This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Friday, May 31, 2019

Jail and Prison - Foster Care and Mental Illness Statistics.



Almost 80% of inmates incarcerated in our prisons have spent time in foster care.
 45% to 75% of inmates are mentally ill. 

Foster care Statistics - Unacceptable Facts and Stories 
40-50% of former foster youth become homeless within 18 months after leaving care.

60% of youth earn incomes below the poverty line.

65% of children in foster care experience seven or more school changes from elementary to high school.

Only 1-3% graduate from college.

25% of foster youth will be in prison within two years of emancipation.  

Four of five (80 percent) young women become pregnant too soon.

Kids who've been in foster care are diagnosed with Post-Traumatic Stress Disorder (PTSD) at six times the general population and double the rate of veterans returning from war.

Eight of ten (81 percent) males have been arrested compared to 17 percent of their peers who were not in foster care.




Serious Mental Illness Prevalence in Jails and Prisons

In state prisons, 73 percent of women and 55 of men have at least one mental health problemIn federal prisons, 61 percent of women and 44 percent of menIn local jails, 75 percent of women and 63 percent of men


Serious mental illness has become so prevalent that jails and prisons are now commonly called “the new asylums.” 

In point of fact, the Los Angeles County Jail, Chicago’s Cook County Jail, or New York’s Riker’s Island Jail each hold more mentally ill inmates than any remaining psychiatric hospital in the United States. Overall, 

Approximately 20% of inmates in jails and 15% of inmates in state prisons are now estimated to have a serious mental illness

Based on the total inmate population, this means approximately 383,000 individuals with severe psychiatric disease were behind bars in the United States in 2014 or nearly 10 times the number of patients remaining in the nation’s state hospitals. The number of severely mentally ill individuals behind bars is 10 times the number of patients in state hospitals. 


Mentally ill inmates remain in jail longer than other inmates. 
In Florida’s Orange County Jail, the average stay for all inmates is 26 days; for mentally ill inmates, it is 51 days. In New York’s Riker’s Island, the average stay for all inmates is 42 days; for mentally ill inmates, it is 215 days (over 5 times longer!)

The average stay for mentally ill prison inmates is 5 times longer than other inmates.

The main reason mentally ill inmates are incarcerated longer than other prisoners is that many find it difficult to understand and follow jail and prison rules. In one study, jail inmates were twice as likely (19% versus 9%) to be charged with facility rule violations. In another study, in Washington state prisons, mentally ill inmates accounted for 41% of infractions even though they constituted only 19% of the prison population. 

Mentally ill inmates are incarcerated longer because they find it difficult to understand and follow the rules.

Additionally, pretrial inmates with serious mental illness experience longer incarcerations than other inmates in many states if they require an evaluation or restoration of competency to stand trial. A survey of state hospital officials in 2015 found that 78% of the 40 responding states were wait-listing pretrial inmates for hospital services. The waits were “in the 30-day range” in most states, but three states reported forensic bed waits of six months to one year. Mentally ill inmates in some states are reported to spend more time waiting for competency restoration so they can be tried than they would spend behind bars convicted of the offense for which they have been charged.

Pretrial inmates with a serious mental illness might have to wait for one month up to one year for hospital services; many wait longer to be evaluated than they would spend behind bars convicted of the offense for which they have been charged.

Mentally ill inmates create behavioral management problems that result in their isolation. 
Because of their impaired thinking, many inmates with serious mental illnesses present behavioral management problems. This is a contributing factor to their heavy over-representation in the subset of prisoners in solitary confinement. In Wisconsin, for example, a 2010 audit of three state prisons reported that

 “between 55% and 76% of inmates in segregation [isolation] are mentally ill."
Solitary Confinement (Isolation)
Solitary Confinement: Torture, Pure and Simple
The practice of placing incarcerated individuals in solitary confinement dates back to the 1820s in America when it was thought that isolating individuals in prison would help with their rehabilitation. Yet, over the past two centuries, it has become clear that locking people away for 22 to 24 hours a day is anything but rehabilitative. 

Solitary confinement is so egregious a punishment that in 2011, the U.N. Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment condemned its use, except in exceptional circumstances and for as short a time as possible, and banned the practice completely for people with mental illnesses and for juveniles.

Despite its barbarity, the United States continues to place thousands of people, including individuals with mental illnesses and children, in solitary confinement, sometimes for decades

There are more than 80,000 men, women, and children in solitary confinement in prisons across the United States, according to the Bureau of Justice Statistics.

Note that figure is a decade old and doesn’t include people in jails, juvenile facilities, and immigrant detention centers. Nearly every state uses some form of solitary confinement, but there’s no federal reporting system that tracks how many people are isolated at any given time.

