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!

Wednesday, January 30, 2013

Finding the joy





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's what helped me:



1.  Understanding why they act the way they do.  
It helps me a lot to know that it's not personal or malicious.  It helped to understand that my son is a scared little boy acting out of fear.  A lot of times with my daughter I repeat my mantra, "She's only 6.  She's only 6.  She's only 6!" (Chronologically she's 17, but emotionally she's only 6). 
Why Won't My Child Just Behave?


2.  Lower my expectations.  
REALLY lower them.  Quit waiting for _______ to happen before I do _____________.   Stop expecting them to grow up and change, or be able to do all but the most basic of tasks.  I found I was mad at her for constantly demanding the privileges of a teen, but not being able to consistently do chores or other responsibilities.  I wanted to punish her and take everything away (special events, toys, my affection...). I finally realized that I had to forgive her, and let her know that I will no longer be expecting her to meet typical teen responsibilities nor will I continuously justify why she doesn't get typical teen privileges.  
Therapeutic Parenting Based on Emotional/ Developmental Age 
Explaining Age Appropriate Parenting To Your Child


3. Redefine Success. 
Like many moms, success for my children meant college, finding a career they loved and that supported them in a lifestyle similar to what they have now, finding true love, getting married, living near me (but not with me!), having children... preferably in this order!  Basically living "happily ever after." When I realized that this was not the path Bear and Kitty were on, or even capable of, I grieved. A lot. Then I took a deep breath and redefined success for each of my children individually.


  • Bear may never be capable of living in an unstructured environment and having a long-term relationship with anyone (employers, friends, girlfriends...), BUT he has found a structured environment that works for him (even though prison is definitely not what I'd hoped for him), and he got there without violence.  He graduated from high school, and college would not be helpful to him with the lifestyle he needs to survive. 
  • Kitty may never be capable of living independently, but she is happy living with us and has the option of living with her biofamily if she chooses to try independence.  If she lives with biofamily then her SSI money will be enough that she can live mostly independently (something she can't afford to do where we live because the cost of living is much higher). As long as she has someone willing to help her she should be OK.
  • Bob and Ponito are on the path I dreamed of for all of my children, but if/when they step off that path that will be OK too.

4. Grieve
Give myself permission to grieve for the loss of the children I had dreamed about, planned for, and the lives they should have had. If you haven't read the story Welcome to Holland, I strongly suggest taking a minute and doing so.


5.  Therapy and meds.  
I'm mildly bipolar and I've definitely suffered from PTSD.  I don't take meds all the time, but when I need to I take them.  I saw a therapist who specialized in trauma and did some EMDR therapy to help with the PTSD.  Learning about my own issues, including my own Adult Attachment Disorder, and accepting and dealing with them has helped a lot too.
Self-Care! Caring for The Caregiver


6.  Date night/ respite with someone who "gets it."  
We are incredibly blessed that my mom, who mostly "gets it," takes the kids overnight almost every Saturday night, keeping them through church ad=nd Sunday School the next day.  Honestly, Hubby and I rarely do much more than rent a movie and go to bed together, but it's a chance to recharge our batteries and remember that eventually the children will grow up and leave home, but our marriage, and each other, will still be there, but only if we prioritize our relationship.
Getting Respite
How We Keep Our Marriage Strong


7.  Discovered my Love Language.  
This was huge for me.  Knowing what I need (Words of Affirmation), made it possible for me to focus on getting it.  I tried to teach my family to give me what I need, and they do their best, but they are overwhelmed too and of course, some of them are RAD!  Hubby is the son of a "strong, silent type", I think my father-in-law said maybe a sentence a year to me, and while Hubby's not that bad, and is a really good listener, Words of Affirmation is definitely not his strong suit.  I went outside my overwhelmed family to get what I needed.  I went to the internet, wrote and read blogs, found support groups, went to seminars and trainings... I also helped and mentored others.  It made me feel good about myself, and they gave me the words of affirmation that I needed.
The Five Love Languages



8.  Set limits.  
Once I knew what I needed, I stopped giving so much that I had nothing left.  I’ve always been a rescuer, giving even beyond what I could afford to lose.   I had learned the hard way to stop doing it with others but had felt that shouldn’t apply to children, especially MY children.   I soon found that the kids not only NEEDED the structure and boundaries I set by saying “No,” but they also did better with them – they felt safe which allowed them to trust enough to feel loved.  (I strongly recommend reading the book, Stop Walking on Eggshells!  The first half helped me with empathy, but the second half gave great practical advice in setting boundaries.)   "Saying "no" is not being negative.  Negative is saying "yes" to things that are destroying you."  
Why Doesn't My Child Feel Safe?
Prioritizing Yourself, Your Marriage, Your Family, and Your Child - In That Order!


9. Find Support from people who "get it." 
You Are Not Alone!! It really helped to have the validation of others, and I sought it out constantly for a long time, before I finally felt OK about this path. I found a forum for those who had adopted special needs children and through that made friends in the blogging community (Life in the Grateful House and Welcome to My Brain), joined a local adoption support group (COAC), then BeTA (Beyond Trauma and Attachment), and finally Facebook groups. Now I admin a FB group called Parenting Attachment Challenged Children and try to help others. This is a good post reminding us that we are an AMAZING PARENT!

10.  Choose joy.  
Every day I try to focus on the positives.  It's hard as heck, but it is important.  I vent, but I try to limit it to a maximum of 3 vents, even less if I can.  I needed lots of validation that what I was doing was the right thing.  Over time, I eventually began to believe it, and that makes me feel better about myself.

I look back at the Godincidences (kind of like reviewing my blessings) that came out of what frequently seemed like tragedies at the time.  I try to focus on how many of these “tragedies” have made me a stronger, better person.  Most importantly, I focus on the positives and Choose Joy , like the little old lady in the nursing home.


