating standards is not the answer, as some alluded to, but efforts to thoroughly investigate a child’s “orphan” status among other things must continue.

Additionally, unregulated custody transfers (UCTs), also known as rehoming, endanger the lives of adopted children. UCT’s occur when parents transfer the physical custody of their child to a person who is not the child’s parent or other adult relative, or adult friend of the family with whom the child is familiar, with the intent of permanently avoiding responsibility for the child’s care and without taking reasonable steps to ensure the child’s safety or permanency of the placement (Child Welfare Information Gateway). Children adopted through foster care and intercountry adoption are at greater risk for UCT. A recent study found challenges associated with these adoptions – the child’s complex physical and behavioral health needs and difficulties finding and, furthermore, paying for needed health services, may lead families to seek out unregulated transfers (Brown, K., Morrison, E., Hartjes, E., Nguyen, N., Sweet, A. 2015. Steps have been taken to address unregulated custody transfers of adopted children. Washington, DC: Government Accountability Office. Retrieved from http://www.gao.gov/products/GAO-15-733). There is legislation currently pending on unregulated custody transfers.

Post-Adoption Services. At this time, there is no federal or state regulation or oversight guiding implementation of post-adoption services. Adoption service providers across the country are at their own discretion to offer such services. We heard from a number of adoptive parents who expressed great difficulty accessing needed resources and support after the finalization of adoption. Adoption service providers themselves agreed that this is the case. We know that children who are adopted are at higher risk for developing emotional, psychological, and behavioral problems as a result of disrupted attachments, trauma and identity issues, even though physically they may thrive in a safe and loving home. The emotional, psychological, and physical state of the birth mother during pregnancy also has tremendous impact on the child. The child brings all of this trauma into the adoptive family, which impacts every member of the family system, including siblings. With this knowledge comes great responsibility to help that child heal. The adoption journey really begins post-adoption. Most services are terminated at that time, yet ongoing support during the first few months and years following are critical to the healthy development and healing of the child.

Lastly, there is legislation pending related to intercountry adoption, but outcomes remain to be seen. And finally, I want to thank the Department of State for welcoming adoptees and birth parents to the Symposium and for showing support to those of us who attended. Thank you to my fellow adoptees for your passion, determination, and tireless efforts to make our voices heard. Huge thanks to Lynelle Long, who blazed the way for us to attend this event. We’ve reached a pivotal point. It is my hope that Adoptees can work alongside other stakeholders to achieve change that brings increased safety, protection and healing to adoptees. We do need to get it right because so much is at stake, now more than ever, and the way forward is to include adoptees as part of the process.

To read Carl Rische’s introductory remarks at the Symposium in full, click here.

Pictured in photograph, L to R: Diego Vitelli, adopted from Columbia, founder, Adopted from Columbia!; Monica Lindgren, adopted from Columbia, attorney; Reshma McClintock, adopted from India, founder, Dear Adoption, co-founder, fp365; JaeRan Kim, PhD, LISW, adopted from S. Korea, Assistant Professor, University of Washington, Tacoma; Cherish Bolton, adopted from India, co-director, People for Ethical Adoption Reform (PEAR), doctorate student; Lynelle Long, adopted from Vietnam, founder, InterCountry Adoptee Voices; Marijane Huang, adopted from Taiwan, social worker, educator, author; Kristopher Larson, adopted from Vietnam, co-director, Adoptees for Justice; Joy Alessi, adopted from S. Korea, co-director, Adoptee Rights Campaign; Trista Goldberg, adopted from Vietnam, founder of Operation Reunite.

 

 

 

Featured post

My memoir!

CoverBeyond Two Worlds: A Taiwanese-American Adoptee’s Memoir & Search for Identity is now live! If you have not yet purchased your copy, don’t delay. I have a few books left, and signed copies can be purchased right here on my website.  Just click on Shop to order. Kindle and hardcover editions are available via my author page at Amazon, and you can also find the book at Barnes & Noble, and Indiebound.org.

If you enjoyed reading the book, please consider leaving a review on Amazon, or wherever you purchased your copy! Unfortunately, I am unable to ship internationally; however, those copies can be ordered through Amazon and Barnes & Noble online. To learn more about the book and to read an excerpt, click here, and to read reviews, click here. Thank you for supporting Beyond Two Worlds!

