Guess I'm still his Case Manager

Bear is almost 20yo and in jail in another state.  We talk to him (collect) once a week, send him letters, and send him a little money.  It changes weekly where he's going to go when he gets out (biofamily, independent - yea right, or back home with us - for us to help him find work and a place to live).  Most of the content of his letters to us is apologies for not listening to us at the end and getting into drugs and trouble.  The rest is asking me to give letters to friends (I often don't forward them because they're full of lies and I can't find the people he wants me to send them to him) and to get in touch with people and ask them to write him.

Lately his letters are full of how much he loves his ex-girlfriend and wants her back.  Bear's relationship pattern is that he meets a girl, immediately tells her he loves her (and expects the same), intense relationship and  expectations that no one can actually live up to.  He fully believes they will live happily ever after, and then the girl falls off her pedestal and Bear pushes her away.  He'd been engaged at least 3 times that I heard of before he turned 19 years old.  His average relationship lasted 3 weeks (hence the name "Kleenex girls" - because he goes through them like Kleenex), and he usually had a "Back-up girl" ready and waiting as soon as the relationship ends.  Occasionally he'd have a long-distance relationship that lasted a little longer (because he felt less pressure), but he was usually involved with someone local as well.

When he moved in with his biofamily, Bear had borrowed money from his local girlfriend's mother, had her give him a ride to the bus station, and left without telling her he wasn't planning on coming back.  She waited for weeks and weeks, with no word from him.  During those 6 weeks in the new state, he had at least 2 more "relationships" before he went to jail.  While in jail, he's put his local girlfriend back on a pedestal and idealized his relationship with her.  Now he wants her back and is thinking he'll marry her and live happily ever after.

All this I'm used to, although I do try to warn the girls if I can.  I have fully warned the local ex-girlfriend, but he can really pick them, and I don't think she believes me.

**********************************

Anyway, my problem now is listening to him vent about wanting to sue everyone and trying to get me to contact people for him.  The one time I did (to help him get back on his psychotropic meds), the jail admin threatened him and Bear fussed at me.  Not really something I feel like repeating.

Now he wants me to contact the ACLU and tell them that he and his fellow inmates are suffering from malnutrition (he says the evidence is in their fingernails) and aren't getting 2000 calories a day.  I looked into it, and the ACLU wants evidence that you've gone through proper channels first.  I found the right place to make the complaint, but they want names and contact information.  Bear has already made it clear that he doesn't want his name involved in this (he's in enough trouble), but if I give them my name, it will be pretty much a DUH! as to who made the complaint (how many people in this state would be complaining about jail conditions in another state.

Just going to print out the complaint form and ask him what he wants me to do about it.

****************

The kids have officially been accepted into their tribe.  Still have to figure out how I'm going to handle getting him a tribal card.  He thinks he can use it to get more services.

FAIR Club Exam and Probation - Repeat Offenders - EDITED!

Seven is on the low end of who the FAIR Club works for (they have to cognitively be able to handle it).  My guess is that her life is set up so that it is still too overwhelming.  

If a child continues to act out while in the FAIR Club, we usually just take this as a sign that:

