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!

Saturday, October 3, 2009

Touch issues

These are horribly blurry, but these are the picture of Kitty getting her award. I don't know if you can see it, but look at the expression on her face in the picture on the right. She looks miserable. Does that look like the face of a child who just got an award?

Kitty’s touch issues are complex. Some of it seems to be the attachment disorder stuff or the fact that she was physically and sexually abused. She doesn’t want people to touch her or get in her space – she doesn’t want anyone to get close to her. One of the reasons I nicknamed her Kitty on the blog is because of think of her as a lot like a cat. She will accept hugs and physical touch, but only on her own terms. She may be OK for a little while if you are “petting” her with permission, but sometimes she’ll turn and “bite” you for no apparent reason. She thinks she doesn’t need others and thinks she is totally independent.

She hates to have her hair and neck touched. Sometimes she’ll let me rub her back, but usually only when I’m tucking her into bed. That’s the one time she doesn’t want me to leave and will hang onto my arm if I try to go. I’m assuming it’s because her defenses are down when she’s tired. She sometimes plops in my lap (all 176lbs of her), but I’m not allowed to hold her while she’s there. She can kiss and hug me (rare but it does happen), but I can’t kiss her. When we’re around other kids she won’t acknowledge my existence (of course neither will Bob), but all other places, most of the time, she’ll walk next to me and hold my hand.

Part of what I understand about RAD is that the child is usually neglected. When they were babies, they cried and no one came, so they learn to ignore the body/ feelings. Or maybe someone came and took care of her or maybe hurt her instead. She didn’t learn cause and effect. The reaction of her caregivers was not consistent enough. I don’t know this for sure, but I do know her birthmother was treated for cocaine and meth within 2 years of her birth, so I make some assumptions. For kids with RAD, because no one interacted with them, they may not learn to associate touch with pleasurable feelings. Because of the C-PTSD they might feel overwhelmed by their feelings, so they dissociate.

Kitty isn’t ticklish, she is proud of the fact that you could hit or pinch her forearms and shins and she doesn’t feel it. She can’t tell you when she’s hungry or full. She doesn’t recognize most feelings and can’t tell you where in her body they are located, she often dissociates when the subject of feelings comes up.

I don’t know why she has this problem. One therapist (EMDR/ trauma) said that as she deals with and processes the PTSD/ trauma then she will be able to handle feelings (body and emotions), and begin to feel again, but she couldn’t handle EMDR and trying to process her trauma – she just dissociated.

The Attachment therapist is working on trying to help her recognize her feelings and where she’s feeling them in her body, but when she does (rarely) express an emotion, she can’t tell you where she feels it (like when I’m tense I feel it in my stomach and my jaw). We’ve also tried getting her to recognize where she is in space, by asking her how her feet feel touching the ground, does she feel pressure, any discomfort? We’ve touched her arms with feathers (if she gives permission), placed stones in her hands, had her hold weighted balls… then tried to get her to describe how they feel. What did we get? Frankly almost nothing, except more dissociation (this is when she loves to ask me for things she knows she cannot have, demand that it’s time to go home, mention she’s starving, or get up and go to a different part of the room to do something else). The attachment therapist’s reasoning is that if we can help her recognize her feelings (physical and emotional) then she will be able to recognize and process the trauma/ issues.

Both therapists are trying to accomplish the same goal, by coming at it from different directions. I feel that Kitty’s walls are so strong around herself that we may never break through and access her feelings, but then again, I never thought she’d accept my hugs at all, or come to me for even the littlest comfort. So maybe we’re making more progress than I think.

I guess I just thought we’d be further along after almost 3 years. Especially after Bear made such a huge turnaround when his bipolar disorder was finally treated. At least we’ve got some more years left with her. She’s only in 8th grade.


Bill and Ronni said...

Sounds like our daughter, but she's now a sophomore. She is refusing to do the EMDR, and says that there is nothing wrong with her.

Anonymous said...

Physical feelings = proprioceptive input = sensory pt/ot and/or neural reorg. Dance, gymnastics, trampoline, Wii Cheer, pogo stick, a dance mat, a punching bag. "Back-door" the recognition of where the limbs are by requiring that knowledge in order to succeed at something she wants. Don't need to use the word "feel", but will need to encourage her to keep at it. She's had a lot of physical growth over the past few years. This is disorienting to anyone. I think you need to avoid the word "feel", as that probably triggers her. "Which hand is it in?" "Is it light or heavy?" "Which hand is hotter?" "Which foot is higher?"...

Anonymous said...

Recognizing emotional feeling would come after recognition of physical needs (think of the hierarchy of needs). Parents of small kids learn their kid's signs of sleepiness (rubbing eyes, grumpy) and then tell the kid "you are sleepy". I suggest imposing a routine on sleep / wake and eating, explaining why = physical health, also some mood control. Then you as external observer can say "I know your bedtime is 10 pm, but your eyes are droopy and you are mindlessly eating crap food, so that means your body is tired. You need to go to bed now." Just like with a toddler, it teaches her the physical symptoms.
It wouldn't hurt to put into words her obvious emotions "I think you are frustrated. You yelled and slammed the door after I told you that you couldn't have something. I'd be frustrated too." Note that I am explicitly avoiding the word "feel" as it seems to trigger her. Once triggered, she won't hear what you are saying.