 

world mental health day

Today is World Mental Health Day. Let’s talk about it.

It’s estimated that one in five people experience a mental illness in a given year in the U.S. That’s 43.8 million people, or 18.5% of the population. I found a catalogue of great stories, commentaries, interviews and videos that explore mental health issues across a breadth of fields globally on Culture Trip. Check out all of the stories here.

Culture Trip is a global tech startup that inspires people to explore the world’s culture and creativity through innovative technology and a global network of local content creators. It was founded in London in 2011 by former academic psychiatrist Dr Kris Naudts and was named by Forbes as one of five fast-growing UK companies to watch. Naudts says, “In my experience, mental health challenges make you more empathetic and creative, more resourceful. Mental health challenges are a strength. Talk about it.”

Among the stories, Culture Trip speaks to award-winning author Matt Haig about his experience with depression and how sharing his story helped him on the road to recovery. We investigate how hysteria still influences women’s medical treatment today and we look into the scarcity of support in the testosterone-charged world of professional football. We meet elderly birdkeepers tackling loneliness in Singapore, attend a London supper club for people experiencing disordered eating, and learn how virtual reality is revolutionising mental health treatments. I especially love the article on the best free mental health apps for anxiety, stress and depression. Check them out!

Wishing everyone good mental health today and everyday.

Free Help:

Crisis Text Line: Text Home to 741741

National Suicide Prevention Lifeline: Call 1-800-273-8255

songs that saved my life

Do you have a song that helped you get through a tough time? This afternoon, KROQ 106.7 in Los Angeles featured songs from a special playlist called, Songs That Saved My Life. The playlist features artists performing covers of songs that helped them through a personally challenging time. This compilation benefits mental health and suicide prevention charities. Songs That Saved My Life looks to engage current artists with cover versions of those songs and share those stories with the world. Currently, this project benefits Crisis Text Line, Hope For The Day, The Trevor Project, and To Write Love On Her Arms.

This week is Mental Illness Awareness Week. In my last post, I shared research that shows adoptees are four times more likely to attempt suicide than non-adoptees. Suicide is the 10th leading cause of death in the U.S. alone and the 3rd leading cause of death for 15-24-year olds, after accidents and homicide. If you or someone you know is struggling with depression, there is a crisis text line that offers free, 24/7 crisis support in the U.S. Text HOME to 741741, or just follow this link. You can also go to the National Suicide Prevention Lifeline here, or call at 1-800-273-8255.

Visit the Songs That Saved My Life website where you can see all of the artists who contributed to this compilation. The playlist will be available for purchase on November 9th, but you preview some of the songs on iTunes, Spotify, Apple Music, and Amazon.

mental illness awareness week

Millions of Americans struggle with a mental health condition. Mental illness affects us all, directly or indirectly, whether through family, friends, or co-workers. Though it is widespread, mental illness is still frequently misunderstood and stigmatized. Research shows that adoptees are more likely than non-adoptees to attempt suicide.

Although it’s suggested that a majority of adopted individuals are well-adjusted, adolescent adoptees experience a greater risk for disruptive behavior disorders, and to a lesser extent, internalizing disorders (depression, withdrawal, anxiety, loneliness) than comparably aged non-adopted individuals. 3 4 In young adulthood, adoptees have increased odds of being diagnosed with substance use and other psychiatric disorders relative to non-adoptees. Furthermore, research examining Swedish national cohorts,1 2 revealed that both intercountry, or international, and domestic adoptees were at increased risk for even more serious indicators of maladjustment, including suicide attempt and completed suicide, compared with non-adopted individuals.

Keyes, Malone, Sharma, Iacono, and McGue (2013) at the University of Minnesota studied the risk of suicide attempt in adopted and non-adopted offspring in the U.S. The results of their research have become well known and oft-quoted. Their research indicated that the odds of a reported suicide attempt were four times greater in adoptees compared with non-adoptees. You can read the research article in full here.