A 92-year-old, petite, poised, and proud lady, who is fully dressed each morning by eight o'clock, with her hair fashionably coifed and makeup perfectly applied, even though she is legally blind, moved to a nursing home today. Her husband of 70 years recently passed away, making the move necessary.
After many hours of waiting patiently in the lobby of the nursing home, she smiled sweetly when told her room was ready.
As she maneuvered her walker to the elevator, I provided a visual description of her tiny room, including the eyelet sheets that had been hung on her window. "I love it," she stated with the enthusiasm of an eight-year-old having just been presented with a new puppy.
"Mrs. Jones, you haven't seen the room ... just wait."
"That doesn't have anything to do with it," she replied.
"Happiness is something you decide on ahead of time. Whether I like my room or not doesn't depend on how the furniture is arranged... it's how I arrange my mind. I already decided to love it. It's a decision I make every morning when I wake up. I have a choice; I can spend the day in bed recounting the difficulty I have with the parts of my body that no longer work, or get out of bed and be thankful for the ones that do."
"Each day is a gift, and as long as my eyes open, I'll focus on the new day and all the happy memories I've stored away ... just for this time in my life. Old age is like a bank account ... you withdraw from what you've put in. So, my advice to you would be to deposit a lot of happiness in the bank account of memories.
Her five simple rules to be happy:
1. Free your heart from hatred.
2. Free your mind from worries.
3. Live simply.
4. Give more.
5. Expect less."
Not easy, but Wonderful Advice....for all of us.

An amazing post about not letting grief steal your days, and one way a woman keeps mourning about the lives her RAD children could/should have had from stealing the joy in her life.

Grateful Journal - I know several people who post a "grateful journal." Every day, they write down what they're grateful for. It helps them focus on the positives, even when the negatives are overwhelming.


Related image11. Forgive myself.
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. Sometimes more than I should.

Yet one of my children did not heal.

Deep down, I felt guilty about this. I knew I had never really emotionally bonded to this child. In fact, I didn'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?

The answer is I'm a great mom! I'm doing the best I can under extremely stressful circumstances and I know you are too. Continuous Traumatic Stress 

Judging myself is not healthy. Allowing other's judgment and shaming to affect me is not healthy. 

I'm not perfect. Who is?! 
I make mistakes. Often!
I'm human. 

Looking back, I can see a million things I could have done differently. There are a ton of "If only"s in my life. The reality is that hindsight is 20/20.

I try to remember to treat myself as kindly as I do the other parents I mentor. 

12. You Have Not Failed!
In my case, for one of my children, healing did not happen. Whenever I start to feel guilty about being unable to heal him, I reread this post - You Have Not Failed

Unconditional Caregiving
In a seminar, one of my favorite RAD Gurus, Katharine Leslie, brought up these points about parenting a child with unhealed RAD (who was therefore not capable of returning any love or affection):


  • There cannot be a Secure Attachment when: The parent receives little or no positive response from the child, and often the child is neglectful of and abusive to the parent. Without either one's needs being met, and unable to "exit" the relationship, there can be little to no feelings of attachment (leaving resentment and apathy).
  • Providing unconditional love to a child without getting anything in return will make you physically and emotionally ill. (If this were a stranger or a celebrity it would be called stalking!). Instead we should practice unconditional caregivingRelationships 
Loving someone who doesn't love you back is not healthy. Despite what society says, not feeling attached to an unattached child doesn't make you a bad parent. Being expected to love your abuser is crazy. In fact, if this child were an adult significant other with the same abusive behaviors, society would be telling you to leave immediately.


My job as a therapeutic parent is not to love this child unconditionally, but to help my child learn how to be in a relationship
Once that happens, if that happens, THEN we can develop a loving relationship.


13. Ignore the "Should"-ers
Not only did everyone try to tell me what I was doing wrong but what they told me conflicted with the next person who thought they knew how to handle it (more discipline, less discipline, be more laid back, you're a helicopter parent, you're overbearing, focus all your attention on this child and he/she will be healed, boys will be boys, my neighbor's nephew's barber did __________ and his child was fine...). 

The worst part was that I was desperate to find a solution to "fix" my kids and I tried just about everything they told me I "should" be doing. I finally started to have faith in what worked for us, even though I was still told constantly that we were doing it wrong.

Why they Act Differently When They're Away From Home

My kids have what I call "Charming RAD" officially known as Disinhibited RAD. That means for my daughter, that she would literally rather die than let others see that they are not perfect --- because it feels like life or death to them.


Prioritizing Yourself, Your Marriage, Your Family, and Your Child - In That Order!

We have to remember that the "should"ers are only focused on the one child. 

  • They don't care about your needs or the needs of your family as a whole. 
  • They work with your child at most 8 hours a day and then go home to their own lives.
  • They are focused on the short-term and are not thinking of your child's future. Once your child moves out of their classroom, graduates high school, is no longer on their caseload... he/ she is no longer their problem. 
  • Most of them have no knowledge of your child's full range of issues and how they interact with each other. They focus on the one part of your child's issues that they have knowledge of and experience with. Yes, children with learning issues can do well in mainstream classes, but when you add trauma, processing issues, depression, brain injuries... Overlapping Diagnoses in Children 
  • They don't know what works with YOUR child. Even if they have tons of experience with kids "exactly" like your child (yeah, right!). What works for other children may not work with yours. My two adopted children are biologically half-siblings less than 2 years apart in age. They have almost identical diagnoses. Yet they require different types of parenting! What works for one may not work for the other.  Therapeutic Parenting, Structure and Caring Support, Level System vs Age-Appropriate Parenting, Using FAIR Club with Kids of Trauma... 


