Tag Archives: Foster care

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

 

elevate adoptee voices

photos-by-lanty-597554-unsplashSince last November, I’ve had the privilege of connecting to many other adult international adoptees around the U.S. via a podcast I hosted called Global Adoptee Talk. Some participated in my podcast and others did not. Nevertheless, just to hear and share stories was incredibly validating, and I appreciate the supportive community that we’re a part of. Unfortunately, I had to let go of my podcast before it even had a real chance to get off the ground due to increasing demands at work and the lack of time and energy I had to keep up with editing/interviewing. I am always inspired, grieved, saddened, angered, and motivated by the many adoptees stories I hear – motivated primarily to elevate adoptee voices in whatever shape or form that may take. It’s always important to be mindful of the fact that though an adoptee may have had a positive adoption experience, there is still undoubtedly loss, trauma, and frequently a longing to connect to his/her cultural roots. That may mean searching for one’s birthparents or birth family or traveling to one’s country of origin, learning the language, and/or connecting to other’s who have similar backgrounds and experiences. It doesn’t go away – it may ebb and flow across the span of an adoptee’s life, but it’s a part of our makeup, it’s part of our DNA and hard-wired into our brains, literally. I don’t have time to go into how separation from birth mother is trauma, but suffice it to say, there is research that supports it. Acknowledging that adoptees have a vital role in the future of how adoption occurs and are given a voice is crucial.

I work in foster care and adoption, and it’s not always easy as an adopted person. Whenever there is an adoption, it’s very difficult for me to celebrate knowing that first there was loss – loss for the first mother and child. When reunification occurs with the child and birth family, my heart makes a little leap, as reunifications are rarer. When they do occur, it is a celebration.

Despite the challenges of working in foster care and adoption, I have the opportunity to work with some resource or foster families that get it to the extent possible in their circumstances- the trauma, the loss, the necessity of keeping birth connections in the child’s life. Families are trained in TBRI, and we talk about loss, trauma, and attachment from the very first clinical interview. I don’t want to villainize every foster/adoptive family out there, as I know some foster/adoptive parents who attempt to understand the loss and trauma adoptees experience. Even so, I dare say that it’s difficult to grasp the magnitude of what being in foster care or being adopted means if you have not experienced it first hand. I observe things through the lens of an adopted person, not as an adoptive parent or case manager or supervisor, and my thoughts and opinions sometimes differ from those I work with. This work gives me an opportunity to educate foster/resource/adoptive parents. Not every family who comes through gets approved to continue the process for multiple reasons, and that’s a good thing.

All in all, I’m sad to let go of my podcast, but I have hopes of one day picking it back up, as time allows. I miss that connection to other adoptees. There are plenty of super podcasts out there. Right now, I’m digging a couple of podcasts related to intuitive eating, health, and nutrition. One is called Food Heaven, and the other is Food Psych. Two of my favorite adoptee podcasts are Adoptees On and Adapted. The Rambler was also a favorite, but the show closed earlier this year. All of these podcasts are available on iTunes – listen in – it’s totally worth it.

I sure learned a lot while producing my podcast and am super grateful for those international/transracial adoptees that I had the opportunity to connect with. Adoptee voices are truly making their way to the forefront of discussions on adoption, as they should. Let us continue to build a strong and vibrant community, inclusive and respectful of all adoptees and their unique stories.

by Photos by Lanty on Unsplash

Past episodes of Global Adoptee Talk are available on iTunes

 

national adoption day

NADThe inclement weather yesterday did little to dampen the excitement of National Adoption Day in Maricopa County. On National Adoption Day, courts and communities in the U.S. come together to finalize thousands of adoptions of children. More than 300 events are held each year on the Saturday before Thanksgiving in November in all 50 states, the District of Columbia and Puerto Rico to finalize the adoptions of children in foster care. More than 40,000 children have been adopted from foster care on National Adoption Day (http://www.maricopanad.org/content/about-us).