The adoptee community has lost a number of adoptees to suicide, including Phillip Clay.  Phillip was deported to his birth country, S. Korea, because, through no fault of his own, he never obtained U.S. citizenship. He had lived his entire life in the U.S. He ended his life at age 29. There are ongoing advocacy efforts being made related to adoptee deportation. It is with great sadness that I also include Kaleab Schmidt, age 13,  Gabe Proctor, age 27, Emilie Olson, age 13, Thaddeus Farrow, age 27, and Jane Trybulski, age 14, who tragically took their own lives. There are others.

sentimoji-share

October 7-13, 2018, is Mental Illness Awareness Week. It was established in 1990 by Congress. World Mental Health Day is Wednesday, October 10, and National Depression Screening Day is October 11. To take an anonymous screening for depression, follow this link to helpyourselfhelpothers.org.

If you or someone you know is struggling with depression or experiencing suicidal ideation, please take the screening and reach out for help. Call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress and prevention and crisis resources. Support can also be found in adoptee groups – many can be found on social media including InterCountry Adoptee VoicesAdoptees from Asia, Adoptees On, Adoptee Suicide Prevention Overcoming Odds, and a Korean-American Adoptee Suicide Prevention Campaign. Additionally, check out Koreanamericanstory.org.

The more we bring awareness to mental health conditions, the more we take down the stigma and misunderstanding. I’ve struggled with anxiety my entire life, and I have loved ones who struggle with the debilitating effects of anxiety and depression daily. It is real, and it’s ongoing, sometimes despite medication. Support from others is essential. Just listening to someone who is struggling and validating their feelings provides more support than you know. Please help to educate others about mental health by openly discussing what it is and how to get help.


1 Hjern A, Lindblad F, Vinnerljung B. Suicide, psychiatric illness, and social maladjustment in intercountry adoptees in Sweden: a cohort study. Lancet. 2002; 360(9331):443–448.

2 von Borczyskowski A, Hjern A, Lindblad F, Vinnerljung B. Suicidal behaviour in national and international adult adoptees: A Swedish cohort study. Social Psychiatry  & Psychiatry Epidemiol. 2006; 41(2):95–102

3 Juffer F, van Ijzendoorn MH. Behavior problems and mental health referrals of international adoptees: a meta-analysis. JAMA. 2005; 293(20):2501–2515.

4 Keyes MA, Sharma A, Elkins IJ, Iacono WG, McGue M. The mental health of US adolescents adopted in infancy. Archives of Pediatric & Adolescent Medicine. 2008; 162(5):419–425.

attachment and attachment styles

In this post, I’ll discuss attachment and attachment styles, including adult attachment styles. This will be a very broad discussion of attachment because it’s such a complex subject!

We know that children who are in foster care and/or have been adopted experience disruption in primary attachment relationships due to relinquishment, abuse, neglect, multiple placements, etc. The separation of a child from his/her first or natural mother is the most significant disruption. The Primal Wound by Nancy Newton-Verrier is a great resource for learning more about the significance of this initial disruption in an adoptee’s life.

Attachment can be described as “a reciprocal process by which an emotional connection develops between an infant and his/her primary caregiver.”2 It influences the child’s physical, neurological, cognitive and psychological development and becomes the basis for development of basic trust or mistrust.” It shapes how the child will learn and relate to the world and others. In other words, attachment is the give and take relationship between the child and parent primary caregiver. It is critical to a child’s healthy behavioral, social, emotional and neurological development. Healthy attachment teaches a child to trust and to form healthy relationships throughout his/her life.

I will not discuss attachment theory fully, as there are a plethora of textbooks and articles written specifically on that. Suffice it to say that key researchers include John Bowlby, Mary Ainsworth, Mary Main, and Vera Fahlberg. Bowlby believed that a child’s healthy psychological development was dependent upon a safe and functional relationship with a parent or caregiver. Bowlby theorized that attachment begins in infancy via a bond between the child and the most present, attentive caregiver. This first relationship forms the basis of the internal working models for the child, influencing his or her thoughts, feelings, and expectations with regard to future relationships. Mary Main developed the Adult Attachment Interview (AAI), which is widely recognized as the tool for assessing adult attachment. And Vera Fahlberg is a doctor who formalized the arousal-relaxation cycle, the positive interaction cycle and claiming behaviors in the early 1990s. She wrote A Child’s Journey through Placement, which is a standard training textbook for child welfare workers. Many others have stepped forward and contributed to attachment theory over the years.