Prisoners are often confined for months or even years, with some spending more than 25 years in segregated prison settings. As with the overall prison population, people of color are disproportionately represented in isolation units. [Solitary Confinement Facts]

Solitary confinement often exacerbates existing psychiatric conditions and not infrequently leads to suicide. 
In Texas, for example, suicides rates for those in solitary confinement are five times higher than that of the general prison community.

Mentally ill inmates are more likely to commit suicide. 
Suicide is the leading cause of death in correctional facilities, and multiple studies indicate as many as half of all inmate suicides are committed by the estimated 15 % to 20% of inmates with serious mental illness. A 2002 study in the state of Washington found that “the prevalence of mental illness among inmates who attempted suicide was 77%, compared with 15% [among inmates] in the general jail population.” In California in 2002, the Los Angeles Times headlined: “Jail Suicides Reach Record Pace in State,” and added: “Some experts blame the recent surge on forcing more of the mentally ill behind bars.”


By the Numbers: Mental Illness Behind Bars
“We’ve, frankly, criminalized the mentally ill, and used local jails as de facto mental health institutions,” said Alex Briscoe, the health director for Alameda County in northern California.

Mentally Ill Women in the System
The statistics paint a stark picture, with mental illness affecting a greater percentage of jailed women than men:

In state prisons, 73 percent of women and 55 of men have at least one mental health problemIn federal prisons, 61 percent of women and 44 percent of menIn local jails, 75 percent of women and 63 percent of men
Jailhouse Fights
 Inmates with mental illness are much more likely to be injured in prison fights. The Department of Justice reported that 20 percent of inmates with mental illness were injured in jailhouse fights compared to 10 percent of inmates without mental illness. In local jails, inmates with mental illness are three times as likely to be injured.
Jail and prison are particularly bad places to be mentally ill. Men and women with behavioral disorders and mental illness end up in stressful prison environments — many are put in seclusion for long stretches of time — that further exacerbate their conditions, researchers say. 

Homelessness
It is estimated that 20–25% of homeless people, compared with 6% of the non-homeless, have severe mental illness. Others estimate that up to one-third of the homeless suffer from mental illness. 

Studies have also found that there is a correlation between homelessness and incarceration. Those with mental illness or substance abuse problems were found to be incarcerated at a higher frequency than the general population. 

Fischer and Breakey have identified the chronically mentally ill as one of the four main subtypes of homeless persons; the others being the street people, chronic alcoholics, and the situationally distressed.


So Now What?

Structure
If your child is like mine, he/she needs a LOT of structure. {Structure and Caring Support} There are only so many places our kids can get that structure once that child legally becomes an adult. 

We looked at a couple of options but unfortunately, my son didn't qualify for either.:

1.  Military
People with current mood disorders or a history of serious mental illness cannot serve. Recruiters have allegedly lied to my son and said he was eligible (to meet their enrollment quotas?) but it is more likely that he lied to them about his diagnoses.

How do you know whether your child may have a disqualifying condition? The U.S. Department of Defense has a directive called the Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces which provides a detailed list of what mental health conditions prevent a person from being in the armed services.
Ex. 

  • current diagnosis or a history of a mental disorder with psychotic features, such as schizophrenia or a delusional disorder
  • bipolar disorder or affective psychoses
  • depressive disorders (for example, major depressive disorder), disqualification from the service will occur if a person had outpatient care that lasted for more than 24 months or any inpatient care. A person with a depressive disorder must be "stable" without treatment for a continuous 36 months to be eligible.
  • anxiety disorders (for example, panic disorder), a person cannot enter the armed services if he or she needed any inpatient care or outpatient care for more than 12 months cumulatively. A person must not have needed any treatment for their anxiety disorder in the past 36 months.
  • history of obsessive-compulsive disorder or post-traumatic stress disorder
  • history of or current dissociative, conversion, or factitious disorder, depersonalization, hypochondriasis, somatoform disorders, or pain disorder related to psychological factors or a somatoform disorder
  • history of an adjustment disorder within the last three months or recurrent episodes of adjustment disorder
  • history of or current psychosexual condition like voyeurism or exhibitionism
  • history of or current alcohol or drug abuse or dependence
  • history of attempted suicide or suicidal behavior
  • disturbances of conduct, impulse control disorder, oppositional defiant disorder, or other personality or behavior disorders characterized by frequent encounters with law enforcement agencies, and antisocial attitudes or behavior are other mental health problems that warrant disqualification from the service
  • personality, conduct, or behavior disorder that is believed to serve as a serious interference to adjusting to the military
  • other causes for disqualification include (but not limited to) a history of anorexia or bulimia, a history of encopresis (soiling your underwear) after the age of 13, or a history of an expressive or receptive language delay
    [Can Those With Mental Illness Serve In The US Military?}

2.  Job Corps

Job Corps is a program administered by the United States Department of Labor that offers free-of-charge education and vocational training to young men and women ages 16 to 24.