The Maricopa County National Adoption Day Foundation was established in 2012. It is a 501(c)3 non-profit corporation, which fundraises, organizes, and runs the National Adoption Day event in Maricopa County each November. The Foundation’s Board Members are 100% volunteer, including all of the judges who preside over the adoption hearings.

This year, my daughter and I joined staff from the agency where I’m currently interning to volunteer at the event. It was a very early morning, as we had to check in at volunteer registration around 8:00 am. It drizzled all the way up to the Durango Juvenile Court Center in Phoenix. I got lost on the way there (typical me), so we were a little bit late. On the way in to the courthouse, we met a young law student, Kalin, who told us he was adopted. We began talking about adoption and about the policies that affect international adoption. We walked to the check-in area together. There were already what looked like hundreds of volunteers dressed in blue T-shirts hard at work setting things up as we entered the courthouse. L and I checked in. Oddly, they did not have me registered to volunteer, but thankfully had L listed. I told them that I had previously been assigned as a Court Guide, so the team leader randomly assigned me to Court #12 on the third floor. This actually turned out to be a small miracle.  L and I headed upstairs to the third floor.

After a briefing on the responsibilities of a Court Guide, L and I waited in front of Court Room #12 for families to arrive. Soon one family arrived and then another. I went downstairs to run a quick errand, and when I returned I noticed a Caucasian woman holding a little Asian girl I guessed to be around the age of one. I became curious because most kids adopted on National Adoption Day are in foster care, and very few Asian children enter foster care. I asked the woman where she adopted her little girl hoping that I wasn’t being too rude or intrusive. She replied, “from Taiwn.” No way! I told her I was also adopted from Taiwan. “I know,” she said, “I have read your blog.” What a surprise! The woman told me that she and her husband had attended our “Somewhere Between” film screening earlier this year. The woman’s husband and parents then arrived, and I immediately recognized her husband, who I remembered speaks fluent Mandarin. What were the chances of an assignment to the very courtroom where their adoption finalization would take place? We all caught up a little, and I thought about how much life had changed for the family since our film screening back in January.

Bolanders

Brian and Sarah’s daughter, Le Le, is 18 months old. They traveled to Taiwan in June 2013 to bring her home to Arizona. Le Le is absolutely beautiful. Within minutes, their attorney arrived and went over the court proceedings. She introduced herself to me, and we were soon ushered into the courtroom. I felt honored to be a very small part of the family’s adoption finalization. After the formal finalization, several pictures were taken by family and by their attorney. It was an exciting occasion, and everyone in the room was smiling from ear to ear. Afterwards, I escorted the family downstairs where a professional photographer was taking pictures of all adoptive families. Sarah told me more about Le Le’s adoption and birth mother, who they were able to connect with via telephone and also plan to keep in contact with. The courthouse had now become a sea of people, and the buzz of animated conversation filled the air. While the family waited to have their picture taken, I took their orders to be certified in the county clerk’s office. I watched as the clerk stamped and sealed their orders and then took the documents back to the family.

Meeting Brian and Sarah and their extended family made the event that more special. I am still blown away that out of all the courtrooms, I was assigned to the one where their adoption finalization occurred. Back in January when we held the film screening, Sarah and Brian were waiting to be matched with a child. Ten months later, they are now parents. I was also deeply touched by another attorney as she cried testifying before the judge on behalf of a 12-year old girl who was being adopted by a single mother. There was a mob of family members crowding the room and looking on. I’m so glad that the family has that kind of support.

National Adoption Day was a memorable event. The children who were being adopted were adopted for the right reasons – they needed loving homes and families due to neglect, abandonment or abuse. For these families, the waiting for finalization is over, but the adventure will continue on.

at the heart of adoption

Heart_ExtraSmallI’ve been interning since August at an adoption and foster care agency that specializes in placing children who have been abused, neglected or abandoned with foster and adoptive families. It’s been interesting. I think what I’m gaining the most at this time is a broadening perspective on adoption. In the past, I’ve been primarily concerned with inter-country and transracial adoption, especially adoption from Asian countries. At the agency, I’m learning about the foster care system and families who want to either foster or adopt children under the care of child protective services (CPS), otherwise known as the foster care system. It’s a very different institution than that of international adoption in many ways. However, in other ways, it’s similar. The similarities between international adoption and the adoption of a child  through CPS are primarily that children have been traumatized and need permanency and adoptive parents need education and support.