In my last post, Healing Childhood TraumaI discussed the arousal-relaxation cycle and how it influences the attachment process in the infant’s first year of life. In a nutshell, an infant expresses a need through crying, fussing, or otherwise raging, which causes her stress response system to become aroused. Her caregiver meets the need, and the infant relaxes. The child’s parasympathetic nervous system helps calm her body once the distress has passed. This dance between infant and caregiver occurs multiple times throughout the first year of life. The signs and symptoms of attachment problems develop as a result of the way a child’s parent/caregiver behaves toward her, environmental factors, and her own particular psychological traits. If a child’s caregiver is unresponsive toward her needs or inconsistent in meeting her needs, she will be at risk for attachment problems. Unattached children have difficulty relating normally to others. For example, it’s common for foster and adoptive parents to report that their child is manipulative, lacks a conscience, or is unable to show genuine affection, when these behaviors are very likely the result of insecure attachment and significant trauma. It’s important to recognize this so that the child is not punished repeatedly for bad behavior, but rather the most appropriate interventions and parenting strategies are sought and learned by the parents. The child does not have it in his wheelhouse to respond in behaviorally/emotionally appropriate ways because brain wiring and neurochemistry have been greatly altered by trauma. Essential areas in the brain that control executive function, common sense, emotional control, etc. are underdeveloped and must be healed in order for change to occur. And this takes time…I’ll say more about trauma and attachment sensitive parenting strategies in another post.

Attachment Styles

Mary Ainsworth pioneered an experiment called the Strange Situation Test. This test was developed and is used to examine the pattern of attachment between a child and the mother or caregiver. The results of the experiment were categorized into four specific types of attachment: Secure, Insecure/Avoidant, Insecure/Ambivalent, and Insecure/Disorganized. Parenting styles are associated with each of these types of attachment. The Insecure/Avoidant and Insecure/Ambivalent attachment styles are interchangeable with or otherwise known as the Anxious/Avoidant and Anxious/Ambivalent attachment styles.

Secure Attachment

Children with a Secure attachment style have a caregiver who consistently responds to them when upset. The infant cries and learns to trust that a caregiver will be available to respond to her needs. Children secure in their attachment go on to have healthy social functioning, have fewer behavioral problems at school, and can become competent leaders within their peer group. They grow up into adults who trust that they are worthy of receiving love, are able to give love/care/nurture, negotiate their needs, and remain autonomous.

Insecure Avoidant Attachment

In Ainsworth’s studies of mothers and infants, observations showed that when some infants became distressed, their bids for comfort were rejected by their mothers. The mothers of these babies were also uncomfortable with close bodily contact. The behaviors exhibited by these infants were later categorized as Insecure/avoidant. Avoidant children do not have caregivers who consistently respond to their needs. When activation of their attachment system leads to painful rejection, infants may develop a strategy where their attachment systems are activated as little as possible.2 These are infants who learn not to cry when they have a need. Avoidant infants and adults appear to suppress activation of their attachment systems, or in other words, have trouble seeking care.

In laboratory studies of babies separated from their mothers, observations revealed that some babies did not seek the mother for comfort or even interaction upon her return as most infants do2. These infants rather actively avoided the mother and became focused on toy play. Avoidant children learn to turn defensively toward self-soothing behaviors, e.g., a play activity, due to past painful rejection when expressing a need.

Evidence demonstrates that avoidant children tend to mask negative affect and replace feelings of sadness with a smile.2 These children often avoid adult eye contact, thus precluding any comfort or reassurance an adult might offer. Although avoidant children may feel and display sadness, they may do so only when there is no child-adult eye contact or when an adult is not present.

Data shows that individuals with an avoidant or Dismissive Adult Attachment style  have trouble seeking or receiving care and giving care. For example, they may fail to share their concerns with others, and may, in fact, withdraw from others as they become more anxious. A number of other studies report that avoidant adults are less likely than secure adults to seek support in response to stress.