1. They may not be ready for the FAIR Club.  A lot of kids of trauma are emotionally much younger than their chronological age.  The FAIR Club works best with kids who have enough cognitive and emotional skills and insight to learn from their mistakes.  That does NOT mean you shouldn't use it if your child is quite there yet, BUT be aware that for now you are "setting the groundwork," not making a whole lot of progress.  Like telling a 2 year old to "Use their words," they probably aren't old enough yet to understand it, but the repetition and role modeling is needed for when that part of their brain is ready.  If this is the case, then I recommend "catching" your child being good (loosely defined) and letting them out of the FAIR Club ASAP.  Do whatever you need to do to help them meet the assignments so they still feel they got a consequence for the behavior that got them in the FAIR Club.   (Ex.  "I like how you didn't yell at your sister when she took the first cookie.  I know that's usually very hard for you.  I think you're ready to be out of the FAIR Club, but I know you haven't finished your writing assignment yet.  Tell you what, I think if we sit down and talk about it (or "would it help if I wrote it for you"), that will be OK this time," or "I know you haven't finished your chore yet, so I'd like to help you with it."  This technique is also useful if you realize your assignment wasn't appropriate or is too much for your child, and you need to modify it. 
2. The child is testing you to see what happens if they pitch a big enough fit - will you let them out of the consequences?  This is something they've usually learned very well - if you throw a big enough fit, the adult will let it go and/or give in.  Unfortunately we have to be VERY consistent with never giving in once we've made a decision (although we can modify it if we're careful).  When I was training one of our dogs (no, I'm not really equating my children with animals, just go with me here!), the trainer taught us to reward the dog with a treat EVERY time they did the trick.  After awhile, you start rewarding the dog occasionally, and eventually only rarely do you give them a treat.  The dog will do the trick consistently in the hope that THIS is the time that he gets a reward.  Unfortunately it works the same way with bad habits too.  Ex.  If your dog is not allowed on the couch, but if you're having a really bad day you might let him up to cuddle... the dog will jump up on the couch EVERY SINGLE TIME in the hopes that this is the time you allow it.
3. Proof that they are not ready to be out of the FAIR Club - this is why it's not like grounding which has an ending time.  We need the child to be RRHAFTBALL to get out of the FAIR Club, and sometimes it takes longer for kids of trauma to be able to get regulated enough to do this.  Unfortunately, my children showed they needed the structure and support of the FAIR Club 24/7. 
4. That the additional structure and support we have provided in terms of making life "fair" is not enough. The child needs, probably extra help with emotional regulation.  A child constantly in the FAIR Club, especially after the initial struggle/defiance due to not liking Mommy finding a new form of discipline, is usually demonstrating that there is something wrong with "normal life."  If you haven't already, this is when I would look at ways to reduce stress, like stripping the child's room of all but bed and a sleep toy, dropping the homework battle - attachment and emotional regulation are MUCH more important - you don't need a well-educated sociopath!  Avoiding stressful/ overwhelming situations - like having a lot of kids over after school, shopping, doing ANYTHING when your child is tired, hungry and/ or ill...  Our most important job is finding ways to help your child attach emotionally, so you can help your child emotionally regulate and learn coping skills.  

ADDITIONAL CONSEQUENCES while in the FAIR Club:

Our kids are under EXTREME stress and trauma, and acquiring and USING coping skills is VERY difficult, especially in the heat of "battle."  If you feel like you're living in a war zone (which our kids with PTSD usually are) then you're focused on survival and living in the instinctual part of the brain - where reactions are limited to fight/ flight/ freeze (F/F/F).  It's tough on us, as parents, but I try to remember that when my child is in F/F/F mode they are not really "home."  The thinking part of their brain is turned off, and they are UNABLE to access it.  

We almost never add consequences to a child in the FAIR Club while the child is in F/F/F mode.  In fact we usually try not to speak to them, but instead think of them like a cornered animal - and wait until they are calm enough to accept comforting.  (I usually try to provide emotional regulation by doing NOISY, slow breathing, with lots of deep breaths, in the hope that my child will unconsciously start to match my emotional regulation.  If I'm unable to be regulated, and it's possible, then I will tag-team with my husband or another adult who gets it, until I am.

Occasionally, after the child is calm and regulated, we will sit down and talk about what happened.  SOMEtimes we will give a consequence, but most of the time we just accept it as more evidence that they need additional assistance (and are not ready to be out of the FAIR Club).

******************************

If we're not talking about raging behaviors, and a child is a "repeat offender" who gets into trouble while still in the FAIR Club, I will often assign sections from the FAIR Club Exam as part of their writing assignment.  The children don't take the whole exam.  Just the parts that apply.  The exam is obviously tailored to our family and the individual circumstances.  Sometimes we put the child on "probation." (See examples).

FAIR Exam

Use your most beautiful handwriting and complete sentences.


Vindictive

1. Look up Vindictive in the dictionary.  Write the definition here.  __________________________________________________________________________________________________________________________________________________________________
2. Mom was vindictive when she put the kitty poop under everyone’s bed.  True / False
3. Mom’s goal for putting the kitty poop under everyone’s bed was so they would understand how it feels to have to smell kitty litter every night while she is trying to sleep.  Do you think she achieved her goal?  Yes / No
4. What was Tony’s response to Mom putting the cat poop under his bed?  __________________________________________________________________________________________________________________________________________________________________
5. If you act vindictive are other people likely to understand why you are upset and apologize or are they more likely to get revenge?  (Apologize / Revenge)
6. On a separate sheet of paper, give a 3 sentence description of 2 times when you wanted to be vindictive.  (At least one sentence should describe your feelings).  Then, for each description tell how the person you were angry/ upset with might have reacted to your behavior.  Last, write at least 2 ideas on how else you could handle it so that the person understood why you were upset and what you could have done to help solve the issue.
Example (you need to use different examples!):
Description:  Ms. P told me that my work was wrong and I needed to redo it.  I felt that she was picking on me and was very angry with her because I don’t like being criticized.  I wanted to yell at her and get her fired.
Person’s response:  If I yelled at her she would get very angry with me and would probably yell back.  If I tattled or complained while I was still upset to Ms. M, Mom, or Ms. B they might not believe me and I might get into trouble.
How I could have handled it:  After I calmed down, I could have written a letter to Ms. P telling her how I feel when she talks to me this way.  I could write a letter (maybe with someone’s help) telling Ms. M and Ms. B how I feel and what I think might help make the issue better.

