Sunday, December 16, 2012

Therapeutic Parenting

A lot of friends and family have asked careful questions about parenting Abi. They wonder why we're so exhausted and why they haven't seen us for eight months. They're curious what a little four-year-old girl could possibly do that is so awful, and wonder if we're merely overreacting to what is actually just a normal child's behavior. The main thing I think they wonder is: "Is it worth it?"

I'll answer that last question first. The short answer is: yes. Is it incredibly hard? Absolutely. But is it worth it? We're parenting the child whom God first put on my heart when I was seven years old. She's the child that we endured almost two years of paperwork and restless waiting to bring home. She's my daughter and my Mommy-love runs as deep and powerful and wide as it does for any of my other children. Sometimes, that's why it's hard. Her pain breaks my heart. Still, is it worth it to change an entire human being's destiny? To take a child who had lost an amazing five caregivers, who had abscessed teeth and no hair, who was undersized from malnourishment, and whose future was bleak at best, to bring her into our hearts, to braid her hair and care for her teeth and feed her proteins and vegetables and to teach her to read, to learn, to get around independently, to someday give back to a world that initially did not want her? To teach her about a God who loves her and who delights in placing the lonely in families? Is that worth it? Worth a little extra love, a little extra trouble, a little extra grief to watch the incredible wonder of a broken heart healing? It's so beyond worth it!

So, what does it look like to parent a child who is adjusting after an international adoption and showing possible signs of Reactive Attachment Disorder? I'll give you some highlights from the last few days.

Bear in mind that Abi's personality is such that she acts "inward" instead of "outward." She doesn't throw huge screaming, kicking fits; instead she withdraws into a shell. The pain is just as raw, though, but sometimes it's harder to spot. Often, it does look like normal toddler behavior, except it's fiercer, more lasting and more needy.

That leads me to another comment about why parenting this child can be so amazingly difficult. Every situation but be carefully observed and evaluated. Is the behavior that I'm seeing a result of attachment problems and fear? Is it normal four-year-old shenanigans? Is it attention-seeking tactics because she's a third child? Is she lonely? Sad? Angry? Fearful? In pain? Tired? Hungry?

With our other kids, we have a similar list of questions when something is wrong, but for Abi, the possibilities are more vast, more tangled, and the consequences for us getting the wrong diagnosis are much more severe. So, we pray fervently for wisdom, and try to stay on our toes, even though the constant vigilance is an added emotional drain.

So what does she do, exactly?

This morning, for example, she refused to get out of bed when the other kids came down to breakfast. Hubby, who gets up before I do, went up to check on her, and she was huddled in bed crying, refusing to speak with him. At last, because he gently persisted, she told him that her eye was hurting.

At this point, he started doing our usual parent assessment list. Is she telling the truth and is in immense pain? Her eyes do have the potential for excruciating pain. He decided to give her some ibuprofen and let her snuggle on the couch for a while to make sure. She lay there moaning. He left to get breakfast for the other kids, and when I got up, she was on the couch, moaning and calling to him.

When I got up, immediately my mommy-radar went off. Abi has been weird ever since the Christmas season started. And though one eye is a bit red, I suspect it's from her rubbing it. I decided to do a little test to see if she really was in debilitating pain.

I told her today was Preschool Sunday (which it was), but if she was too sick, we could stay home. Suddenly, by magic, she bounced up off the couch, her pain utterly gone. She hurried in to the dresser to find a pretty dress.

Hubby and I rolled our eyes to one another and then had a parent team-huddle in the kitchen. She had ignored Daddy, lied or exaggerated about her eyes, and manipulated him to get attention when actually nothing was wrong. Now, we had a choice. That could be normal four-year-old behavior. It could have been fear or grief manifesting in the need for attention and pampering.

My mommy instincts said it was something else. The more we discussed the details, the more it seemed to me that she was testing to see if she was smarter than Daddy and could pull a fast one on him. You see, I'm getting to know this little girl. Hours and hours and months of being together, of talking to each other and praying for her and holding her close has developed the sixth sense that Moms need to tell when their child is needy or just being a pill.

We decided that whether she was acting as she did out of neediness or out of manipulativeness, that Daddy needed to send a clear message. He needed to communicate that he loved her, that nothing she would ever do would change that, but that he knew what she was doing, he was smarter than she thought, and that lying and manipulating were not okay.

Painful though the decision was, we determined not to let her sing in the Preschool Sunday, the very thing she was absolutely wanting to do. Instead, she would sit snuggled on Daddy's lap during the service. It felt wrenching to tell her that, knowing how disappointing it would be and how watching Bean sing would sting even more.