Insecure Ambivalent Attachment

Ainsworth observed that mothers of Insecure/Ambivalent infants were inconsistent in providing care. Sometimes these caregivers were loving and responsive, but only when they could manage, not in response to the infant’s signals. An infant whose mother is sometimes responsive, but at other times, preoccupied or overwhelmed, may develop a strategy to stay near the mother at all times.2 The infant cannot count on her mother to monitor her needs. She may cling and vigilantly monitor her mother’s availability in case some need arises. The infant/child takes on a disproportionate share of the burden in maintaining the connection. As a result, hyperactivation of the attachment system occurs.2 These infants/children may show extreme distress on separation and difficulty in calming upon reunion. They may display angry, resistant behavior toward the parent. The negative emotionality of the ambivalent child may be exaggerated and chronic, as the child recognizes that to relax and allow herself to be soothed by the presence of the attachment figure is risky – she may very well lose contact with the inconsistently available caregiver.2 The child may have trouble maintaining boundaries between another person’s distress and his own. Furthermore, the child may feel that the only way to gain care is by sending exaggerated signals of need.

This hyperactivation in adults with an ambivalent or Entangled Adult Attachment style manifests as an insatiability for closeness to others.2 These adults may have a desire to merge with a significant other. They portray themselves in relationships as ‘preoccupied’ and may be particularly upset by relationship breakups. The heightened desire for closeness reflects an impairment of the attachment system. Ambivalent adults may expect others to fill all their needs; thus, they have difficulty negotiating needs and remaining autonomous. They may be codependent or threatened by another’s desire for autonomy. Obviously, this behavior can lead to ambivalence and resentment in both the individual and the significant others in his life.

Insecure/Disorganized Attachment

Children with an Insecure/Disorganized Attachment style have had experiences of maternal/caregiver behavior that is so frightening or unpredictable that they are incapable of developing an organized, strategic response to it.2 Their attachment systems are behaviorally disorganized. The child has no pattern for how to relate to her caregiver. She may behave erratically with toys and might prefer a stranger over her caregiver. These infants may demonstrate a high-pitched cry and/or shriek.

Children with a disorganized attachment style may have the most severe difficulties related to seeking care. Frightening behavior by a caregiver activates simultaneous competing tendencies: to flee to the parent as a safe haven, and to flee from the parent in response to alarm. In this paradoxical situation, there is no organized behavioral strategy available.2 The infant/child is in a terrible position, as neither proximity-seeking nor proximity-avoiding is a solution, and the resulting behavioral responses become freezing, disorientation, and/or disorganization. The adult with a disorganized, or Unresolved Adult Attachment style, has difficulty giving and receiving care/love/nurture, negotiating needs, and remaining autonomous.

In Summary

It’s important to know that these attachment styles are fluid. You may see features of yourself in each of the attachment styles, or may notice that you lean toward one attachment style with one person, e.g., your spouse, and a different attachment style with another, e.g., your mother. This is normal, the point really is to notice and gain awareness.

None of us has a perfect attachment style. Learning and understanding which style I lean toward has given me incredible insight into why I behave as I do and why some of my relationships are more difficult than others. As a younger adult, I was often told that I seemed aloof, that other’s did not feel connected to me, and that I lacked facial expression. Can you guess what my attachment style is?

Upon reflection, I recognized that I did not have a strong attachment, if any at all, to any one person during infancy, as I was in an orphanage for the first four months of my life. My relationship with my adoptive parents was not emotionally close. They provided for all of my physical needs, but I did not feel connected to either of my parents. I loved them, but I had great difficulty expressing my needs and showing affection. My adoptive parents were ill-equipped to nurture a strong attachment. They did the best they could with the knowledge they had, which was pretty minimal. This insight has empowered me to be more intentional in how I interact with certain others in my life. It’s also helped me to understand how important it is for fost/adoptive parents to understand attachment, and furthermore, to get appropriate training and education. I hope that this very brief overview of attachment and attachment styles is of benefit to you and gives you some insight into your own particular style.

                                                                                                                                               

1 The Association for Treatment and Training in the Attachment of Children (ATTACh). Retrieved from http://www.attach.org/about-us/attach-accepted-definitions/.

2 Cassidy, J. (2001). Truth, lies, and intimacy: An attachment perspective. Attachment & Human Development, 3(2), 121-155.

Featured Photo by Tanja Heffner on Unsplash

healing childhood trauma

Hello everyone. In this post, I wanted to talk about childhood trauma. To heal childhood trauma, it’s important to understand how trauma affects a child’s development. So, that’s where we’ll begin. If you have not yet read my last post on adoption and preverbal trauma, you can check it out here. Today, I’ll present a very brief overview of brain neurosequential development and how trauma affects this process. I am a trainer and educator to fost/adoptive parents on complex developmental trauma, attachment, and TBRI®.