These are some things that helped me - 

Dear Adoptive Parents walking the hard, hellish, lonely road of trauma…THIS POST IS FOR YOU. And ONLY YOU.

Why Do They Act Like That? (If You Find Out I'm Not Perfect, You'll Leave)

Structure and Caring Support


New School Year LetterI give this to teachers to give them some understanding of my child and how to help them. It also establishes that I'm a concerned and caring parent (hopefully) before they decide I'm a bad parent who "should" be doing ______.


Tuesday, January 22, 2013

Why do adopted kids go back to birth families?

On a support board, a lot of us adoptive moms are dealing with newly adult children who are going back to biofamily... with some pretty severe consequences as the children discover that most of the reasons they ended up needing adoption in the first place.  One of the ladies asked WHY the kids go back to birth family.  My situation is a little different in that my children were not removed from the home for abuse and/or neglect, but were placed in foster care by biomom, for a lot of reasons I choose not to go into here.  The reality is though that my kids still FEEL the same way that kids who have been removed feel - abandoned, unwanted and unlovable.

Here's my response to: Why Do Adopted Kids Go Back to Birth Families?


1.  The biggest is that they want to negate the rejection/ abandonment.  They don't want to believe that the family didn't want them, because that means the child is unworthy and unlovable.  Going back "proves" that their family really loves them.

2.  Extreme denial.  My kids can dissociate from reality, and distort it to the extent that they rewrite history, and BELIEVE the new version.  They don't remember, or want to remember, the real past - good, bad and everything in between.

3.  My children have very black and white thinking.  People are either evil or on a pedestal.  The kids literally don't see the shades of grey that describes all humanity.  Most people are wonderful, caring, supportive, relationship possibilities (best friend, girlfriend, new mom..)... until Bear or Kitty flips a switch and ALL they can see is the person's flaws.  My son is especially bad about this.  He goes through girls like Kleenex, discarding them when they show the tiniest sign of imperfection (I believe my son thinks that love means they are instantly and totally devoted to him, anything less and he's afraid they will abandon him, so at the first sign of independence, he rejects them before they reject him) or they get too close (and he runs before they can see his flaws and reject him).

The kids have idealized many members of biofamily, and literally don't remember any of their flaws.  When Bear went to live with his bio Grandpa, real life quickly took over, BioGrandpa became human (worse, a human who had some authority over Bear), and Bear couldn't accept that.  In less than 6 weeks, he was ready to move on.

4.  Escape.   "My adoptive parents and everyone else are the reason things aren't going right.  If I can get away from them then my life will be perfect."  Hubby and I tell our kids that they have to work on their issues instead of running away from them, because the issues are inside of them, and will follow them everywhere.  They don't want to believe us.

Obviously these characteristics are all linked to each other.  


5.  One thing I firmly believe is one should never criticize bio family to the children, something I learned from my mother, who never criticized my father in front of me, despite a nasty divorce.  Knowing my children are idealizing their bio family doesn't change my belief, but it is a little frustrating to know that my lack of reality checks makes some of their fantasies possible.


I think they want to go back to biofamily to live the fairy tale/ fantasy they have used to escape over the years.  That little Orphan Annie reality that my "real family" is perfect, rich, will never make me do chores or be held accountable for anything I do (not that I'll do anything wrong, because it was everyone else's fault)...

We have to let them go.

It's hard, but I think we have to let our kids know that we understand this desire to reconnect with birthfamily, and let them go. I tried to make it very clear to my children that the door was always open... as long as they understood that the house rules haven't changed.

When the reality sinks in, a lot of these kids will come home.

Unfortunately they usually come home with the results of living this other life style:
pregnancy, drug addiction, off their meds, criminal records, health issues... feeling entitled to the freedoms they enjoyed (and suffered from).

For some children, the grass is always greener on the other side of the fence - no matter which side of the fence they are on. We ran in to this with Kitty. Her perception of reality means the instant she walked away her memory of the other place become even more black and white. She instantly forgot all the good stuff (or bad stuff). When she lived here at home, she longed for the "freedom" of having no rules and structure - being treated like an "adult," without the responsibilities and accountability of  actually being one. When she was living with biofamily, she longed for the calm, supportive, loving environment (and the luxuries) of home.

Your decision is whether or not to let your child come back home - knowing they will bring this new baggage and possibly see your home as a revolving door or a way station.

We let our children know that very little has changed. They are expected to come home to mostly the same structure as when they left. If they can't follow the rules, then they will not come home. For our son in prison, he will need to go to a halfway house and get stable on his meds before we would even consider allowing him to come home.

It's not easy watching our children self-destruct, but I have to hope that when they get older and their brain is fully developed (about 25 years old?), that they will be happy, functioning citizens capable of healthy relationships with as few permanent scars as possible.

NOTE: When our kids approach times of transition (graduation, turning 18, moving out...) they tend to stress out and act out. This is a defense mechanism to distance themselves from us to try to make it hurt less. I try to remind myself of this, when mine are lashing out at me. 

More on Contact with Birth Family.

Monday, January 21, 2013

Bear Update



Bear will be accepting a... OK, I don't know what you call it.  A plea bargain I guess.  It's not ideal, but it's probably for the best under the circumstances.  He was a little confused, and I'll probably get this wrong, but basically he got 25 years.  5 in prison and 20 probation.  He only has to serve 15% of his sentence in jail (don't check my math... I got the numbers from him!).  When he signs the acceptance/ agreement next month, he'll have been in jail about 7 months.  He says because of his good behavior that counts double so he'll have technically already served over a year of his sentence. He thinks that means he only needs to serve about 9 months total.

When he signs the acceptance, he'll go through a medical intake at a hospital for 1-2 weeks (apparently all new inmates go through this).  At which point he'll finally receive a psychological evaluation and we assume get put on meds.  Depending on how fast the system moves, when the eval is done, he'll have been in the system for about 8 months.  Since he only needs to serve about 9 months, he and the system will have a choice at this point.