Unfortunately, Job Corps has a strict student conduct policy. Violence and drug and alcohol use are strictly prohibited. This may rule out many kids with trauma issues, mental illnesses, aggression, criminal history...

You may NOT be eligible for Job Corps if you:

  • Use drugs illegally under federal law
  • Exhibit behavioral problems that could prevent you or others from success in Job Corps
  • Have certain criminal convictions or require court supervision

Helping Your Child Support Him/Herself

Supplemental Security Income (SSI)
Many people with a serious mental illness live on Supplemental Security Income (SSI), which averages just 18% of the median income but can allow your child to live more independently. It includes Medicaid, which can get your child most, if not all of the health services and medications that he/she needs.  {Getting SSI For Your Adult Child}

Living Outside of the Home
You love your child but having him/ her live with you may not be an option.

So what do you do?

  • do you try to find a group home or assisted-living place that takes people with your child's disability?
  • do you pay out of pocket?
  • do you take your child to a shelter? 
  • do you give her a bus ticket to wherever she thinks her life will be better (and pray she doesn't get pregnant)? 
  • do you pay for an apartment for him? (not that that's financially an option for us). 
  • do you hand him a tent and a sleeping bag? 
  • do you pay for a hotel room just until...? 
  • do you help them find roommates and a place they can afford?
  • do you bring them groceries?
  • do you co-sign something?

When does it stop? How many hours do you take away from everything else to devote to keeping this child out of jail and a place to sleep? What if this isn't the first (or the 50th!) time you've had to find her a new place or he's asked you for bail money?
Prioritizing Yourself, Your Family, and Your Child - In That Order!

Finding A Place to Live
Your child may run into housing issues after being discharged from an inpatient care unit or jail. Finding him/ her a place to live can be difficult.

Section 8 Housing 
This program provides vouchers for people with low incomes to obtain housing in the community.  In general, a Section 8 recipient has to pay approximately one-third of her monthly income towards her rent, and the voucher pays for the rest.  Many people with special needs who receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits as their sole source of income will likely qualify for Section 8 as well. 

Section 8 vouchers can allow people with mild or moderate special needs and low incomes to live on their own in the community.  However, they're cutting this program back more and more and it usually takes 5 to 10 years to obtain a Section 8 voucher and, once acquired, there may not be any available Section 8 units for rent in the individual's community. Section 8 housing is also not appropriate for people with more complicated special needs who can't live on their own.


  • Section 811 Housing
    Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities.


Group Homes
This type of housing provides the most support for its residents. Trained staff members are present 24/7 to provide care and assistance with things like medication, daily living skills, meals, paying bills, transportation and treatment management. These group homes provide their residents with their own bed, dresser and closet space, and shared bathrooms and common areas. This is the best type of housing for people experiencing a serious mental illness which may affect their ability to perform their daily tasks.

Residents of group homes usually have a disability, such as autism, intellectual disability, chronic or long-term mental/psychiatric disorder, or physical or even multiple disabilities because those are the non-profit and state-regional organizations which began and operated the homes.

How much does it cost to live in a group home? On average, residential care homes are about half the cost of skilled nursing facilities and less expensive than many assisted living communities. The cost can range from $1500 to $4,500 a month. It will depend on the level of care needed, the quality of the home, the location, and if the room is single or shared.

Partially Supervised Group Housing
Some support is provided for the residents, but staff isn’t there 24 hours a day. The residents can be left alone for several hours and are able to call for help if needed. People who choose to stay in these group homes can perform their daily living tasks independently or semi-independently, help with cooking and cleaning and may even hold a part-time job or participate in a day program.

Supported Housing
Supportive housing provides very limited assistance. The residents of these homes live almost independently and are visited by staff members infrequently. However, they do have someone to call and resources available to them if a problem does arise.


Finding a place that takes Medicaid, Medicare, some sort of government program that doesn't require years on a waiting list... 



At What Point Do You Let Go?
Many of my friends are struggling with children who are chronologically on the cusp of adulthood, but do not have the skills needed to be successful... in fact, most of their kids are determinedly on a rapid, self-destructive path.

It sometimes felt like I was in the middle of the ocean holding my son like a lifeguard.  We did everything we could to teach my son to "swim," and he just couldn't learn.  For as long as I held him up, he hated me, was actively fighting me, and was absolutely convinced he could do it all on his own. 