Trust

1. Why is trust a good thing to have in a relationship? (circle all that apply)
a. You can get away with breaking rules because no one thinks you would do that.
b. If something goes wrong people don’t assume you did it.
c. Everybody needs love, and you can’t have love without trust.
d. The more people trust you the more responsibilities and privileges you will get.
e. This is a trick question, trust is not really necessary.
f. People aren’t afraid of you because they know you will not hurt them.
g. People will loan you their things because they know you will give them back or replace it if it gets lost or broken.
h. You can try new things and go new places without having to check with anyone if it’s OK - but you tell them anyway because you know that they like to know what you are doing.
i. You feel safe, because you know the people around you have your best interest at heart.
j. You can ask for help, and no one will think you are stupid or annoying – and they will help you.
k. You don’t have to apologize or try to fix it if you do something wrong.
l. People don’t accuse you of lying or stealing all the time.

2. What is the best way to develop trust?
a. Always try hard to do your best at everything you do.
b. Have the best interest of others in mind when making a decision.
c. When you do something wrong or make a mistake you admit it and try to make things better.
d. All of the above.

3. Write 2 specific things you can do to develop trust (different from question 2).
1.________________________________________________________________________________2.________________________________________________________________________________


Healthy Eating

The following are rules about eating in our house – with some reasons why.  Fill in the blanks or circle the correct answer.

1.  No food or drinks in bedrooms.  Do not leave out plates, bowls, wrappers, silverware, and /or _____________ after meals or snacks.
a. It attracts rodents and bugs;
b. Spoiled food smells really ________________;
c. Unrefrigerated food can go bad and give people stomach _________________ or diarrhea.
d. Leaving dishes all over the house means we _______out of cups and bowls more often.
e. When the cats eat people food they ________________________ or get diarrhea.
f. When people visit our home they do not want to see ____________________ dishes, wrappers, and spoiled food everywhere.

2. No snacking after 11am, after 5pm, and after dinner.
a. If your ________________ is full of snacks you won’t be hungry for dinner.
b. Snack food is not as good for you so you need to save ______________ in your tummy for healthier foods.
c. Snack food costs a lot (more/ less) than regular food.
d. Getting up in the middle of the night to eat means you aren’t getting enough sleep and you will probably wake up (mommy/ daddy/ everyone).
e. If you eat up special treats, it is (more/ less) likely that we will buy/make more.

3. Breakfast foods are to be eaten for breakfast.  Lunch and dinner foods are not to be eaten for_________________________.
a. If you eat cereal and other breakfast foods for snacks then we will run out sooner.
b. Often the food in the fridge/ freezer/ pantry is to be _____________ for a meal.

4. No cooking or preparing food without the supervision of an (adult/ sibling/ cat).
a. You need _______________________ to get food in the pantry that could be cooked, because it is not on an approved shelf.  The (first/ second/ any) shelf is the one that has approved snacks.
b. Often the food in the fridge/ freezer/ pantry is to be _____________ for a meal.
c. You need to earn trust and prove you are responsible enough to prepare food.  To do this you must show that you know how to follow a recipe and know how to (measure / guess) the ingredients.
d. You must also earn trust by always remembering to ________________ up your messes.

5. If you leave empty wrappers, pig out on snack food, eat in the middle of the night, aren’t hungry at mealtime, keep food in your room, leave big messes, cook without approval, whine and beg for special treats, hide treats from everyone else, and don’t share, Mom will most likely:

a. Accuse you when food goes missing, and not believe you if you deny it.
b. Stop buying treats for the whole family.
c. Start locking up the food.
d. All of the above.



Authority

Adults have different roles in your life.  Most of them have authority over you.

1. Look up Authority in the dictionary.  Write the definition here.  ________________________________________________________________________________________________________________________________________________
2. List some people in your life who have authority over you (ex. parents, police officers...). ________________________________________________________________________________________________________________________________________________
3. Which of the following people do NOT have authority over you and you should not listen to.  You need to tell a parent or other caregiver if you are having a problem with this.
a. Friends who are telling you to do something dangerous or illegal.
b. Siblings who are not relaying a message from a caregiver.
c. Adults who tell you to do something you know is dangerous or illegal.
d. All of the above.