  • If it's only a couple of weeks until his time is up, they might just release him and add the missing time to his probation.  
  • He can serve the remainder of the 9 months in prison.  
  • He can go to boot camp, which is 6 months long, and the "extra" time will be reduced from his probation.
He's vacillating between completing the time in prison and getting it over with, and going to boot camp.  He thinks boot camp might look better than hard time (not sure to whom), but at the same time he's worried that he might get into trouble at boot camp (which is young adult offenders).

When he gets out he believes he'll be able to transfer his probation to another state, and he plans to go "home."  I had to ask him where home was.  I'll be honest, it hurt a little to have to ask.  Home is with his bio grandmother in Nebraska.  I'm OK with that.  

I did mention he might want to think about going to boot camp so he'd have more time to get stable on his meds before he goes to live with family, so he doesn't damage his relationship with them.  At that point in the conversation he was saying he didn't want to go to boot camp.  Maybe that will change down the road.  I think he'd benefit from the extra activity and extra time to get stable, but I can't make him.

I hope it works out the way he wants it to.  I'm really glad he'll be getting medical treatment soon.  After he's released, "someone" will help him get signed up for SSI benefits, and it sounds like he'll be willing to try to get therapy and plans to stay on his meds.

Thursday, January 17, 2013

Books and Methods - Food/ Hoarding/ Diet


Atypical eating behaviors are common, especially in children with severe neglect and attachment problems.  

Many of our kids have food triggers (especially if there has been a time in their life when they didn't have enough food), emotional eating, depression, anxiety... and the child can develop significant eating and body image issues. They may hoard food, hide food in their rooms, eat as if there will be no more meals--even if they have had years of consistently available foods.  They may have failure-to-thrive, rumination (throwing up food), refuse to eat, swallowing problems, and, later in life, unusual eating behaviors that are often misdiagnosed as anorexia nervosa.




My Child Doesn't Remember the Neglect as an Infant, But His Body Does by Foster2Forever

My son doesn’t have a memory of being hungry as an infant, but his brain does. That baby’s developing brain was hard-wired with a terrifying memory of being hungry, not knowing when he would be fed, and believing he was going to die!
The fear response of fight, flight or freeze would kick in – and my baby would fight! – the only way he could as an infant – by screaming. As he got older, his fear response from hunger escalated from screaming to actual fighting!

Attachment and Eating Disorders (ED) - 

"Research indicates that higher levels of attachment anxiety increase risk for severe ED manifestations and adverse treatment outcomes." ~A Place for Eating Disorders within Attachment Theory’s Frame Kelsey N. Wallour, BSFCS

Avoidant Attachment

Primary caregivers of children with an avoidant/ dismissive attachment tended to be emotionally unavailable or unresponsive to them a good deal of the time. This child can develop a feeling that they have no value and expects that they will be rejected and their needs neglected. They may learn to "shut down" their emotions and ignore their needs. Their interactions with food may also be avoidant in nature. Their issues with food may come from an overwhelming desire to elude emotions and feelings of fullness. This might lead to issues with anorexia nervosa.
 (This study mentions that adult patients with this type of ED may not do well in group therapy, but have enormous potential for personal reflective functioning and awareness).

{When Kitty first came to us, we found that some of Kitty's "anorexic" tendencies improved dramatically as she became more attached and allowed herself to feel again. Both her physical and emotional feelings returned and once the dissociations improved, I think she started realizing that she was hungry (or constipated, or had food on her face, or needed to go to the bathroom...).}


Anxious Attachment

The anxious/ ambivalent child’s caregivers were often unreliable and unpredictable. These children may come across as “needy” because they seek constant validation from others. Instead of dissociating from their needs, they constantly mull over their past experiences and memories which keeps them "agitated" and self-focused. They often have difficulty recognizing the needs and emotions/ effects of others. Because they are highly dependent on external sources such as society and peers, the extreme fear of rejection from others worsens their desperate need for approval and high body dissatisfaction.

Anxious attachment patterns are more likely to lead to bulimic symptoms or binge eating disorders, because of their issues with interacting with others and their relationship with food. Their hyperactive/ hypervigilant awareness of stress can lead to a high state of reactivity. Their attempts at coping and self-soothing might be bingeing or engaging in the binge-purge cycle.

(This study recommends group therapy in a safe and validating environment for its adult patients with this type of ED).


Attachment Parenting/ Therapy

Dr. Karen Purvis, Ph.D. of TCU, author of The Connected Child, believes there is a strong connection between nutrition and healing the "kids from hard places."  She lists resources on her website:  

http://www.child.tcu.edu/resources.asp http://empoweredtoconnect.org/ 

http://www.child.tcu.edu/Resources/Resources_Topics_Neurotransmitters.htm 

http://findarticles.com/p/articles/mi_m0ISW/is_282/ai_n19170309 empoweredtoconnect.com

http://adoptionnutrition.org/


Control Issues -

Oftentimes, trauma issues can lead to anxiety and control issues. Eating (or not eating) can be one of the few things our children feel they have control over. 

"Strictly regulating {their own} food and body weight offers a small sphere of control for people who otherwise feel out of control. When this is the case, unintentional weight gain may lead to thoughts of 'I’m losing control' instead of 'I’m fat.'"