I knew his struggles could drown me and they almost did many times.

I knew that the minute I let go, he would flounder for a little while, but inevitably, he would sink to the bottom of the ocean.  

How do you let go, knowing your child will most likely drown?  At the same time, I knew I could not hold him forever.  At what point do I let go?

I got some excellent advice from a fellow trauma mama: 
The fact of the matter is this - Bear is going to drown no matter how much you do for him. The only difference is that you are going to drown right along with him if you continue doing the things you're doing. He is very clear that he doesn't want your help. He is even making things worse in his zeal to get you off his back. As long as you are giving help and advice, he is convincing himself that he knows better, is smarter and can handle it all himself - and hating you for it. What's wrong with letting him know that you are going to step back and let him handle things, but that if he needs your assistance with meds (or whatever you decide the boundaries to be) that you are willing to help in any way you know how - but only if he asks. Maybe after a few months, he will concede that things aren't going as smoothly as he thinks.
His perception of how he's taken care of himself all this time on his own is only a small indicator of his distorted thinking. The one thing I've learned (the hard way over and over) is that their reality doesn't really have to be based on the facts, and when it isn't, there is no reasoning with them. I know it is so painful to watch, but this is real life and unless you have guardianship (and lots of times even when you do), he is legally able to make his own decisions - which he's been doing. YOU are doing all the work on improving his life and he's fighting you every step of the way. Let your husband field the phone calls and advocate for him - I think he will find out quickly that helping Bear isn't as easy as it may seem.

Detachment Parenting
When I first heard of it, it sounded like heaven to my burned out, PTSD suffering, guilt-ridden self. I'd been trying to parent my attachment challenged children the way society told me I should, the same way I parented my neuro-typical, totally attached bio-kids - nurturing, child-focused, self-sacrificing... and it was killing me! {Giving Until There's Nothing Left - But My Child NEEDS Me!}

I see Detachment Parenting as a small step beyond all of that. A step I desperately needed. A way to validate not feeling guilty for not prioritizing my child's needs over everything else - even though I knew my child would most likely fail without my constant intervention (and remember that my child would most likely fall whether I was there or not). {You Have Not Failed} 


Re-Prioritize
I had to prioritize my life differently in an effort to function again - to get a thicker skin about ignoring other's expectations and "shoulds", and stop being reactive or even proactive about my child. I needed to parent my attachment-challenged child calmly and with perspective about the needs of my family and myself.

I realized I needed to focus on myself (especially healing my PTSD and building my reserves up so I had enough to give again.), my husband, my family as a whole, focus on the other kids (not just the squeakiest wheels), and only then on the child that I couldn't heal. 

I know it sounds impossible, but SELF-CARE has to be your first priority!

But My Child NEEDS Me! 

When my kids first got here, I was empathetic, calm and patient with them- maybe TOO patient.  I stuffed things down, let it roll off my back, and GAVE and GAVE and GAVE... until there was nothing left. Nothing left for my child, for my family and most of all, for my self. I was so burned out and overwhelmed that we were all miserable.

You can't help anyone if you're so emotionally drained that there's nothing left. 

I once heard a house parent in a residential treatment center for emotionally disturbed girls tell a teen that she was a "bottomless pit of need." At the time, I thought he was a horrible person. Now I get it. If we drain our emotional reserves trying to fill a child who can't be filled, then we're empty. You can't fill from an empty cup. Our kids need a different type of parenting and society's "shoulds" can suck it! {Finding The Joy




Boundaries
One thing that really helped me with setting boundaries with all of my teens (even my neurotypical biokids), was one of my favorite books, Stop Walking on Eggshells. I still reread it often. It helped me with setting boundaries for my children and for myself too. 



You Have Not Failed
Not only did I need to grieve that my children didn't have the life I'd hoped for them, but I had to acknowledge it was not my fault. I did everything I reasonably could. Often more than I should.

Yet one of my children did not heal.

Deep down, I felt guilty about this. Especially because I knew I had never really emotionally bonded to this child. In fact, I don't like to be around him. As a mother, especially as an adoptive parent, I was supposed to feel nurturing and loving toward this child, right? What kind of mother am I?


I had to acknowledge that not feeling nurturing and loving toward my abuser (and yes, that is what he was) is perfectly understandable. Yes, he was a child who did not always have control over his actions. That does not change the fact that it hurt and scared me when he lashed out at me and my family. 


