Thursday Night: April 21

First, I want to thank my wife for documenting in this blog a diary of the special challenges and struggles that we as parents of adopted children face.  These children have been hurt deeply in ways that many times we know nothing about and that happened before we even met them.  I am the only father that Yelena has ever known and very often I feel powerless, inadequate and frustrated when my good intentioned efforts to love, nurture and to teach Yelena the basic skills necessary to function, form healthy relationships and to respect other’s property and feelings prove totally ineffective.  On the contrary, my repertoire of efforts to parent, which come primarily from the ways I was parented, usually result in exacerbating Yelena’s tantrums and do not help her to connect any of her behaviors (including stealing, playing with fire and threatening her mother and I with knives and fists) with any consequences (loss of privileges, chance to earn them back, etc.) that follow. 

It seems that thus far, in the ongoing struggles to love and parent our daughter, any of the consequences that I try to enforce are taken in by Yelena as another justification that I am the “mean daddy”.  All too often I take this in personally, become outraged (I would never talk to my father that way), and argue with my wife about backing down from enforcing consequences such as, “Yelena, when you are punching us or waving a sharp object at us I will call the police and/or crisis team because that is unacceptable.” 

I feel deeply inside myself the frustration that taking Yelena’s behavior personally is not helpful and yet almost all of the time (even though I am a psychotherapist with over 30 years of experience), I have absolutely no idea in the moment what to do. Except to remember that  twelve years ago in a far away land and for the first year and a half of her life Yelena was deeply hurt. Then she was taken away by two strangers in a big flying machine thousands of miles away to another far away land. When I remember this, it helps me to not take anything Yelena does or says too personally.

Late Thursday night, it occurred to me that perhaps the reason that it helps me have compassion for my daughter is that in my life, I have been deeply hurt too.   

Vacation Week

Saturday night Yelena had a sleepover with a friend and came home late Sunday evening. Monday morning she slept until 12 PM! I can see her slipping into the teenage life. I think she was also really tired and had not slept much Saturday night. I didn’t wake her because I had a lot to do for our Passover Seder that night and I was grateful for the extra time.

Yelena’s father had offered to take her out to the farm to see the chickens in the afternoon which she usually loves to do but she said that she would rather stay and help me. I was pleased that she wanted to do that so I suggested we clean up a little before we started cooking, wash dishes, empty the dishwasher, etc. She said she didn’t want to so I suggested she go upstairs and take a shower. I thought she had gone upstairs and about a half and hour later my cell phone rang with a number that I didn’t recognize. It was Yelena saying that she was at our next door neighbor playing with legos. She came home right before our company came, took a shower and put some nice clothes on. A little while later she came into the kitchen with her two friends who live down the street. I greeted them and asked where their Mom was and they said she wasn’t with them and I asked them how they got to our house and they said Yelena came and got them. She had to cross the street to go get them and she did not tell me she was leaving. I’m not sure how to deal with her leaving the house without telling anyone…

We had 13 people at our Seder which included 5 girls around Yelena’s age and of course Elijah which made 14. Yelena didn’t get to bed until after 10 PM that night. Tuesday she went to a vacation program at the local Girl Scout Camp where she goes in the summer and loves. She had a therapist appointment on Tuesday afternoon so I picked her up a little early. When we got home she asked to watch a movie and I told her that she needed to do some homework before she watched any TV. For some reason, I think due to another impending round of MCAS, she got an inordinately large amount of homework over the vacation and they usually don’t get any home work over vacations.

Yelena had done some of the work over the weekend. I had asked her to do a little bit every day before she was allowed to watch TV. She spent about 15 minutes and then came upstairs and said “Can I watch TV now?” I asked to see the homework to make sure it was done and she showed me the pages which were incomplete and very carelessly done. It was obvious in several places that she hadn’t either read or understood the question and just wrote down a hasty answer. I commented on this saying that I would be happy to help her. She got snarly and rude and said “OK, now I have to go all the way downstairs and do some of this stupid homework and then come all the way upstairs again.” Which she did do but with no more of the questions answered than she had the first time. I decided to leave well enough alone and said she could watch TV for an hour.

At the end of an hour, I asked her to turn off the TV and to come have dinner which she did. We had some leftover chicken soup with matzo balls. She sat sideways at the table and held her bowl in her lap. When I suggested that this was not the proper way to eat soup at the table, she got snarly again, drank the rest of the soup right from the bowl and stormed out of the room. It was bath time and she ran upstairs and locked herself in the bathroom. She said, “I am going to take such a long shower that there won’t be any hot water left for you tomorrow morning.”  I had wanted to give her her medications so I tried to open the door (I can do it with a paper clip when she locks herself in). She threw all her weight against the door and refused to let me in. I added a ½ of an Ativan to her meds to try and calm her down and tried again. After I was finally successful in getting her to take the pills, she locked the door again and I decided to lie down on my bed and read rather than to continue with a battle of wills that wasn’t going anywhere.