Geraud said it’s common for eating disorders, substance abuse and mood disorders such as depression or anxiety to coexist.
“There are often pre-existing anxiety disorders in people who develop eating disorders, especially as children.” 
"Children tend to think in very concrete terms, and when they have anxiety or other uncomfortable emotions and feel the accompanying physical sensations in their body, they may think that if they can change or control their body, they can prevent those emotions and feelings. Alcohol or drugs might be used for the same purpose." ~Lisa Geraud, senior clinical director at The Moore Center in Bellevue
Not Feeling SafeSometimes food issues occur because the child doesn't feel safe and food is often one of the few things they feel they can control. Ironically, when they have the control, instead of the adults, then they get more afraid and things cycle even farther out of control.
If the child feels that they are in control instead of us then their world is not SAFE.
Just like our kids keep using old defense mechanisms that are no longer needed, our kids often get stuck in the feeling that they are not safe. 


This is a life or death feeling! 

Feeling unsafe is not rational. You can't explain to the child that they're safe now. Logic doesn't work. Feelings of being unsafe can pop up at the most unexpected times, like a PTSD flashback. Generally, this feeling of being unsafe will fade as our child heals, but there will probably always be times when it comes up again. 

A child who feels unsafe is a scared child. An insecure, scared child behaves in increasingly bizarre and scary ways to get control of their world. 



Food Hoarding  - 

Trauma and Food Hoarding -

"Food hoarding is a common issue displayed by foster-adoptive children. Food hoarding can be central in a child’s world and resistant to change. Additionally, hoarding food behavior can bedevil and bewilder parents.

So why does a child hoard food? 

Often food hoarding is directly connected to significant neglect that the child has experienced in consistently having their basic needs for life-sustaining food denied or inadequately met. As a result, the child is forced to become prematurely self-reliant in meeting their own basic needs. 

For example, in a situation where the parent is chemically dependent resulting in inconsistency in providing and having food available, it would be reasonable that when food is available that a child would view this as an opportunity. It would be logical that a “survival mentality” would be for the child to respond to the availability of food in self-reliant ways which could include over-eating and hoarding food in secretive ways. In neglectful situations, food hoarding is a wise alternative to ongoing food deprivation."




Emotional Eating - 

Trauma and Weight Gain -

Emotional trauma is a very painful experience that can lead to weeks, months and even years of emotional distress. People will turn to a variety of things to help them cope with their intense feelings relating to the trauma. For some people, food becomes a source of comfort as they try to — literally — push down their feelings with food. Trauma and weight gain go hand in hand when the person suffering begins to emotionally eat. Sometimes this emotional eating, combined with the mental effects of the traumatic event, can lead to a serious eating disorder known as compulsive overeating.


Human Connection — Our kids often crave sugary, comfort foods to fill the gaps in human connections. Why Comfort Food Comforts.
Marythemom:  Caregivers also frequently emotionally eat - we use comfort foods as a substitute for the love our children cannot provide.  The average RAD mom gains 10-15lbs a year working with a RAD child.
I cannot recommend SELF-CARE! highly enough for parents with kids with trauma issues. 

Distraction/ Dissociation — A way of changing the subject or avoiding dealing with a trauma-triggering issue.


Marythemom: When my daughter was having a particularly rough therapy session she would often try to dissociate (flight/ escape) using food. She would suddenly feel like she was "starving" and her focus would become all about her wanting to leave and go to McDonald's, effectively ending the session. When she gets upset she still turns to food. I often mention to her that this feeling is based on her emotions, not actual hunger, and sometimes I can get her to recognize it.




Medications
Making changes in medications.

Side effects of many medications often include an increase or decrease in appetite. Many stimulant ADHD meds decrease the appetite. Many anti-depressants increase appetite. Anti-anxiety medications can reduce a child's issues with appetite.


Fetal Alcohol Spectrum Disorders (FASD)/ Prenatal Alcohol Exposure (PAE) - Inappropriate Feeding Behaviors and Dietary Intakes in Children with FASD or Probable PAE
Abnormal eating patterns are common in children with FASD/PAE and may contribute to their delayed growth and nutritional inadequacies. Their poor satiety may reflect poor self-regulation and impulse control. Damaged self-regulation could cause the feeling that they are not full which can cause them to increase feeding behaviors. 

ConstipationMany medications can cause constipation, diarrhea, and other gastric distresses. Often leading to issues with food.

Constipation is common in children with FASD/ PAE and could reflect low dietary fiber or altered gastrointestinal function. 

Nutritional Deficiencies
Exploratory data suggest that children with PAE may be at risk for nutritional deficiencies, which are influenced by inappropriate food preferences (cravings), disordered eating patterns, medication use, and the stressful dynamics surrounding food preparation and mealtime. 


PicaPica is a compulsive eating disorder in which people eat nonfood items. Dirt, clay, and flaking paint are the most common items eaten. Less common items include glue, hair, cigarette ashes, and feces. The disorder is more common in children, affecting 10% to 30% of young children ages 1 to 6. It can also occur in children and adults with intellectual and developmental disabilities, such as autism. On rare occasions, pregnant women crave strange, nonfood items. For these women, pica often involves eating dirt and may be related to an iron and zinc deficiency. 

The Addictive Brain - 
Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It's how we get our satisfaction. If we can't connect with each other, we will connect with anything we can find -- the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about 'addiction' altogether, and instead call it 'bonding.' A heroin addict has bonded with heroin because she couldn't bond as fully with anything else.
So the opposite of addiction is not sobriety. It is human connection.
Marythemom - My son has an "addictive brain." We've seen evidence of it for years, and knew it wasn't the drugs themselves because the addiction shifted often and he could stop seemingly cold turkey (drugs, alcohol, tobacco, but also sugar, sex, adrenaline, chaos...). A large part of this is because of his attachment issues - the (in)ability to make human connections. 


Endorphins  — 

Your brain naturally produces these neurotransmitters in response to pain or extreme exertion to take the edge off and generally make you feel amazing. Really amazing. Experts actually compare endorphins to opiates because they deliver such intense pleasure, says psychologist Elizabeth Lombardo, Ph.D., M.S., author of A Happy You: Your Ultimate Prescription for Happiness.