It’s been interesting, too, at the agency to encounter different views on adoption. For instance, some have difficulty comprehending why people would adopt outside of the U.S. when there are so many children here in foster care who need loving families. I don’t share that same attitude, however, the number of children in foster care in the U.S. is tragically high. In Arizona alone, one of the highest-ranking states of children in foster care, there are approximately 15,000 children in out-of-home care. On the other hand, it was estimated in 2005 by  UNICEF that there were over 132,000,000 children identified as orphans, children who had lost one or both parents, globally (sub-Saharan Africa, Asia, Latin America and the Caribbean). UNICEF statistics do not include abandonment or sold and/or trafficked children, and I’m sure that number has increased over the years. According to data released in 2003, an estimated 8,000,000 boys and girls worldwide lived in institutionalized care (http://www.orphanhopeintl.org/facts-statistics/). Alternately, according to the latest available figures from the U.S. Department of Health and Human Services (HHS), there are about 123,000 orphans in America (http://www.orphancoalition.org/new/foster-care.php). The U.S. population is around 317,023,906 (U.S. Census Bureau). Any way you shake it, the number of orphans and children in out-of-home care world-wide is staggering. It’s an enormous issue of social and political concern.

Within child welfare circles, we often hear the phraseology, “in the best interest of the child.” But what does that mean exactly? Essentially it means that the health and safety of the child physically, emotionally and psychologically come first and foremost. I say that because I think that there are misconceptions about adoption. It is a way to expand families and is an option for couples who have experienced infertility, but, more than anything else, adoption should be for the child, not the adoptive parents. In other words, the motivation for those seeking to adopt should be to care for a child who has, through no fault of his or her own, come into adoption due to the circumstances of abandonment, relinquishment or maltreatment. That is and should be at the heart of adoption.

Adoption is often an exciting endeavor for families, yet there are many risk factors to consider beforehand. Most adopted children have experienced trauma and may have difficulties with bonding and attachment and/or problems with behavior and emotions. It’s a fact. As an adoptive parent, are you prepared to handle such challenges long-term? Are you willing to go above and beyond BEFORE the adoption to educate yourself on issues of race and culture if your adopted child is of a different race and ethnicity? How will you handle rejection, bonding and attachment difficulties, caring for a child with a physical and/or psychological disability? What tools and strategies will you equip yourself with  to help your adopted child face racism and discrimination, and how will you as a family respond? What opportunities will you seek to help your adopted child stay connected to his or her birth culture, and how will you respond to your adopted child’s curiosity about his or her birth family? How will you foster open communication with your child so that he or she feels comfortable approaching you about such issues? Most adoptive parents I talk with are unprepared for the task of raising a child adopted internationally, or taken by surprise by some of the challenges they’ve experienced, and some parents I’ve spoken to who have adopted children through CPS express similar sentiments. Parenting in and of itself is obviously a difficult task, but parenting an adopted child has special challenges. Proactive is always better than reactive.

November is National Adoption Month. Adoption provides permanency, love and stability for children who have been orphaned, relinquished or abused. But, what is disturbing is the naivete surrounding adoption and the lack of substantial support for adoptive parents post-adoption, at least for those families who have adopted children internationally. I’m happy that stricter policies have been put into place for inter-country adoption to ensure ethical practices by adoption agencies. But so much more could and should be done to educate adoptive families pre-adoption and support families post-adoption. It is my hope that positive changes will continue to be made legislatively for international adoption and that adoptive parents will proactively seek education and support both pre- and post- adoption.