After awhile, I heard the shower go on and then after about ½ an hour, I knocked on the door and said that it was time to get out of the shower and get her jimmies on. I opened the door and Yelena was standing in the tub covered with bright red nail polish. There was nail polish on the sink, all over the tub, the shower curtain and the walls. My immediate reaction was anger and I turned and went downstairs to get the bottle of nail polish remover and asked her to start cleaning the tub when I returned. After a couple of minutes I realized that I should be concentrating on cleaning her up and getting her into bed rather than cleaning the bathroom.  She had painted designs on her arms. I asked her what had happened and all she could say was that it was an accident and the bottle had spilled. I started to wash her off with acetone and she started screaming. For someone without sensory issues, acetone is a pretty powerful smell and she had it all over her hands and had a few small cuts on her hands that stung really badly. I went and got the other ½ of the Ativan for her. I concentrated on her face and hands and left her legs (that wouldn’t be seen at camp when she had her clothes on) for another day. 

She was sobbing when I put her to bed so I lay down with her for awhile and she started talking about how scared she was about the rest of the MCAS and how her teacher had told her to hurry up and put a lot of pressure on her and then wouldn’t let her go to recess. It’s mostly in our heart-to-heart talks when she is in bed that she is able to tell me a lot of stuff that has been happening to her. She said she couldn’t go back to school on Monday and she was really scared of her teacher and didn’t think she could manage the rest of the year. It was after I said goodnight to her and went to the bathroom that I saw the inside of the toilet which was covered in nail polish. How she managed to do that, I have no idea...

The next day was Wednesday. I had to pick her up a little early from camp as she had an appointment with her psychopharm nurse. After her appointment, we did a few errands and then headed home for dinner. When I suggested homework she started slapping me with a computer cable. She went into the bathroom to take a bath. When I went in to get her after she had been in there for 45 minutes (shades of the teenager to come), I saw hair lying all over the sink and the floor. She had cut her “sideburns” off and she had cut about a one inch square area right in the front center of her forehead down to the scalp. And she had also cut off her eyebrows. I asked her what was going on and she said it was an accident. She started to cry and say that everyone was going to laugh at her and tease her. She sat down stark naked on the floor of my bedroom and said “OK, please just kill me now. Please kill me. Just kill me. I don’t want to live.”  Another Ativan - I didn’t bother to cut it in half.

I said that I could do two things to help her, we could either shave off her whole head or I could cut some bangs to try to cover the bald spot, She said “OK, then shave my head.”

Never suggest something that you are not prepared to do… I cut bangs for her. She wore a baseball cap to camp for the last two days of the week. She has asked me a few times if I like the way it looks and I answered her question with a question: “Do you like it?” I think she kind of does like it. I’m not sure if she thinks it’s cool and very Goth or she likes it because it is different and will get her some attention. I don’t think she has any idea what kind of attention that it might get her in school. I asked her tonight if she wanted me to try to even out her eyebrows (she did a very choppy looking job) and she said no, she likes it the way it is. I modeled head bands and scarves but I don’t think she is going to want to wear any of it to school. The kids are not allowed to wear hats during the day at school and if an exception was made to the rule she would just stand out even more. I did send an email to the school today just so they would be ready for her on Monday:

Yelena has had an extremely difficult vacation week which almost required crisis intervention services on two occasions.  On the advice of members of her outpatient treatment team, who we will be meeting with on Monday morning, it was suggested that we inform you of the following before she returns to school on Monday.

Due to her emotional distress this week, she has been unable to focus on the vacation homework assignment packet despite our many attempts to encourage her with reward contingencies for her to accomplish some piece of it each day.  Each attempt has usually escalated into major tantrums. She is worried that she will be punished for not completing her homework assignments.

She has been engaging in concerning behaviors, such as cutting off her eyebrows and patches of her hair.  We anticipate that it will be again a struggle to get her to return to school on Monday both for fear of being reprimanded by her teacher (which she has already stated) as well as her usual hypersensitivity and anxiety about being teased.

We have tried to remedy the situation by cutting bangs to hide the bald spot in the front of her head and have discussed the wearing of a headband or scarf but we are not sure that she will want to do that on Monday. She has been wearing a baseball cap for the past few days and we know that she cannot wear a hat at school. And you can’t miss the eyebrows…

It will be helpful in getting her to school on Monday if we can tell her that we have already informed the school staff of all of the above and she does not need to worry. We will assure her that the staff at Plympton will be there to support her during this emotionally difficult time.

