Tuesday, January 13, 2009

RAD, to get help or not?

I was chatting with a friend today and she wanted to know why Marceli is not currently in counseling. I have had a couple of people ask me about his problems and what we are or are not doing and of course I have had lots of people offer me advice. So let me explain a few things.

1. His diagnosis. He has been diagnosed with Reactive Attachment Disorder. This basically stems from the fact that over the years he had several caregivers, those caregivers always left. This led him to beleive that love was not safe. If you love someone and they leave it hurts. We all know people who have had a bad relationship and avoid more relationships after that. Well, this is the same thing. He and I have discussed it. He knows we love him, he has tested that love. One of the sweetest things he ever told me was "Man, mom your love is so strong, nothing I can do will break it, I tried and tried." This many not sound sweet to some, but remember this kid had the attitude that he would "break up with me before I broke up with him". Forming a relationship is hard sometimes and it requires risk. He was afraid of that risk. He did not trust us not to send him back, so he didn't want to get attached. He has now given up on that. This does not mean he doesn't have fears, but that he is now willing to take that risk. Also a part of this, the reactive part, is the skills he learned that helped him in the orphanage. He learned how to get attention, he learned that being cute, and loud and smiling got him attention. He learned that repeating everything he heard got him laughs and attention when he was little. He had to compete with other children for attention and he was very good at getting the attention by doing whatever it took. He no longer needs those skills, but many of them are habits now. He learned that telling people at school he was mistreated in the orphanage got him extra attention at school and allowed him to get away with things he might not have otherwise. He learned that telling the caregivers at the orphanage that he was mistreated at school got him attention there, he even played caregivers against each other, telling one shift the other one was mean. He felt like he had to control his environment to be safe, but conversely he did not respect the adults he could control. To complicate things more, when a caregiver could see through his acts, that also frightened him and he would do what he could to get rid of that person. So when asked a question, instead of answering honestly he answers with what he thinks the person wants to hear, truth has no bearing on it. He has gotten so much better! He has truly come a very long ways and is opening his heart to us more every day.

His other diagnosis is an eating disorder. This is not a case of him being a picky eater, or not liking American food, or me trying to make him eat too much. This is a problem he had before he was adopted, though we were not told about it. There are several reaons, which I won't go into because they are very personal to him. However, what is important is that this is getting better too. He is still underweight and his health is in danger because of it. He will go days without eating or drinking if I let him. He has been hospitalized in the past for this. We have tried letting him pick whatever he wants to eat, he wants to eat nothing. He does not enjoy eating or drinking, it's all a chore. He used to throw up daily and hide food and do anything else he could to get out of eating. He has gotten better. He still had issues when schedules change. He lost three pounds over the two weeks of Christmas break recently. He is 8 years old and only weighs 30lbs. Even accounting for missing legs and arm, this is not enough. He was 26lbs when we got him two years ago. He has gotten himself as low as 23lbs (he was dangerously sick then and sleeping most of the time) He has never been above 32. Right now our goal is to not loose weight. We would love to see him grow and gain weight, but for now we are happy with maintaining. We have tried many, many things to help him, but the truth is the only thing that helped was him deciding he wanted to be healthy.

2. Medication: We have tried a few medications. I don't like the idea of giving him medication, but we were desperate to keep him alive. I do think medications are over prescribed. I think things like ADD and possibly even RAD may be over diagnosed. However, for kids who have real problems the medications can be a godsend. I have me children who truly could not concentrate and for home ADD medication was a life saver. These children were so much happier with medication. I have also met children who were just normal active kids who were medicated to make life easier for thier parents or teachers. The medications did help some with Marceli, but not enough to really make a large difference so we have taken him off of all medications. I beleive that as parents we are the experts on our own children and we need to advocate for them and see that thier needs are met.