Anorexia Nervosa --
"An eating disorder is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape. A person with an eating disorder may diet, exercise, or eats excessively, which can have life-threatening or even fatal consequences." -- Anxiety and Depression Association of America

"Anorexia is characterized by weight loss or failure to gain weight appropriately (in children). Individuals with anorexia often demonstrate a distorted body image, in which they see themselves as larger than they really are. They often engage in restrictive behaviors, purging behaviors, and excessive exercise. When family and friends start to worry, people with anorexia often try to hide their behaviors.

Anorexia is a serious mental illness with possible life-threatening outcomes. Anorexia has the highest mortality rate of any psychiatric disorder. Half of the deaths in anorexia are due to complications related to the disorder and the other half is due to suicide. The majority of individuals with anorexia are female. However, the prevalence is increasing in males and the transgender population.
In the past families and society were blamed for causing eating disorders. As we have developed a better understanding of eating disorders, we now realize that eating disorders are biologically-based disorders. "
-- Alsana 

Treatments

Treating Anxiety/ Depression - Eating disorders commonly co-occur with anxiety disorders. For those who have an anxiety disorder, a co-occurring eating disorder may make their symptoms worse and recovery more difficult. It’s essential to be treated for both disorders. 
Neurodevelopmental model of etiology for anorexia and other eating disorders. This model states that eating disorders develop as the result of a genetic and neurobiological predisposition triggered by dieting behavior. The eating disorder is then maintained based on the functions that it serves (e.g., emotion regulation, fear avoidance, neurobiological homeostasis). 

Culinary TherapyMany cooks know what a sanctuary the kitchen can be. Now, some health-care clinics and counselors are using cooking or baking as culinary therapy tools for people suffering from depression, anxiety, and other mental-health problems.


The courses are often partly aimed at teaching healthy cooking and eating skills to people living tough, chaotic lives. In addition, clinical counselors say culinary therapy also soothes stress, builds self-esteem, and curbs negative thinking by focusing the mind on following a recipe. Often, the courses are part of a larger treatment plan that also includes talk therapy or medication.

Medication - Treating underlying anxiety or depression with medication can help alleviate anorexic symptoms.
{Our son showed signs of anorexia (which runs in families). An anti-anxiety medication helped alleviate some of his symptoms.}

Nutrition Dense Foods

Interventions

We want to avoid drawing battle lines around food!

As with all behavior and emotional challenges, a child’s special needs and individual circumstances should be considered when designing interventions. Additionally, professional therapeutic assistance can offer help in the assessment and treatment of food issues. In an effort to understand the function of food issues, the following questions can assist in a parent’s understanding of their child’s food issues.


  • Could there be psychiatric or medical/biological issues contributing to the food issue?
  • Does the child’s history reveal reasons for fixation on eating/hoarding?
  • Does the child substitute a food fixation for a loving relationship with parents?
  • Are there things that trigger eating problems in the child?
  • Is the child displaying an emotional neediness in the way they eat?

How To Get Your Child To Eat When He Refuses 
Sometimes, there is a disconnect between how much the parents think their child should eat, and what is normal and appropriate for the child’s age. Remember, young children eat small volumes of food compared to kids and adults. Bowlfuls of food for baby, or medium-size portions of different food groups at one sitting for the toddler may overdo it and exceed their nutritional requirements. If you think your child isn’t eating enough, do a quick check of his growth chart and refer to the food portions that are appropriate for your child’s age. 


It’s not your job to get your child to eat {or not eat}.

But, there are important aspects around feeding your child that are part of your job.

  • Your job is to set up a positive environment at mealtime so that your child enjoys coming to the table.
  • Your job is to create eating opportunities several times each day, based on your child’s age, so that he can meet his appetite and nutritional needs.
  • Your job is to select, cook and assemble a well-balanced meal that is tasty and has eye-appeal.
  • Your job is to help your child eat if he truly needs it, but simultaneously be hands off and let your child explore food on his own.
  • Your job is to respect your child when he says he’s done.


After that, you’re done. It’s all up to your child to do the job of eating at that point.

Refusal is a Rite of Passage for Young Children - Saying “no” is an act of independence for many children. A way to differentiate themselves, have a voice, and initiate their autonomy. Each child, I believe, has the right to say no. And that goes for eating food, too.

What making your child eat may do, however, is erode the trust he has in you as an unconditionally loving and supportive human being (ahem, a parent), while potentially damaging or delaying his developing relationship with food (and you).

Ways to increase endorphins (besides food):


Attachment: 
Focus on increasing attachment. Here's some ideas - The Attachment Challenge
10-20-10 Each day, look for three moments of connection with your children.
     -10 minutes of closeness in the morning
     -20 minutes of closeness when you get home
     -10 minutes of closeness at bedtime

Exercise:

Not just running. Working out stresses your system, so your brain pumps out endorphins to cope.

Work out together:

In addition to being good bonding/ attachment activity, a small British study found that athletes who rowed together could tolerate twice as much pain (a sign that endorphins are present) as athletes who rowed alone. Working out with others can improve your endorphin flow.

LOL!
When you get a case of the giggles, your body releases endorphins that increase your pain threshold. So go ahead, laugh until it hurts.

Play!

Not only does playing with your child increase attachment - PACE (Playfulness, Acceptance, Curiosity, Empathy), but it's good for you as well! Don't forget to Play!


Kids live for when their parents step outside their comfort zone to join them in something fun.
Children with a history of trauma desperately need to play every single day. It is one of the ways they heal (write that one on your bathroom mirror and read it every morning). That is an area where I was painfully misguided when I first started therapeutic parenting. I took a stance of expecting them to EARN their play (AND I WAS WRONG!).
Now I know better, so I do better. -Christine Moers, Welcome to my Brain 
Make music:
Your brain spews out even more endorphins when you actively take part in creating music. If you're not a classically trained musician (just guessing here), tap, hum, or dance along to your favorite tunes. The sillier the better (laughing increases endorphins).