4. A caregiver can include your parents, your teachers, your principal, your after-school providers, your nanny, sometimes your therapist or doctors, your grandparents, the parent’s of your friends if you are in their home….  Circle all of the following choices that are things that your caregivers are allowed to do.
a. Tell you to do your schoolwork.
b. Check your homework/ school work and tell you to redo it.
c. Tell you when and what you may eat.
d. Tell you that you HAVE to eat something or that you have to eat all of what they give you.
e. Give you medicine and make sure you take it.
f. Look at your private parts (not including exams at the doctor’s office).
g. Tell you to do your chores.
h. Tell you to do or stop doing something even though a parent said you could or couldn’t do it.
i. Tell you to do something dangerous or illegal.
j. Search your room or personal property.
k. Call you names like stupid, ugly or bad.
l. Restrain/ hold you if you are unable to control yourself or are threatening to hurt yourself or others.
m. Tell you that you are doing something wrong.
n. Criticize you loudly in public or in front of your friends or siblings.
o. Yell at you, hit you, or deliberately hurt you.
p. Tell you that you need to stop doing what you are doing.
q. Tell you that you must be respectful of them and others.
r. Remove your personal items from your room.
s. Tell you that you cannot watch TV, play outside, talk to certain friends, or talk on the telephone.
t. Watch you while you use the restroom, take a shower, or change clothes.

5. If an adult is telling you to do something you don’t agree with, you don’t like a family rule, or someone is breaking the rules. The ONE thing you must do is:
a. Yell at the person you don’t agree with
b. Refuse to do it
c. Tell a caregiver
d. Write down your complaint and give it to Mom or Dad
e. Go ahead and  break the rule too
f. Tell Mom and Dad about it
g. Call an emergency family meeting.

Schoolwork / Chores
Work and chores are an important part of your life.  EVERYONE has to work and do chores, even babies are doing very important work (learning how to cope with the world around them and get their needs met – this starts out by crying to get others to do it for them, until they are old enough to start helping themselves).  As you get older your responsibilities and privileges increase.
1. In our house EVERYONE has chores to do.  (True/ False)
2. The more trust you earn by being responsible, the more privileges you get.  (True / False)
3. If someone says they will do your chores for you, you are no longer responsible for them getting done. (True / False).
4. You have schoolwork, because:
a. You are being punished because you misbehave.
b. Your parents want you to be smarter than everyone.
c. Your parents want to boost your skills to help you achieve your goals.
d. Your parents think you are stupid and need all the help you can get.

5. If you do your chores slowly, poorly, or not at all.
a. It won’t matter because Daddy doesn’t give allowances anyway.
b. You will not be acting responsibly so are not RRHAFTBALL and will end up in the FAIR Club.
c. Someone else will do the chores eventually.
d. No one will notice or care.

6. When I do my chores well I feel proud of myself for doing a good job. (True / False).

How Others See You

How people feel about you is based on your behavior, your body language, your tone of voice, and your expressions.  HOW you say things is more important than WHAT you say.

1. It is possible to effect how others treat you. The following are things you can do to change other’s way of seeing you.  (Circle all that apply)
a. Speak softly, because your “regular” voice sounds intimidating.
b. Smile often.
c. Stay away from others when you are in a bad mood.
d. When you know what’s best.  Tell others how to do things.
e. The louder you speak the more likely people are to listen and do what you tell them to.
f. Adults like to be told what to do when you know more than they do.
g. Crossing your arms and putting your hands on your hips tells people you are mad.  Avoid this.
h. Teasing, poking, rough play, and calling people names is NEVER OK.
i. Listen and use encouraging words and tone when helping someone who’s asked for help.
j. Always ask before hugs.
k. Draping your arm over other’s shoulders can be intimidating.  Try to avoid this.

2. When others like the way you act and appear, they are more helpful and loving toward you.                                          (True/ False)

 Me

Write the following statements in your best handwriting.

1. Mom and Dad love me, and want the best for me.
__________________________________________________________________________________________________________________________________________________________________

2. I am smart.  I try to do my best.
__________________________________________________________________________________________________________________________________________________________________

3.  God loves me and gave me the strength I need.
__________________________________________________________________________________________________________________________________________________________________

*************************************************



Probation

Dear Bear,
As you are aware, we feel that what you did to get in the FAIR Club is VERY serious.  You have met the requirements for getting out of the FAIR Club, but we are concerned that you might feel that this means your actions/behavior were no different from a minor offense.  Therefore you will be on probation for 2 weeks ending on May 9th.  If during this time you are not RRAFTBALL and/or have even the slightest behavior problems or actions you will re-join the FAIR Club.  Also, be aware that disciplinary actions will be more severe.  During this probationary period:

1. You will only watch shows deemed appropriate by your parents (if Ponito can’t watch it.  You can’t).  This means no MTV, VH1, CMT or violent shows (including the History Channel shows about war or weapons).
2. Phone time is to be limited to 10 minutes TOTAL per day.  Grab a timer.  I wouldn’t recommend spending it all at once.
3. No inappropriate music (this includes songs that use bad language and/or talk about sex, drugs or violence.  If a radio station plays songs that have to be, or should be, censored -it is inappropriate).  You can listen to your CDs if they have been approved by Dad.
4. You may have friends over up to three times a week with at least 24 hour notice.  You must be supervised at all time by YOUR parents.
5. Lights out is 9pm.  In your room at 8:30pm.
6. You will complete all of your chores and will mow the yard if necessary and do dishes during this 2 weeks.  People can help you with these chores, but it is not required that they do.  All allowance money will go toward paying off your debts.  It is strongly suggested that you do extra chores to earn extra money for paying off debts or for pocket money.  We will help you find extra chores, but we are not obligated to do so.

As always, if you have a concern or complaint, please submit it in writing to Mom or Dad.  We will discuss it at our convenience and let you know.

Love,
Mom and Dad

Books and Methods Review - Trauma and Reactive Attachment Disorder

The way the world looks at Reactive Attachment Disorder (RAD) has changed over the years. Parents are often told that it is "rare" and most diagnosticians are reluctant to diagnose. The reality is that while it may be rare in the general population, for those of us dealing with adopted and foster children, it is far less "rare" and I would say, it is common. 

DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition has changed the definition of RAD. While Reactive Attachment Disorder (RAD) still exists, it is now used to describe "Inhibited RAD." What used to be called "Disinhibited RAD" is now called Disinhibited Social Engagement Disorder (DSED).  {More info below}

So What Do You Look For? A List for Recognizing Trauma & Attachment Issues 

by Beyond Trauma and Attachment and  Dr. Arthur Becker-Weidman

The following list of often-experienced behaviors of traumatized adopted children was developed by Dr. Arthur Becker Weidman, Ph.d.  He has studied attachment and complex trauma especially in children who were adopted after the age of 18 months.  If you are an adoptive or foster parent and you can check off more than a few of the characteristics on this list, you may have a child with attachment and/or complex trauma issues.

1. My child acts cute or charms others to get others to do what my child wants.
2. My child often does not make eye contact when adults want to make eye contact with my child.
3. My child is overly friendly with strangers.
4. My child pushes me away or becomes stiff when I try to hug, unless my child wants something from me.
5. My child argues for long periods of time, often about ridiculous things.
6. My child has a tremendous need to have control over everything, becoming very upset if things don't go my child's way.
7. My child acts amazingly innocent or pretends that things aren't that bad when caught doing something wrong.
8. My child does very dangerous things, ignoring that my child may be hurt.
9. My child deliberately breaks or ruins things.
10. My child doesn't seem to feel age-appropriate guilt when my child does something wrong.
11. My child teases, hurts, or is cruel to other children.
12. My child seems unable to stop from doing things on impulse.
13. My child steals, or shows up with things that belong to others with unusual or suspicious reasons for how my child got these things. {Handling Lying and Stealing}
14. My child demands things, instead of asking for them.
15. My child doesn't seem to learn from mistakes and misbehavior (no matter what the consequence, the child continues the behavior).
16. My child tries to get sympathy from others by telling them that I abuse, don't feed, or don't provide the basic life necessities.
17. My child "shakes off" pain when hurt, refusing to let anyone provide comfort.
18. My child likes to sneak things without permission, even though my child could have had these things if my child had asked.
19. My child lies, often about obvious or ridiculous things, or when it would have been easier to tell the truth.
20. My child is very bossy with other children and adults.
21. My child hoards or sneaks food, or has other unusual eating habits (eats paper, raw flour, package mixes, baker's chocolate, etc. ) {Food/ Hoarding/ Diet}
22. My child can't keep friends for more than a week. {"Kleenex Girls"}
23. My child throws temper tantrums that last for hours.
24. My child chatters non-stop, asks repeated questions about things that make no sense, mutters, or is hard to understand when talking.  {Therapeutic Parenting - Nonsense Questions and Chatter}
25. My child is accident-prone (gets hurt a lot), or complains a lot about every little ache and pain (needs constant bandaids). (Even though he/she may not complain about serious injuries or illnesses - Psychosomatic "Illnesses"}
26. My child teases, hurts, or is cruel to animals.
27. My child doesn't do as well in school as my child could with even a little more effort.
28. My child has set fires or is preoccupied with fire.
29. My child prefers to watch violent cartoons and/or TV shows or horror movies (regardless of whether or not you actually allow your child to do this). {Media and RAD}
30. My child was abused/neglected during the first year of life and/or had several changes of primary caretaker during the first several years of life. (This can include multiple or extended hospitalizations)
31. My child was in an orphanage for more than the first year of life.
32. My child was adopted after the age of eighteen months (It is possible to have RAD even if the child was adopted at birth - if the child was "pickled" in utero with drugs, alcohol, and/or stress hormones...).