3. Counseling: Counseling has it's place and we have seen several counselors. However, some counselors can do more harm than good. For instance a counselor who did not want me in the counseling sessions, told Marceli that he needed to learn to spend time away from me. She did not get that he had spent six years without a mother, what he was learning about was accepting a mother. He did not need help learning to seperate from me, but rather to attach to me. She also did not back me up when I explained to her that we were working on honesty. She did not think this was something to work on, I disagreed. He was having trouble separating fact from fiction and I wanted him to have help with this, but she made it worse by allowing him to tell her things that were obviously not true and not call him on it. He had no respect for her becuase he felt she was not smart enough to know when he was telling her a lie. So we left. I dealt with a social worker who felt it was my parenting that caused his eating issues. Um, they started before I met him, so I don't think I was the cause! We have also met with some wonderful specialists who did help. Right now, I think we are doing well on our own. I am in support groups where I can get advice when I need it. I have made it a point to study my son (all my children really) and work hard to give him what he needs. Some things that work for other parents who have kids with similar issues work for him, some don't. Every child is so unique and each has thier own individual set of needs. I think parents really need to be students of their children. This takes time and love, and listening.

Anyway, if someone has a question about these issues please feel free to ask. I don't know if I covered everything my friend wanted me to cover or not.


Johanna said...

I found your blog from a post on the adoption forums. I have two children adopted out of foster care and one bio-child. I totally get the idea of studying your kids and figuring out what works for them. When I first started this journey I thought there were experts out there that could "fix" everything. I've come to realize that my instincts on what my kids are doing are pretty accurate and while professional help can be helpful, it isn't a cure-all. I consider myself the expert with regard to my difficult child. I "get" him a lot better than most of the experts we've seen over the years. Thanks for sharing.

Mike and Christie said...

It can be so painful to have to explain ourselves to others. Many people have placed counselors on such a high pedestal, that they think they have all the answers, when in truth, most of the "counseling" out there is just not that great. The best counselor would offer advice to YOU on things to try, and include you in the counseling.

The very best for any child is to have a loving parent who can take the time to study their child to best figure out how to help them.

Patience is always on your side.
(something that is easy for me to lack)
But that continual loving, caring experience will be the healing balm for Marceli and all our children who have had trauma in their lives.

It is painful to be rejected and the best counselor would tell us to do our best to not take it personally, because it truly isn't personal. It is fear.

The poor child who wants to be loved is also afraid of being loved.
When you study them, it really makes sense how to help them.

You are a great mom. :)

Lorraine said...

Thanks! He has come so far! He got back up to 30lbs yesterday for the first time since before Christmas. He was so excited and he told me he was so lucky he had a mom that loved him enough to make him eat and be healthy. Then he said that it was because I had forever love. He is finally accepting my love. It was one of those rare moments when you get affirmation that you are doing something right even though it may not look right to outsiders.

Brenda said...

The ONLY type of therapy that has been helpful to us has been attachment therapy alongside EMDR therapy. Is there anyone in your area who does these? I agree. All other forms can do more harm than good.

Lorraine said...

Thanks Brenda, so far we have not found anyone in our area. Some of the people we have tried claimed to practice attachment therapy, but I have learned that does not always mean much. LOL
We are still looking, but meanwhile he is making tons of progress. He has decided he wants to attach and that has made all the difference.

Mike and Christie said...

I am convinced from my very core, that no amount of therapy will do any good unless a person WANTS and has DESIRE to attach. Therapy too soon can be very counter productive and induce unnecessary fear. Sometimes, the best cure is unconditional love, combined with TIME..... :)

Deb said...

You have educated yourself well as a mother. Sometimes that is the only/best therapy available, what we do ourselves to help our children.
Thanks for sharing the difficult details of your experience.
As someone who is going through her own journey with a RAD child I truly empathize.

FaerieMama said...

"For instance a counselor who did not want me in the counseling sessions, told Marceli that he needed to learn to spend time away from me."

THat would have put me theu the roof! I did not put my RAD daughter into therapy until year fOUR. She needed ME, not yet another random adult in her life. I got alot of flack for that. SO many therapists know nOTHING of RAD. It was disheartening!