Eat hot peppers: 

Even if you love the taste of spicy foods, your body senses the heat and responds the same way it responds to pain. Enter, endorphins! Just be careful with this one - forcing a child to eat hot peppers (or anything) can be considered abusive.

Lavender:

Spritz lavender on your pillow everywhere. In a 2012 study published in the Journal of Caring Sciences, women who sniffed lavender essence reported less anxiety than women who sniffed a placebo. The study authors say aromatherapy makes nerve cells release a mix of neurotransmitters, including (You guessed it!) endorphins.

Acupuncture:

Why would anyone in their right mind want to be repeatedly poked with needles? Research suggests the pain sends a message straight to the brain, which releases endorphins as a remedy. 
I'm not sure how well this would work with kids with trauma/ attachment issues. 

ADHD:
A study took a group of children with ADHD, half of whom were on Ritalin and the other half did 20 minutes of exercise every morning that "bounced" their brains in an up and down manner (like jogging or trampolines). Both sets of children were sent to school and the teachers could not tell the difference! The exercise lasts a little less time than the medicine, but you can always repeat!


Interventions focused on neglect-based food hoarding:

It is important to understand how the child’s food issues impact you as a parent. Become aware of your own food issues and explore if they influence your ability or willingness to look at the child’s problem with an open mind and creative flexibility. Also, study yourself to determine if the child’s food hoarding personally threatens your role as a provider/nurturer.


Attachment Therapy:

When children feel safer {Why Doesn't My Child Feel Safe?} the fear causing the hoarding behaviors decreases and therefore the behavior decreases.

Food Baskets/ Snack Cabinets:

Provide food baskets/ snack cabinets in the home that incorporate the child’s input in creation and consist of snacks that are healthy and appealing to the child. The child should be told the food baskets will be re-filled and are a “better alternative” than hoarding. If the child hoards the food basket; set limits but do not discontinue. Some schools will also cooperate with food baskets; especially if the child is prone to take other student’s snacks.  (Can also use a fanny pack or cabinet/shelf full of appropriate foods.)

Alarms and Locks:
For children who hoard and/or gorge, sometimes we need to lock away foods. I firmly believe that if you use this option that you need to be sure the child always has access to some food (we had a cabinet that held food our children were allowed to eat at any time). This wasn't just

There were many times when I reached for something that I planned to use for dinner, only to find it half empty or gone. Special treats (or even a bag of sugar!) eaten or wasted. The school called occasionally to let me know my son was selling food to his friends again (once he brought an entire pumpkin pie to sell!). 

One time, a child's Halloween candy stash was eaten by another child because he decided it was her own fault for not hiding it well enough.
 



  •  
  • change out the doorknob to a walk-in pantry to one with a key lock
  • some chest freezers come with locks
  • we put a door alarm on the door to the garage where we had a second refrigerator 
  • small refrigerator that can be put in a room or closet that locks.
  • lock boxes - like office hanging file boxes which can even be used in a refrigerator (we also used these for meds that needed to be refrigerated)Master Lock Locking File Box
  • toolboxes and chests that can be locked
Backpacks:
When packing lunches for school or events, pack a “special container” of food that can be removed and is with the child. This provides a traveling sense of food security and food availability for the child.

"Super Snack Day" (suggested by an awesome Trauma Mama):

First thing in the morning, tell him, "Since I am such a super, awesome Mom, I have noticed how hungry you've been lately. So today I have 15 snacks ready for you! (Show him the pile of small! snacks you've prepared). When you feel hungry, just say 'Mom, may I please have a snack?' And I will say yes!" This removes the need for begging or whining for food. If the child doesn't say, "May I please have..." then he's probably letting you know he really doesn't want the snack, instead, this is more about being in control (fear and safety).

You stay strong in a loving way and redirect the child to something else. Fluctuate the number of snacks available each day until the child trusts that you really will always feed him/ her and have food available. I have found you have to surprise them sometimes with how amazing and generous you are (while still being in control)! Obviously, your goal is not to teach him to need 15 snacks a day, but rather how amazing and awesome his Mom is! :-)


Coupling nurturing with food:

Always positively reinforce any progress the child makes on hoarding behavior. If the child utilizes a food basket, nurture the child when they seek items from the food basket. Positively comment on how all family members are always fed. Weave this message into mealtimes and have this message commented on by various family members.

Some parents have the child request snacks, so the child equates the parent with meeting their needs.


Meal planning and cooking together: - this helps reduce some of the anxiety around food and increases nurturing and attachment at the same time. 

Teach food regulation:

If the child has a tendency to gorge, set a “food time out” after a complete meal is consumed. Make certain this applies to all family members. The goal is to assist the child in learning to experience a sense of “fullness”. The “food time out” should not be presented as denying food but rather delaying additional eating for a prescribed period of time. Describe how the physical sensation of “fullness” feels. Fifteen minutes, after the completion of a meal, is an estimate of the time before fullness will be experienced.

Posted Menu:

Knowing when the next meal/ snack is and what it is going to be can be extremely comforting to many kids. Plus, it allows you to not have to answer, "What's for dinner?" a thousand times a day. Also, it makes grocery store trips a little faster because you have a menu! ;) It also saves arguments about what to have for snack or desserts. "It's not on the list, Sweetie."

Letter Parties:
Giving the child some control over what he/she eats can encourage them to eat healthy foods with less pressure.