This video gives a good description of RAD symptoms (heads up - lots of Christian faith mentions)

{Marythemom--I do not agree with everything in this video - particularly his claim that EVERY adopted child has RAD. I do believe that every foster/ adopted child has experienced trauma of some sort - just being adopted or in foster care means that there has been a traumatic break from the birth family)}

Attachment Disorders and Post Traumatic Stress Disorder should be viewed on a continuum. 

Symptoms can be mild and healed relatively easily - or extreme and complex.   Post-Traumatic Stress Disorder is usually caused by a significant traumatic event or two.  Complex PTSD is usually caused by years of traumatic events, like a child abuse victim.  Reactive Attachment Disorder is the extreme end of attachment disorders and usually causes permanent brain damage.  {Chronic Post-Traumatic Stress Disorder (C-PTSD)}

 Reactive Attachment Disorder is usually associated with some form of abuse or neglect in the first two to three years of life. This normally involves physical or emotional abuse, abandonment, a drug-addicted caregiver, a sequence of foster placements, or similar emotional trauma. In some cases, children may have symptoms of an attachment disorder if they have experienced divorce, long periods of hospitalization, a parent with chronic depression, or if their brains were altered by the mother's substance abuse.

The most common factor for children with attachment disorders is that in the critical first years of life, either the child did not have the opportunity to bond emotionally with any single individual and maintain that bond, or the child did experience an emotional attachment and then was separated from the caregiver. ~  Strategies for Classroom Teachers of Students with Reactive Attachment Disorder

According to the DSM IV-TR, There are two types of Reactive Attachment Disorder:

 Disinhibited Type:

• Being way too “cute” and charming, especially as a means to get what they want, whether it is attention or material objects/food.
• Acts like a baby/uses the “baby voice” and behaves inappropriately younger than their age.
• Exaggerates about everything, especially their “need” to be helped.  
• Easily/readily goes off with strangers and/or seeks affection (i.e. hugs) from strangers.
• Makes friends with a lot of other children (usually younger than themselves), but is not very close to any one of them.
• Talks a lot – asks a lot of “crazy” questions 
•  Makes up stories – long, long, stories.
•  Wants just about everything they see and feels “unloved” when they do not get it.
•  When they do get the item, pays attention to it for only a short while and then either breaks it or puts it away and ignores it/forgets about it (unless you try to get rid of it, then they desperately love it!). {Decluttering}

Inhibited Type:

• Avoids relationships and is in a constant pull-push mode with the people trying to be close to him, such as parents.  (Gets close enough to get what he wants, then pushes away again.)
• Resists affection / stiffens when you try to hug them.
• Avoids eye contact (unless lying, then will look you straight in the eye and forcefully deny anything, even obvious things).
• Is always “on guard.”  (Whenever you want to talk with them, they get defensive and think they’re in trouble.)
• Keeps score.  Knows exactly what he “got” vs. what his brother got for birthdays, Christmas, etc.
• Has very few friends.  The friends he does have are not all that close.
• Prefers to be alone.
• Lies a lot.  “Crazy lies” about things that do not matter.  Believes own lies. {Lying and Stealing}
• Engages in self-soothing behaviors rather than seek comfort from parents.

Either type:

• May hoard food, trash. {Food}
•  May steal. {Lying and Stealing}
•  May argue about ev.e.ry.thing.
• May act completely different than the type they usually exhibit.  (Ex.  a disinhibited child may shut down and be surly from time to time, while an inhibited child may occasionally act silly and much younger than his/her age.)

Trauma Triggers
A child whose past trauma is triggered will likely exhibit several of these signs at one time, and they may be even more exaggerated than usual.  Kids can be triggered by sights (violent TV shows, someone who looks like a past abuser, a situation that reminds them of a traumatic event), smells (fried potatoes), sounds (a full laundry basket falling to the ground, a siren, a fire alarm at school, or a loud/sharp yell), and sensory feelings (a certain touch, a particular fabric, cold weather).   