If my spouse had treated me the way my son did, everyone would criticize me for not leaving my husband. Because my abuser was my child, everyone told me I could not leave and, in fact, I was shamed for not being more loving and nurturing. 
****************************
Here're some of the posts that helped me through this - 


Saturday, March 9, 2019

Continuous Traumatic Stress (CTS)


Image result for abused parent



We call ourselves Trauma Mamas (and Trauma Papas).  We live with our abusers and care for them on a daily basis. Unlike other battered women, we are not encouraged to leave. Instead, we are told we have to stay. We're told that we *should* devote all of our time and energy to this child. 
{Fighting the *shoulds* - Prioritizing Yourself, Your Family, and Your Child - In That Order!}

Our house often feels like a war zone. The stress feels like it never ends and even becomes our new normal. It affects our bodies, our minds, our relationships.


{Not coincidentally, our kids with Chronic Post-Traumatic Stress Disorder (C-PTSD) often perceive chaos as normal and their bodies can become "addicted" to the stress hormones, to such an extent that they attempt to recreate the chaos in their everyday life with us. Why Doesn't My Child Feel Safe?}



Continuous Traumatic Stress


It's not Post-Traumatic Stress Disorder if you're still living it.
Back in the 1980s, mental health professionals dealing with victims of political repression in South Africa found that the usual treatment for PTSD provided little help for people living in fear that the victimization could happen again at any time. 
CTS - Not a Disorder
People experiencing continuous stressful environments might be formally diagnosed with C-PTSD* or DTD**. 
Although many people experiencing these kinds of repeated traumas will have enough resilience to avoid developing full-blown trauma symptoms, coping with CTS often depends on how or where the trauma takes place. This includes war zones where the threat of physical attack remains very real and a state of “permanent emergency” exists. 
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013  
I think we can safely include parents of children with severe trauma, aggression, violent tendencies, and other disorders among those dealing with CTS on a daily basis.




CTS in Parents/ Caregivers

The following article refers to Post-Traumatic Stress Disorder,  but I believe you'll agree that the more accurate term is Continuous Traumatic Stress. "Post" implies that the traumatic event(s) are over.

PTSD in Parents of Kids with RAD


Many foster and adoptive families of Reactive Attachment Disordered children live in a home that has become a battleground. In the beginning, the daily struggles were expected, after all, we knew that problems would occur. Initially, stress can be so subtle that we lose sight of a war which others do not realize is occurring. We honestly believe that we can work through the problems.
Outbursts, rages, and strife become a way of life. An emotionally unhealthy way of life. We set aside our own needs and focus on the needs of our children. But what does it cost us? {Handling Rages}
In war, the battle lines are drawn; an antagonism exists between two enemies. In our homes, we are not drawing battle lines; we are not prepared for war. We are prepared for parenting. Consequently, the ongoing stress can result in disastrous affects on our well-being literally causing our emotional and physical health to deteriorate.
The primary symptoms of Post Traumatic Stress Disorder include:
  • Avoidance -- refusing to recognize the thoughts and feelings associated with the trauma, this further includes avoiding activities, individuals, and places associated with the trauma.
  • Intense distress -- when certain cues or "triggers" set off memories of the traumatic event. You may have trouble concentrating, along with feelings of irritability, and frustration over trivial events that never bothered you in the past.
  • Nightmares and flashbacks -- insomnia or oversleeping may occur. You may exhibit symptoms such as heightened alertness and startle easily.
  • A loss of interest in your life -- detaching yourself from loved ones. Losing all hope for the future and a lack of loving feelings.
Secondary symptoms of Post Traumatic Stress Disorder can include:
  • The realization that you are no longer the person you once were. Relationships have changed by alienating yourself from loved ones. Loneliness and a feeling of helplessness prevail in your daily life.
  • Depression, which can lead to a negative self-image, lowered self-esteem, along with feeling out of control of your life and environment. You may become a workaholic and physical problems may develop.
  • You become overly cautious and insecure. Angry outbursts may occur putting stress on significant relationships.

Stress - Fight-or-Flight  
Your body perceives stress like an attack (think of our ancestors being attacked by a tiger) and reacts with an instinctual fight or flight response. This feeling prompts your adrenal glands to release a surge of hormones, including adrenaline and cortisol.

To fight the "tiger," adrenaline increases your heart rate, elevates your blood pressure, and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues.

Image result for stress tiger
Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system, and growth processes. This complex natural alarm system also communicates with regions of your brain that control mood, motivation, and fear.



When the natural stress response goes haywire
The body's stress-response system is usually self-limiting. Once a perceived threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels and other systems resume their regular activities.

But when stressors are always present and you constantly feel under attack, that fight-or-flight reaction stays turned on.