First, let’s talk about childhood trauma. You can go to this link to learn more about adverse childhood experiences, or ACES, and the impact of negative experiences on an individual’s lifelong health and wellness. We know that children in foster care and children in orphanages have suffered trauma, and their ACE scores are high. The very fact that they are in such institutions is a trauma. Children in foster care typically come into care due to neglect, physical/sexual/emotional abuse, domestic violence between parents. Kids in foster care and kids who have been adopted experience separation, loss, and grief, feelings of abandonment, instability, and have often not been provided with the kind of sensory diet that promotes healthy development. Additionally, many kids in foster care have experienced multiple placements. Prolonged exposure to one or more of these factors can lead to complex developmental trauma, which psychologist Bessel van der Kolk describes as “the experience of multiple, chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (italics and bold added).” Complex trauma impairs social, emotional, and cognitive development.

Dr. Karyn Purvis, Developmental Psychologist and Co-founder of Trust-Based Relational Intervention (TBRI®), described six early risk factors that influence the way children from difficult backgrounds think, trust, and connect with others: 1) Difficult pregnancy – the birth mother has experienced medical problems, drugs/alcohol, crisis, or other trauma. Persistent and high levels of stress throughout pregnancy affect the infant in-utero. Stress response chemicals in an infant’s brain can remain for up to a month after the mother gives birth.  2) Difficult birth – a difficult and traumatic birth is risky for lots of reasons, including perinatal hypoxia, which can lead to mild neurological insult. 3) Early hospitalization – children who experience early hospitalizations often experience painful touch rather than nurturing, comforting touch in the first days of life. 4) Abuse – the brains of children from abusive backgrounds have been trained to be hypervigilant, or always on guard, to the environment around them. 5) Neglect – children from neglectful backgrounds, e.g., orphanages, often suffer from the most severe behavioral problems and brain deficits. The message they have learned is you don’t exist. 6) Trauma – this may include witnessing an extreme event, like a natural disaster or 9/11, or any number of traumas in the child’s life. A child’s developmental trajectory will change as a result of trauma.

brain 2

As you probably already know, different parts of the brain have different functions. Author and psychiatrist, Dr. Dan Siegel, says the brain is like a two-story house. Emotional reactivity, motivation, attachment, and the “fight, flight, or freeze” response are regulated in the downstairs brain. This is where the brain stem and limbic system are located. I’m not going to discuss all of the structures in the brain, but will highlight the areas that pertain to this discussion. The limbic system is involved in emotions and motivations related to survival, including emotions that are pleasurable, e.g., eating and sex. The upstairs brain regulates executive functioning, thinking, planning, control over emotion and body. It’s where the cerebral cortex or “grey matter” is located.

When you experience a strong emotion such as fear or stress, your downstairs brain sounds an alarm, and a stress response is activated. The sympathetic nervous system triggers the fight or flight response. This causes certain physiological responses to occur in your body. Think back on a time when you felt frightened or stressed. Your heart and respiration rates increased, your pupils likely dilated, and the blood flow to your muscles increased in preparation to fight or flee. This is a survival response. Other parts of your brain are off-line when your stress response is activated. In other words, thinking clearly or executing a well-defined plan become much more difficult when your stress response system is activated.

Now let’s talk about brain neurosequential development. The brain develops sequentially from the bottom to the top and inside-out from the brain stem to the cortex. Our downstairs brain comes much more developed at birth than our upstairs brain. Each part of our brain develops at different times beginning in-utero and continuing to adulthood (the brain is fully developed around 25-years of age). An infant’s brain stem is the most developed region of her brain. When distressed, she needs a responsive caregiver to help her regulate. She has a need and expresses it through crying, fussing, or raging. The need is gratified when a caregiver changes her soiled diaper, feeds her, provides movement, skin-to-skin contact, speech, and warmth. The parasympathetic nervous system helps to put on the brakes and calm the body once the distress has passed. All of these actions serve a very important purpose – to teach the infant how to self-regulate. We refer to this dance as the arousal-relaxation cycle.