But that is what we did, keeping her close beside us during the entire service, snuggling her and loving on her. Will it send the desired message? We have no idea. Possibly it could be breeding seeds of anger and rebellion. There is no way to know.

Another behavior lately has been deliberate bed-wetting, which we calmly respond to by resuming diapering her.

She resists change: learning to wipe herself at the toilet is something she told me she wants to do, but at the same time refuses to do. Rearranging the furniture, even though I had her help me and made sure she knew where everything was, made her angry for days. Skipping church makes her angry; going to church makes her angry. She loves to ride in the car to the store, but acts angry while we're there, doing strange things like licking the shopping cart or asking us the same odd question over and over, like, "Mommy, is there broccoli?"

At lunch today, we ate a treat: McDonald's food and afterward, I found one of her nuggets on the floor of the van. It could have been an accident, but more likely it was a deliberate attempt to hide food that she did not want to eat. Either way, I made sure it was not too grody and had her eat it anyway.

Playing downstairs with Cody, she has figured out how to make him angry enough that he'll yell or hit, and thus get in trouble. Lately, I've been doing quiet surveillance on the stairs too see when the yelling starts if its actually her who is instigating the fighting. Again, something a normal four-year-old would do, but the quiet insidiousness with which she does it indicated so much more than mere mischief. When that happens, I have her apologize to Bean, and I bring her up to sit on my lap for the next hour or so. Not only does it end her playtime, but the physical contact with me builds trust in her mis-wired little brain.

It's hard, though. Rebellion, defiance, rule-breaking, ignoring, picking fights... They all make me feel frustrated and angry inside. Why can't she JUST BE OK? Sometimes, it's the hardest decision in the world to pull her close, to choose to hug and cuddle when what I feel inside is frustration and anger. The constant watching, the constant conflict, it's draining. I feel like I have no rope left a lot of the time, and I need rope for my absentminded, artistic Curly, my careful, deliberate Mister and my wild and cheerful Bean.

Yet there are times (and this is really surreal) that the coin flips and she turns into the most happy, contented, delightful child. She chatters enthusiastically about the current activity, shares nicely with her siblings and is courteous and cooperative toward us. I never know from moment to moment which child she'll be: withdrawn and silent, or outgoing and cheerful.

More and more, as I get to know her better, I'm learning what triggers the outbursts (or inbursts), and more importantly, how to snap her back out of them. I'm quicker at recognizing what we call "being pouty" and faster at finding something to refocus her and help her regain her equilibrium. Sometimes, though, nothing seems to work except just hours and hours and hours snuggled together in the rocking chair.

People ask me all the time: why? Why does she do these things? What makes her so weird? Will she ever get better?

No one knows exactly why the symptoms of attachment problems manifest the way they do. Across the board, kids with early trauma and neglect exhibit similar symptoms: lack of eye contact (irrelevant in our case), cruelty to pets or younger siblings, compulsive lying, eating disorders, asking nonsense questions, inappropriate affection for strangers, tantrums or withdrawal, toilet training regression, upset by holidays or other changes in routine. What is wired wrong in their heads? Who knows. Our training says that the symptoms can diminish over time and with lots of therapeutic techniques, like consistent meeting of needs such as food, bed, schedules, tons of touching and hugs, allowing regressions until that need to be a baby is met with the kind of care they never received when they were babies.

Over this past year, I've come to realize something: she may never be "cured." She may always struggle with this. And you know what? That's both intimidating and totally okay. It will always be heartbreaking to know she suffers. It will alway be difficult to be blindsided by a "pouty" phase when I was looking forward to going to the fair or the cabin or a birthday party. But it's okay too. The amount of love I feel for my daughter means I am completely willing to do the extra work of accommodating this special need. I will do my utmost to make sure her life is overall stable, and when those triggers do come, I'll help her through the fear and feeling lost, because I'm her Mommy, and that's what Mommies do.


  1. Thanks for posting this we have a foster child currently that has several symptoms of RAD and it was good to read your feelings about its so hard to hold this child when you are so frustrated at the behaviors it also gives me some direction to ask her psychologist about. WE are travelling to get 2 blind treasures next month from the Ukraine I am sure I will be emailing for help at that

  2. I just found your blog and have it in my RSS now. As a Christian woman who will be pursuing domestic adoption (from foster care, most likely) down the road (contracted in my job for another 5 years), I'm trying to read up as much as I can on both sides of adoption - the easy side and the tough side. Ironically, I found your blog through a google search for MC Escher quilts (got the LJ, not this one, but the LJ linked to here).

    So thank you for sharing your story and the help I'm sure it will give me as I learn what I can about the future for my husband and I!