We also need to find out what the dates are for the upcoming MCAS because Yelena has already become anxious about it and we need to be able to console her by letting her know exactly when they are so she does not worry needlessly. She also reported that for the last MCAS that she was told she was taking too much time and that she missed recess as a consequence. We know she has accommodations for the test and hope that the future MCAS will go more smoothly for her.

Thanks for your concern and help.

The Boy From Baby House 10

This was an amazing eye opening book about children lost in the "child care" system in Russia. They just did a segment on Dateline about it and it is definately worth taking a look at. 
There but for the grace of G-d...
Go to http://www.msnbc.com.  Click on the "Dateline" tab.  The video is in six parts. They just follow one after another. The whole thing is not terribly long.

MCAS Week

This has been a very rough week and it’s all a jumble in my mind. I want to try to write things down as they happen so I can keep it all straight in my mind.

Yelena had two days of MCAS (Massachusetts Comprehensive Assessment System) testing this week and all the children get totally freaked out about it. I told her numerous times that it wasn’t important, the scores don’t matter and she should just try to do her best and relax. She came home and said her teacher said that they did get grades on it and that it was really important.

The school system does teach to the MCAS.  For 2010, Plympton has not made adequate yearly progress in either English Language Arts or Mathematics and their status is Corrective Action due to prior years’ reports.

The absurdity of even making a student like Yelena even take the MCAS (which she will fail) is mind boggling to me and then add the anxiety component on top of it and the situation becomes totally insane.

She had Language Arts this week on Wednesday and Friday. Math is sometime in May. Fortunately, her teacher did not give any homework most of the week.

She had a big meltdown Tuesday night. She didn’t have any homework to do and her instructions from her teacher were to have a good dinner, get a good night’s sleep, have a good breakfast and make sure to take all her medications! Medication is NOT under the jurisdiction of the school system. She was in a great mood and asked to be able to watch a movie because it was a special night and I said that she could watch for an hour before she ate dinner and took a bath and got ready for bed. Needless to say, that was a mistake on my part as she was incapable of turning off the TV after an hour. I ended up getting kicked and punched before I got her into a bath and to bed.

Wednesday was her first day of MCATs. When I picked her up at school, the front of her shirt was all wet. I jokingly asked her if she had dribbled her juice and she told me that she had thrown up in science class after the exam. I asked if she had gone to the nurse and what she had said but Yelena told me that she didn’t go to the nurse’s office which I thought was pretty strange. When we got home I asked her to go change her shirt and brush her teeth before she lay down and I called her teacher to see if I could get more of the story.

Her teacher told me that Yelena hadn’t really vomited; she had just regurgitated and spit up into the sink in the room. She also told me that she wasn’t there when it happened but the aide had been there and told her. She said that she hadn’t gone to the nurse because it was 2:30 pm and almost time to go home. What makes her such an expert on whether someone has “really” vomited or not especially if she wasn’t even there? Yelena continued to complain that her stomach hurt and she felt like throwing up so she wanted to cancel her appointment with her therapist and get in bed. She told me that she threw up again twice that evening and I’m not really sure if she did or not. My husband told me to ask her for “evidence” the next time she vomited. I asked why she hadn’t called me if she was sick and she asked me why she would. I said that it was comforting to have your Mom with you when you threw up and that my mother always held my head for me and her cool hand on my forehead always made me feel better.

The next day, Thursday, was not going to be a testing day and it was also an early release day so I decided to let her stay home. She slept until 10 AM which is very rare for her but I think she needed the rest. She did go to her chorus rehearsal and her social skills group that afternoon.

She had told me the day before that the kids were all spreading rumors about her throwing up in science class. (Is it a rumor if it’s true?) Of course, she ran into a girl from her class at chorus rehearsal and the first thing she asked her was if she had heard that she had thrown up in class. At her social skills group, she reported about throwing up as the low point of her week.

As an aside about social skills: we went to an event on Sunday and Yelena was playing with a bunch of kids. At one point I walked over to them and she told me that the boy she was playing with had gone to the same camp she had gone to and that he had wet his bed when he was there. He didn’t looked very put out by her comment (he must have told her all about it) but the other kids looked surprised. I tried to explain to her that her comment was not appropriate especially in front of a whole bunch of kids.

Friday was another round of MCAS and it seemed to go well. Yelena and I had a pleasant evening together – we had dinner and watched Tangled before she went to bed.

Saturday morning she got up and read and listened to music. The three of us sat down to a breakfast of challah French toast and my husband casually asked her if she had left a folder with music in it in his car. All hell broke loose. Why? I don’t really know but she started a major tantrum based on that seemingly innocuous comment. She said that what was in the folder was personal and he had no right to look at it and she moved her chair away from him and closer to me (which he hates).