Arousal-Relaxation+Cycle.jpgWhen abuse and neglect occur, it interrupts the arousal-relaxation cycle, and consequently, affects the attachment cycle. This leads to serious problems in the development of personality, which has long-lasting effects into adulthood. When the cycle is not completed and repeated, difficulties may occur in very critical areas, including social/behavioral development, cognitive development, emotional development, cause and effect thinking, conscience development, reciprocal relationships, parenting, and accepting responsibility. Furthermore, positive or negative experiences that occur during critical or sensitive periods of brain development alter the development in that particular area, which cascades and alters other areas of the brain. When children experience repetitive activation of the stress response system, their baseline of state of arousal is altered. The child lives in an aroused, hypervigilant state, ill-prepared to learn from social, emotional and other life experiences. She is living in the minute and may not fully appreciate the consequences of her actions. Her brain stem has “muscled up” in fight, fright or freeze mode, as any part of the brain that we use most often is the part most developed. Her ability to control her emotions and body and behave in ways we consider age appropriate may be severely compromised.

As a side note, two Yale pediatricians, Provence and Lipton, found that if caregivers did not meet the needs of infants quickly, they stopped crying within a period of 30-60 days. The infant learns that no one comes. She has lost her voice. Despite the absence of crying, the baby may still be hungry, scared, soiled, or in pain. Additionally, she is likely to have high levels of cortisol, or stress hormones, released in her brain, though outwardly she may appear to be calm and not at all distressed.

Infants and young children need to feel safe. They use attachments with their caregivers as models for future relationships. Caregivers are a secure base from which infants can explore their physical and social worlds. As you can well imagine, children who have histories of abuse or neglect very often have not experienced felt safety or secure attachment. This sets them up for attachment difficulties with foster and adoptive parents and difficulties in relationships with others.

There are numerous theories and therapy approaches directed at parenting and healing children who have experienced trauma, including abuse, neglect, grief and loss. I will delve into this in later posts, but a good resource is Attachment Theory in Practice: Building Connections Between Children and Parents edited by Karen Doyle Buckwalter and Debbie Reed. There is a chapter at the end of the book called The Voice of the Adoptee written by adoptees Faith Friedlander, Clinical VP and co-founder of Kids and Families Together, and Melanie Chung-Sherman, Licensed Clinical Social Worker and psychotherapist. Finally, an attachment-based professional/parenting resource that includes adoptee voices!

We know that traditional parenting does not work with kids who have experienced trauma. With deep fear comes a desperate need for deep control. It’s a survival strategy, as these kids do not know to do anything better. The way they think, feel, learn, process the senses, and interact with peers has been profoundly altered due to trauma. Their stress systems stay on, and the smallest thing or a transition can cause a meltdown. They fight or flee. They have lost their voice. Timeouts, spankings, and lectures are not effective and may further traumatize the child. There is hope. Parents must become healers and help repair their child’s brain by creating the proper environment for change. The brain can adapt and new behaviors can be taught and learned. In the next few posts, I’ll offer more resources. Stay tuned for an overview on attachment and attachment styles in my next post.


Featured Photo by Carlo Navarro on Unsplash

Keck, G.C., & Kupeckty, R.M. (2009). Parenting the hurt child. Colorado: Navpress.

Perry, B. (2005). Maltreatment and the developing child: How early childhood experiences shapes child and culture. Retreived from http://www.lfcc.on.ca/mccain/perry.pdf.

Provence, S., & Lupton, R. C. (1962). Infants in institutions. New York: International Universities Press.

Purvis, K. and Cross, D. (July 2013). The healing power of “giving voice.” Retrieved from http://www.adoptioncouncil.org/files/large/f7bb17e8fba418b

 

adoption and preverbal trauma

I am often confronted by fost/adoptive parents who question the impact of adoption on a child adopted at infancy. “What can an infant know or remember?” they ask. In this post, I’ll discuss this question and adoption as trauma.

In Nancy Verrier-Newton’s book, The Primal Wound, she writes,

Many doctors and psychologists now understand that bonding doesn’t begin at birth, but is a continuum of physiological, psychological, and spiritual events, which begin in utero and continue throughout the postnatal bonding period. When this natural evolution is interrupted by a postnatal separation from the biological mother, the resultant experience of abandonment and loss is indelibly imprinted upon the unconscious minds of these children, causing that which I call the “primal wound (p.1).”