The long-term activation of the stress-response system — and the subsequent overexposure to cortisol and other stress hormones — can disrupt almost all your body's processes. Stress Management - Mayo Clinic 

"[C]hronic stress can be debilitating and overwhelming. It can affect both our physical and psychological well-being by causing a variety of problems including anxiety, insomnia, muscle pain, high blood pressure, and a weakened immune system. 
Research shows that stress can contribute to the development of major illnesses, such as heart disease, depression, and obesity. The consequences of chronic stress are serious." Chronic Stress- American Psychological Association

*Complex PTSD (C-PTSD)
Though CTS is not considered a disorder in itself, a new diagnosis has been suggested to take continuous traumatic stress into account:  Complex PTSD (C-PTSD).   
Judith Herman, author of Trauma and Recovery (1992), suggested people dealing with child physical abuse, intimate partner violence, women trapped in sexual slavery and other people experiencing long-term stress often showed symptoms very different from people experiencing single-event traumas. As a result, they can often become passive and withdrawn (due to learned helplessness), or develop highly unstable personalities. This could lead to dangerous repetitive behaviours such as becoming involved with violent partners,  repeated self-harm attempts, or chronic substance abuse. 
Though not part of the new DSM-5, suggested C-PTSD symptoms in adults include:
  •         Difficulties regulating emotions, including symptoms such as persistent sadness, suicidal thoughts, explosive anger, or covert anger
  •         Variations in consciousness, such as forgetting traumatic events (i.e., psychogenic amnesia), reliving traumatic events, or having episodes of dissociation (during which one feels detached from one's mental processes or body).
  •         Changes in self-perception, such as a chronic and pervasive sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
  •         Varied changes in their perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with their relationship to the perpetrator, including a preoccupation with revenge.
  •         Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer.
  •         Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair.
**Developmental Trauma Disorder (DTD)
Since C-PTSD does not adequately reflect the kind of developmental impact seen in children, clinicians have suggested an alternative diagnosis, Developmental Trauma Disorder (DTD).
Symptoms for children are similar but also include:
  • behavioural problems,
  • poor impulse control,
  • pathological self-soothing (through dysfunctional coping mechanism such as self-cutting), and
  • sleep problems.  
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013



Treatment of CTS
Image result for hypervigilance
Living with CTS 
So what do classic PTSD symptoms such as flashbacks, nightmares, hypervigilance and the startle response mean for people who are afraid of being re-victimized? People experiencing CTS are usually more preoccupied with the possibility of future traumatic events than by what happened to them in the past. 
For them, staying vigilant is a healthy way of responding to what they must face although they need to learn to tell the difference between realistic vs. imagined threats to their safety. 
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013

Caregiver Fatigue/ Compassion Fatigue


The demands of caregiving can be overwhelming, especially if you feel you have little control over the situation or you’re in over your head. If the stress of caregiving is left unchecked, it can take a toll on your health, relationships, and state of mind—eventually leading to burnout.
When you’re burned out, it’s tough to do anything, let alone look after someone else. That’s why taking care of yourself isn’t a luxury—it’s a necessity.

Caregiver stress and burnout: What you need to know
Caring for a loved one can be very rewarding, but it also involves many stressors. Caregiver stress can be particularly damaging since it is typically a chronic, long-term challenge.

If you don’t get the physical and emotional support you need, the stress of caregiving leaves you vulnerable to a wide range of problems, including depression, anxiety, and burnout. And when you get to that point, both you and the people you’re caring for suffer. That’s why managing the stress levels in your life is just as important as making sure your family member gets to his doctor’s appointment or takes her medication on time.


Common signs and symptoms of caregiver burnout
  • You have much less energy than you once had
  • It seems like you catch every cold or flu that’s going around
  • You’re constantly exhausted, even after sleeping or taking a break
  • You neglect your own needs, either because you’re too busy or you don’t care anymore
  • Your life revolves around caregiving, but it gives you little satisfaction
  • You have trouble relaxing, even when help is available
  • You’re increasingly impatient and irritable with the person you’re caring for
  • You feel helpless and hopeless

Helping Ourselves - Recovering from CTS and Burnout 

There will always be times when we feel defeated. Like we just can't take one more step. We want to run away.  We want to drop kick this kid.  I have heard so many people say, "I am DONE!  I can't take anymore!"  


I have soooo felt this way myself.  First of all, remember that YOU ARE NOT ALONE!! 


But My Child Needs Me! Giving Until There's Nothing Left
By the time most women reach out, I think we have hit rock bottom. 

 Like most moms, especially moms of special-needs children, I gave and gave and gave until there was nothing left. No reserves. Nothing. I was completely empty. That's hard to come back from.