They can also be triggered by "traumaversaries" anniversaries of significant events (like entering foster care), birthdays, and holidays. {Holidays, Birthdays, and Other Traumaversaries}

{How We Handled It - Calming/ Relaxation Techniques Handling Dysregulation/ Meltdowns Handling Rages}

Female Caregivers (the "Nurturing Enemy")
A common defense mechanism for our kids is to try to leave before what they believe is their "inevitable" abandonment by us. Attachment and people loving them is scary. Especially love from the female caregivers - they push us away the hardest of all. They try to move on before things get emotional. Demanding that they want to be put into a new family, foster care, group home... somewhere else, where everything will be "better."

 “Nurturing Enemy” - Our kids tend to behave differently (usually worse) with the female caregiver. In their mind, the mother is the person that hurt them the most, that can hurt them the most. They turn their hatred and loss they feel towards their birth mothers abandonment and abuse toward us. 

Even though we have never hurt them (and never would!), sometimes they get stuck in the past. Often with my kids, it was because things that happened to them before they came to us, got their feelings and the events of their childhood mixed up with me as their mother figure. I know some kids talk about things that they remember having happened to them as a child, as though it had happened recently.


Another thing about their issues with mothers is that we're almost always the ones "forcing" them to deal with attachment and feelings,

Why Does My Child Act Differently With Everyone Else? 


Changes from the DSM IV-TR to the DSM V - American Psychiatric Publishing

DSM-IV  Reactive Attachment Disorder
The DSM-IV childhood diagnosis Reactive Attachment Disorder had two subtypes: emotionally withdrawn/inhibited and indiscriminately social/disinhibited.

DSM-5  Reactive Attachment Disorder and Disinhibited Social Engagement Disorder
In the DSM-5, these subtypes are defined as distinct disorders: Reactive Attachment 
Disorder and Disinhibited Social Engagement Disorder. Both of these disorders are the result of social neglect, trauma, or other situations that limit a young child’s opportunity to form selective attachments.

Although sharing this etiological pathway, the two disorders differ in important ways. 

Because of dampened positive affect (ex. they don't show their feelings with body language), Reactive Attachment Disorder more closely resembles internalizing disorders; it is essentially equivalent to a lack of or incompletely formed preferred attachments to caregiving adults. 

In contrast, Disinhibited Social Engagement Disorder more closely resembles ADHD; it may occur in children who do not necessarily lack attachments and may have established or even secure attachments.

The two disorders differ in other important ways, including correlates, course, and response to intervention, and for these reasons are considered separate disorders.

Reactive Attachment Disorder - DSM V
Diagnostic criteria for RAD:

• A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
• Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
• Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
• No diagnosis of autism spectrum disorder

Disinhibited Social Engagement Disorder - DSM V

A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:

• Reduced or absent reticence in approaching and interacting with unfamiliar adults.
• Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries).
• Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings.
• Willingness to go off with an unfamiliar adult with little or no hesitation.

B. The behaviors in Criterion A are not limited to impulsivity (as in Attention-Deficit/Hyperactivity Disorder) but include socially disinhibited behavior.

C. The child has exhibited a pattern of extremes of insufficient care as evidenced by at least one of the following:

• Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation and affection met by caregiving adults.
• Repeated changes of primary caregivers that limit ability to form stable attachments (e.g., frequent changes in foster care).
• Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios).

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C).

E. The child has a developmental age of at least nine months.

Specify if Persistent: The disorder has been present for more than 12 months.

Specify current severity: Disinhibited Social Engagement Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Another post on RAD - Psychoses or Syndrome?

Online Support and Resources
Wikipedia definition 
Mayo Clinic definition
American Academy of Child & Adolescent Psychiatry 
Medline Plus

Where can I go for help, support, or to learn more about parenting a child with RAD?
My Top 10ish Things I Couldn't Do This Without
Parenting Attachment-Challenged Children and other Facebook groups!
Christine Moers

Dear Bear,

I wrote this letter while waiting for Kitty, who was at equine therapy.  The 45 minute each way trips, often turn into "Dreamkiller" conversations. :(  I decided to have her read the letters "to make sure it made sense."  I hadn't intended for her to read it out loud, but that's what she chose to do.  We had a pretty decent conversation afterward, so this letter may have served more than one purpose!  

Dear Bear,

I hope you're doing OK.  I talk to you on the phone so often that I almost have nothing left to say here!  :)  I miss you; we all miss you a lot.  We think about you often and there are a lot of people praying for you.

I opened my Bible today to look for a verse about forgiveness for you, since forgiveness is something you ask for often in your letters, and this verse jumped out at me.