We used to have Letter parties when our kids were younger. It started as a way to help the kids learn their letters, but became a fun way to spend some time together - planning, shopping, preparing, and partying! It also helped when we got stuck in a rut with the kids complaining about everything I cooked.


These letter parties make planning meals a lot easier. The kids get involved and there was more thought to it than - "start a big pot of water boiling and I'll decide what to throw in it when I get home." We had very little leftovers too.

Medication:
There's a med used for alcohol and drug addiction that stops the cravings, Naltrexone (Vivitrol - a monthly shot of Naltrexone instead of a pill). If your child's issues are related to addictions, this might be worth speaking to a psychiatrist about it. Naltrexone could potentially be a game changer in terms of behaviors that stem from wanting food, stealing food, hoarding food, emotional eating...
{Marythemom: I haven't tried this, but it was recommended by a fellow trauma mama. It really worked for her son}


Document! Document!! Document!!!


One thing I HIGHLY recommend to any parent dealing with children of trauma is to DOCUMENT, DOCUMENT, DOCUMENT!! 

You've heard me say it before... I'll say it again, and again.  It has helped protect us (from false allegations among other things), get services for our children, refresh my memory of past issues (so I can see progress and make sure chronic issues get addressed), and track what interventions have worked and what haven't.


FALSE ALLEGATIONS
False allegations can be reported by outsiders looking in who don't understand therapeutic parenting techniques and/or how our children behave when out of sight of outsiders. Documentation can protect us from accusations of abuse by someone who is looking in at (judging) our life from the outside.  {Dear Person Who Just Doesn't Get It}


Our children are especially prone to false reporting for many reasons -

Distortion of Reality - One reason we deal with a lot is an actual distortion of the events in the child's mind (they remember the feelings and often associate it with things that happen in the past). We try to remind Kitty that her perception is off when she describes events that led up to a meltdown (she doesn't remember anything when she's in "fight/ flight/ freeze mode"). She'll say "Daddy was yelling at me," when all he said was, "Who left the butter out?" in a totally normal voice.


 "I was following the medical/ therapeutic advice of .... " and  then present them with your documentation!
"My child is under the care of a medical and/or therapeutic professional. (This "professional" could be you as the therapeutic parent by the way!)

Non- Trauma-related Food Issues

Marythemom:  Sometimes it's good to remember that just because our kids have one or more diagnoses, doesn't mean they might not have other reasons for their behaviors and issues too!  Allergies, foods, and meds have caused constipation, unusual reactions to medications, and behavior issues.  Some people find that changing diet can help alleviate some of these as well.  A gluten-free/ casein-free diet is often recommended, especially for children on the autism spectrum.  No red dyes, no processed foods, all raw foods, vegetarian, vegan... so many options!


Medications - 

Another common problem causing food issues for our kids is medications. Many kill the appetite (especially stimulants for ADHD), and some increase the appetite dramatically (many anti-depressants).

Anxiety and depression can cause serious food issues. Finding the correct medication can alleviate these symptoms.

For some medications, weight gain or loss in appetite can be a side effect. 
{Our daughter had been on stimulant ADHD meds which appeared to be contributing to her severe lack of appetite (she was very underweight). Over the summer, we stopped the ADHD med. We also added an anti-depressant. Our daughter gained 70lbs in 3 months! After seeing the rapid weight gain in the first month of that anti-depressant, we changed to a different one but had the same results. Changing her anti-depressant medication to an extended-release medication slowed/ stopped the rapid weight gain. Starting her on a non-stimulant ADHD med prevented the issues with appetite suppression.}



Nutrition/ Allergies/ Supplements

Diet can significantly impact the impaired brain. Neuroscience shows the limbic system is a hot spot for traumatized children (and stressed out parents).  When overused (typical for people dealing with stress/trauma) we can “burn out” the stress receptors.  Additionally, we often crave the food(s) to which we are most allergic/sensitive.

Marythemom:  Sometimes it's good to remember that just because our kids have one or more diagnoses, doesn't mean they might not have other reasons for their behaviors and issues too! {Overlapping Diagnoses in Children}



Kids with Food Allergies - Safe Eats® Allergy-Friendly Recipes! 
You can search to meet your special dietary needs, or you can browse by category. The "free of" boxes indicate that the recipe can be made without those allergens (it may require substitution to make the recipe safe for your particular needs).

Feingold diet.  http://feingold.org/

Dr. Bernui of Hendersonville, TN was one of the recommended practitioners in Jenny McCarty's 2007 book Louder than Words: A Mother's Journey in Healing Autism. He and other holistic practitioners are investigating nutrition and require much more lab work than what we may be used to.  http://www.restoreyou.net/index.php?tag=NFDTC2R1S.

Dr. Daniel Amen (publisher of SPECT scans of addicted and recovering) http://www.energypsychologycafe.com/healing/amen/gift.asp?id=9876
 

Gut and Psychology Syndrome - Dr. Natasha Campbell-McBride –  Gut and Psychology Syndrome (GAP Syndrome or GAPS) is a condition which establishes a connection between the functions of the digestive system and the brain. Describes how it develops and how to treat it effectively with a sound nutritional protocol. Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression, and schizophrenia.        Videos

Is This Your Child? By Doris Rapp - In this breakthrough book, Dr. Doris Rapp offers a simple yet effective approach to handling "problem" children. Is This Your Child? shows parents how to identify the common foods, chemicals, or common allergic substances that could be the culprits that cause some children or adults to feel unwell or act inappropriately. If your child is always sick, hyperactive, a slow learner, or cranky, the first question you should ask is not "What drug should be prescribed?" or "What have I done wrong as a parent?" Instead, find out the cause.

Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More by Dr. Katja Rowell - who is known as the feeding doctor. 


12 Reasons Your Child Won't Eat by Jill Castle, Childhood Nutrition Expert.



Our kids can be so complicated!!