A woman on one of my support groups was talking about feeling overwhelmed to the point that she found herself having no patience for her child and yelling at him all the time.  She was no longer able to be a therapeutic parent like she used to be.  In my response to her, I realized that things really have changed for me over the years, and I don't think it's just because Bear is out of the house and Kitty is stable.  I really am in a better place emotionally.

I totally get it.  When my kids first got here, I was empathetic, calm and patient with them- maybe TOO patient.  I stuffed things down, let it roll off my back, and GAVE and GAVE and GAVE... until there was nothing left.  I was so burned out and overwhelmed that we were all miserable.  

Here are some things I did to get ME back:



I know it sounds stupid, but I needed "permission," encouragement, and constant reminders to take care of myself.

Parenting a child with attachment issues is incredibly draining and we need extra support to deal with that. But it felt so wrong to prioritize my self over the needs of everyone else.

Society tells us that as women, we should be nurturing and prioritize our family. We should always put ourself and our needs last.
People who work with our child tell us we should prioritize that child. That we should do more for the child. 

They are all WRONG! 

What you HAVE TO do is prioritize yourself over the needs of the family! 



All those well-meaning people who say you SHOULD (or should not) be doing something have no idea what living 24/7 with a child with an attachment disorder is like. 

Even those who have experience working with special needs children don't know YOUR child and how your child is with YOU - plus they work at most an 8-hour shift with your child, then they get to go home!  Also, none of them take into account your other children or your marriage, let alone your needs as the caregiver of your family.  Their priority is the one child, not your family as a whole.




I also needed "permission to prioritize myself and the rest of the family over the needs of one child. Yes, my job as a parent is to help this child, but not at the expense of my marriage and the other children. Prioritizing Yourself, Your Family, and Your Child - In That Order!

Putting Yourself First
Remember what they say when you're on an airplane that is in trouble -- put the oxygen mask on YOURSELF first.  If you are not taking care of yourself, then you can't help anyone else.  

You have to find what works for you.

This is definitely easier if you have support, but you have to prioritize your needs, even if it's just something little, like keeping the best piece of whatever you're serving for dinner for yourself. 
If you give and give and give without getting much, if anything, back, then there is nothing left for anyone!

I knew I could not help anyone on empty. I had to find ways to refill my cup before I could even think about the rest of my family. It sounded impossible. 


Self-care? Who has time for that?


The answer: Without it, you're out of time (and emotional reserves). It's the only thing you have time for until your tank is no longer empty.


BE "SELFISH"
Go out of your way to do things just for you. Things that remind you of who you are outside of being a parent. I don't mean go to the gym once a week. This is not a New Year's Resolution kind of thing. I mean put the kids to bed early every night (we called it "room time") and have some adult time. Plop the kids in front of a video with a PB&J on a paper plate and do something that fills you up. {Getting Respite, Planning a Retreat }

REFILL YOUR TANK

For me, that meant getting my Love Language needs met. I'm a "Words of Affirmation" girl. I found ways to get people to praise my work. I blogged. I mentored. I hung out with people who "got it" and were encouraging me. I tried not to expect that affirmation from my husband and children. I knew they were too overwhelmed and drained to fill my love tank. {Five Love Languages}

TAKE CARE OF YOUR BODY

I know you're going to ignore this, but GET SOME SLEEP!  DRINK LOTS OF WATER!  Eat Right!  Exercise!  All 4 are important, but they are in order of priority.  Please do everything you can to take care of yourself.  No one else can.

FYI, exercise does not have to be joining a gym or running 2 miles a day. It can be blasting your favorite tunes and dance like no one's watching, break out the hula hoop, take the dog for a walk... kids can join in if they want to.

GET SUPPORT!!
Find people who "get it."  Real life, online... just find them, and share!! Remember, "YOU ARE NOT ALONE!"

ASK FOR HELP!!!  and ACCEPT it!!  

When someone has a baby or has been hospitalized, people come over and help out.  They bring food for several days or even weeks.  They clean, go shopping, mow the yard, take care of the kids...  just because we haven't been to a hospital, doesn't mean that we aren't living like survivors of some catastrophic illness or major life event.  When people say, "Can I help?"  Say YES!  You need help.  You deserve help.  Ask for it.  Accept it.  Please!

SURROUND YOURSELF WITH PEOPLE WHO "GET IT" 

Not only avoiding toxic people as much as possible but actively surrounding myself with people who "get it." This is why I admin the group Parenting Attachment Challenged Children. It is a safe, positive place

THERAPY

Therapy - for ME!  I needed to talk to someone whose primary goal was helping ME deal with my life. I found a therapist who specialized in trauma.