Adoption is a traumatic event that occurs in the life of a child. As Verrier-Newton explains, separation from a child’s biological mother is a loss that is imprinted upon the unconscious mind of the child. It is stored as an implicit memory. This is also known as preverbal trauma or preverbal memory. The child is torn away from her biological mother and placed in the arms of strangers. Though the assumption is that the child will not remember any of it, psychologists now believe that children remember their birth and the following events, including relinquishment and adoption, up to age three. The infant is left with fears and anxiety with no way to verbalize, express, mourn, or contextualize her feelings. According to Debra Wesselmann, MA, LIMHP, “Implicit memory bypasses language and involves procedures and internal states that are automatic.” Infants and young children can feel emotions, but cannot place them in context. There is no narrative.

When a child experiences such distress, the only way she is able to cope is through crying or reacting to physical touch and anger. These coping strategies can manifest in overt expression or a marked lack of expression. An infant may cry in response to distress or rarely cry and be perceived as a “good” and peaceful baby when she actually feels quite the opposite and may be hurting. She may respond by recoiling from human touch or may become too attached to the sensation, displaying indiscriminate affection toward others, even strangers, as she matures. A child may express her anger through tantums – yelling, screaming, kicking, hitting, spitting, pulling hair – or withhold emotional expression.

According to adoptee, Karl Stenske, every adopted child falls into one of these two categories. She will either act out, or she is quiet, adaptable and compliant. The degree to which the child falls into either category is individual. In any case, adopted children have experienced ruptured relationships, hope, and trust. Some adoptees who act out will go to extremes, e.g., run away from home, threaten fost/adoptive parents, rebel academically and behaviorally, or even attempt suicide. In a study published in 2001, adopted teens in 7th – 12th grades were more likely to have attempted suicide (7.6% vs 3.1%) and to have received psychological or emotional counseling in the past year (16.9% vs 8.2%) as compared to their non-adopted peers.

The child who acts out may attempt to initiate some form of rejection from parents, teachers, peers and others to prove that she’s unlovable. She may reject others first in order to avoid being rejected. The acting out child is often perceived as “difficult” by her parents and others. Parents, teachers, and counselors may not associate the behaviors with trauma, and therefore, “lay down the hammer,” which in fact, only exacerbates the behaviors and trauma wounds. The compliant child, though not seen as having any outward problems and perceived as well-adjusted, is often overlooked and not given any form of counseling or assistance in healing from emotional wounds. This child, however, is just as much at risk and may be experiencing similar distress to the child who is acting out.

These two behavior types may present at various ages, although adolescence is a common time for them to reach their peak. Furthermore, some kids may actually experience both behavior types, alternating from one to the other depending on the environment and individual trajectory through childhood and adolescence. In my own experience, I was very much the quiet, compliant child. When I reached adolescence, however, I rebelled academically and in every other way. Though many teens rebel during adolescence, I attribute most of my emotional turmoil and acting out to adoption-related issues, including identity confusion, rejection, and a desperate need to fit in with my white peers.

Still, when presented with the above information, some remain skeptical. After all, what can an infant remember? Research strongly suggests that a baby is able to recognize her mother’s voice. Within a few days of birth she begins to recognize familiar faces, voices and smells and is drawn to them. She is able to discriminate her mother’s voice from those of other voices. If you are a parent and have biological children, think back on the time when your baby sought your presence, sought your face and smile, was comforted solely by you. How could we not assume that an adopted baby recognizes the loss and separation from her birth mother, despite her inability to narrate it? I argue that she does recognize such loss – she knows abandonment, sadness, and hurt. Though healing can and does occur, she carries that loss with her the rest of her life.

Stay tuned for my next post when I discuss healing childhood trauma.


Photo by Luma Pimentel on Unsplash

Verrier, N.N. (1993). The Primal Wound: Understanding the Adopted Child. Baltimore, MD: Gateway Press, Inc.

Stenske, K. (2012). What can a tiny baby know? Retrieved from http://www.theadoptedlife.com/angelablog/2012/11/20/adoptee-view-what-can-a-tiny-baby-know.

Wesslemann, D. (2013). Retrieved from http://www.adoptionknowledge.org/wp-content/uploads/2013/11/Wesselmann-Preverbal-Trauma-ppt..pdf.