Things went from bad to worse. She picked up a fork that was on the table and said she was going to kill him. She said she was going to kill herself and she stormed out of the room and slammed the door. We finished our food and she came back screaming and yelling. I told her that she needed to take some time to herself to calm down and that I didn’t want to be around her when she was behaving this way. I went upstairs to my bedroom and picked up a book and started to read. She followed me up stairs and I asked her to go take a shower and get dressed as she was supposed to go to a friend’s house for a playdate (I hear that I am now supposed to say “hang out” instead of “playdate”.) She repeatedly refused to get in the shower, She took a picture of herself out of the frame that it was in and ripped it up into small pieces that she threw at me. She took a book and thrust it menacingly at my face repeatedly. She took a pointed metal nail file that was on my bureau and threatened me with it. After I had asked her to stop numerous times and repeated warnings of consequences, I finally said that I was not going to her friend’s house. Her behavior immediately changed. She calmed down and began to plead to be allowed to go. My husband came upstairs and said that if she wasn’t going to her friend’s house, maybe she would like to go to the farm with him. I said that I thought that if her behavior wasn’t good enough to go to her friends then it wasn’t good enough to go to the farm. He agreed.

Later, after she had been calmed down for awhile, he did take her to the farm and then out for ice cream. I had gone to a movie with a friend. After they got home, my husband found Yelena at my desk with both of my computers on, which she is not allowed to do. He repeatedly asked her to turn them off which she didn’t do so he pulled the plugs out. She cracked her knuckles, put up her dukes, looked at him menacingly and picked up a computer cord and spun it around in the air almost hitting him in the eye. He grabbed her hand to stop her and it hit her instead by accident. She then started to cry “You hit me, You hit me. I hate you.” She couldn’t let go of the fact that she had been hurt and it was all his fault…

She has been late for school every day this week. It has been very frustrating. We have been getting up earlier and earlier but it does not seem to help. I spent 2 hours cajoling her, tickling her, sweet talking her, threatening her this morning to try and get her to school. I feel like it is a small victory to get her there at all and I stop caring if she is late.

After Yelena’s appointment with her therapist on Wednesday, her therapist asked to speak with me and said that Yelena was not at all herself and she was very concerned about her behavior during the session – very anxious, unable to express what was bothering her, unable to play a game or sit still.

Yelena had a concert Thursday night and was worried for a few days that she wouldn’t be able to get her home work done that night so she asked me to write to her teacher. This is the email I sent:

I wanted to express my concern about Yelena's ability to do any homework Thursday night. She has her social skills group after school and then the all-city concert which starts at 7. Yelena is worried that you will get angry with her if she doesn't do her homework.

Her teacher’s reply:

I wasn’t planning on giving homework to the kids who are participating in the concert.  I am extremely concerned with Yelena being late for school on a daily basis; we can discuss this at the meeting on Monday.  See you then.

My reply to her teacher:

We are also extremely concerned about Yelena’s lateness. She is having a very difficult time right now. We are working with her therapists to figure out what is happening.

The meeting on Monday is for the IEP and I would like to keep it about the IEP. If you want to discuss Yelena's emotional distress, we can schedule another meeting to talk about that on Monday.

We have an IEP meeting on Monday morning. Oh my...

Childhood Trauma

While waiting for Yelena at her therapist's office today I found a really interesting article on international adoption. The article is in the February 2011 issue of Good Housekeeping and it is titled "Love Medicine" by Melissa Fay Greene . It is reprinted here by Theraplay:
http://www.theraplay.org/downloads/Good_Housekeeping_Article.pdf


In looking on the web for the article, I came across an interesting blog about Guatemalan adoption which had an interesting analysis of the article. It looks like an interesting blog and worth looking at: http://www.mamalitathebook.com/2011/02/melissa-fay-greene-article-in-february-2011-good-housekeeping/

There is also an article titled "The Poverty Clinic" by Paul Tough in the March 21, 2011 issue of The New Yorker.  It is about Nadine Burke, a physician who started a clinic in an inner-city neighborhood in San Francisco who noticed a high correlation between traumatic events in childhood and serious illness later in life.

"The traumatic events that (Nadine Burke's patient) experienced in childhood had likely caused significant and long-lasting chemical changes in both her brain and her body, and these changes could well be making her sick, and also increasing her chances of serious medical problems in adulthood." Tough talks about the ACE (Adverse Childhood Experiences) Study which deals with bridging the gap between childhood trauma and negative consequences later in life.   See: http://www.acestudy.org/

He ends the article by quoting Burke as saying,  "It's not that if we poured all of our money into treating ACEs the jails would empty out and we would no longer have any kids in special ed. But this is a huge, huge issue, and as a society I don't think we've even come close to grasping its significance."

It makes so much sense. A damaged child can grow into a damaged adult. We have so many hurt, abused, neglected children in this world.  It's a long hard road...