MEDICATION

It is not shameful, and it doesn't have to be forever, but a LOT of therapeutic parents I know (including myself) take medication to help with the anxiety and depression that come from parenting kids with trauma/ attachment issues.

FORGIVE YOURSELF

Forgive yourself for not being the "perfect parent" (which doesn't exist!) that could heal/fix your child.  Give yourself time to grieve the child that you wanted (one who could love you back, heal with your help, be RRHAFTBALL... 

FIND TIME TO LAUGH!

Do silly, fun stuff with the kids. Do silly, fun stuff just to entertain yourself! Here're some ideas 99 Ways to Drive Your Child Sane and Brighten Up a Boring Day!

TREAT YOURSELF!

Even if it's for the most minute of successes.  Have you seen that Wendy's commercial about a little girl who lost her baseball game, but they celebrate because she didn't get hit by a ball?! 
  • I didn't smack my child when she screamed in my face for the millionth time (Get a mani/pedi - even if you do it yourself).  
  • My kids ate dinner, fast food in front of the TV counts!  (Go on an ice cream "date" with one of my healthy children).
  • No blood was spilled in the last hour! (Take a hot bath with a trashy novel and a glass of wine after the kids go to bed).
  • Behavior Bingo - Behavior Bingo is something I heard about from somewhere on the web. As a way to cope with her children's behaviors, this mom started pretending that whenever her child did something annoying (like pitch a fit, or paint with poo, or call her a $%#*... she would sometimes act really excited like she'd gotten to put a marker on her imaginary bingo board. She didn't tell her kids what she was doing or why. Every now and then she would yell out, "Bingo!" She usually thanked the child for the behavior (again without telling the child why), and rewarded herself in some way (got an ice cream or a margarita or whatever). She said it made her feel better and confused the heck out of the child(ren). lol
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  • ... 

CALMING/ RELAXATION TECHNIQUES

  • How to Have Good Dreams 
  • Deep breathing - slow, deep, even breaths from the diaphragm, rather than short, shallow breaths from the chest. Can try counting - especially if trying to go to sleep
- Get comfortable and relax muscles.- Inhale deeply and hold it.- Exhale and repeat.- Try adding stretching.
  • 4-7-8 Breath. I use this quick and simple breathing every night. It works!
  • EFT Emotional Freedom Techniques (aka Tapping).  This can be a full tapping routine or just something simple like a side hand chop.
  • Mantra (can be used with tapping) - Choose a positive, calming word or phrase. Repeat it over and over to yourself silently to prevent distracting thoughts from entering and calm yourself.
  • Exercises that cross the mid-brain (like Brain Gym).  Sometimes I use a tapping-type technique - like patting my left knee and then the right, over and over. I've also crossed my arms over my chest and alternately tapped the backs of my upper arms in a subtle way that others probably won't even notice.
  • EMDR is a therapy that works in similar ways (crossing the mid-brain).  
  • Exercise - Going for a walk or run, yoga, jumping on a trampoline to clear the mind and reduce stress.
  • Distraction/ Redirection - Find a different activity or something to focus on that distracts from an event that is causing stress.  Lots of ideas in this post about the Attachment Challenge.
- Read a book or magazine.- Listen to relaxing music or watch a video.- Do a crossword puzzle, or play an electronic game.- Make cookies.- Play with playdoh- Try lying down and taking a nap.- Go somewhere in your imagination.- Cocooning (create a cozy, womb-like area with books and soft toys). 

PRIORITIZE YOUR FAMILY


Prioritize Your Relationship with Your Significant Other
With any luck, this person will be around long after your kids are out of the home.  Respite, date night, at least 5 minutes a day of time together where you DON'T talk about your kids.  I also found it helped to have 10 minutes a day to talk about the kids, and schedules and how your day went...

Prioritize Your Relationship with Your Other Kids
Spend extra time with your other kids.  Go on "dates" with them.  Find times to chat.  Treat them to a little extra mommy time.  The squeaky wheel gets the oil and that means often the other kids can get shoved to the side.  Plus it helps you by getting some time with your child(ren) that is capable of having a relationship with you.

My Top 10ish Things I Couldn't Do This Without

Stop Walking on Eggshells - A book that really helped me set boundaries for living with RAD/ Borderline Personality Disorder/ Older Teens


Finding the Joy 

This is one of the hardest things I've ever done and one of the most important. I wasn't ready for it until my "love tank" was a little more full. I highly recommend this post to you when you're ready!

You Have Not Failed

I did have to accept the fact that one of my children was not able to heal. While I was recovering from the PTSD caused by him living with us, I would often start feeling guilty about my failure to "fix" him. I have reread this post a thousand times to help me combat this feeling. It works for me.