Your families... shall rejoice in everything you have put your hand to, because the Lord your God has blessed you.  (Deut. 12:7 NIV)

This may seem like a weird quote to send to your son while he's in jail, but it's true.  While I wish this hadn't happened, I also choose to see it as happening for a reason.  I don't know what that reason is, and I may never know, but I believe God has a plan for you, just like he does for me.

God has allowed me to make big mistakes.  He's allowed others to hurt me; I could believe that that means he doesn't give a crap about me - and for a long time I did.  I threw God, my dad, and a lot of other people out of my life, because they weren't doing what I wanted/expected them to do.  I wanted my dad to be a warm, loving parent, who was always there for me... and he just wasn't capable of that.  I pushed Hubby away because I couldn't/ wouldn't trust him.  Like everyone else, he's human, and made mistakes.  I finally had to accept that no one could love me the way I thought love should be.  I had to learn to love myself, flaws and all, before I was ready to love another imperfect human.

You are lucky.  You accepted God/ Christ into your life at a young age.  He has forgiven you your sins and continues to forgive you for your mistakes.  All you have to do is ask - and believe!

Honey, you don't need to keep asking for our forgiveness either.  We have forgiven you!

Now you need to accept that forgiveness and move on.  Your past is over.  You are a new creature, blessed by God, loved by many.  Learn from your mistakes, and all the ones you will make in the future (as a wonderfully, God-made human), and use them to make yourself a better human, citizen, son, husband, lover, father, employee, brother, mentor, Christian...

We are all sinners.  We have all had horrible things happen to us.  Use this knowledge to be an understanding, caring witness to those around you.  I know you are capable of being a warm, loving, helpful witness to others.  Use your talents:  caring for others, protecting those weaker than you, understanding others who've been through some of the things you've been through and help them.  By doing this, you will become the person I know you to be.  The person you couldn't be if you hadn't experienced all that you have.

I know YOU! - The kid that is smart, funny, helpful, caring... Yes, you've made mistakes and not so great choices.  This does not mean you are a bad person.  You are human!  I know you are strong enough to turn this into a positive, learning experience.

When you come home, be aware that it is going to take time to show everyone that you've changed.  I know you know how hard it is to trust someone who hurt you.  I know you won't use this as an excuse to toss that person out of your life.  I know you will do the hard work to rebuild that trust, make amends (restitution), and feel sympathy toward them as they work hard to trust you.

I believe you are capable of doing the hard work it's going to take to get the help, and accept the help, that you'll need to become the man that God wants/ expects.

I promise to help you in every way I can to achieve this goal.

Because I love you!

I have sent your letters to {ex-girlfriend here in Texas}.  She still cares about you, but Bear, I hope you will give yourself time to work on yourself and learning how to be a strong, healthy person with the skills needed for being in a relationship - FIRST!  I think you need to get back into therapy and work on your past relationships with your family (bio and adopted) before you're ready for a relationship with a woman.  Having had my own attachment disorder, I hope you will believe that this is something I understand, because I've been there.

I want you to have a good, strong, happy relationship and a family of your own, but you have plenty of time for that.  You're not ready yet.  You will be, but please give yourself some time to heal and grow before you become responsible for others' hearts.  I know you're lonely.  We all want the "They lived happily ever after," but that's just a fairy tale.  In real life, Cinderella married a guy with a totally different life, that she met once, at a party.  They now have to deal with her family issues, his expectations (he thought she was a princess so rich and pampered that she wore glass shoes!), her expectations (should she get a job, who will take care of all her rodent friends - RATS! - will they move to the palace?  What if the prince doesn't like her friends?)  This relationship is pretty much doomed... unless they get more help from a genie or fairy therapist. :)

My hope for you is that you'll get back on your meds, get back in therapy, accept help and give yourself some time before you try to become an independent, responsible adult.  Not everyone has the chance to take this time... you do.  Just like the bear in the story they wrote for you at {the place that took months and did a thorough neuropsych almost 2 years ago}, you have a chance to do a little more growing, to make up for the time you lost as a child, not getting to be a child.  I hope you've learned that being a responsible adult is hard work that maybe you weren't quite ready for.

You rushed into adult life; you had to do a lot of growing up fast when you were a child.  That's not fair, and you missed out on some of the important steps and some of the fun stuff too.  Please take this chance with us to wait a little longer before you grow up!

This is a long letter, so I'm going to close with the verse my Bible opened to when I was flipping around, looking for just the right thing to say to close this letter.  Couldn't believe how appropriate it was - normally I don't recommend looking for solutions by randomly opening the Bible, but I think God was trying to send you a message:

The God of All Comfort

3Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, 4 who comforts us in all our troubles, so that WE can comfort those in any trouble with the comfort we our selves have received from God. (2 Corinthians 1:3-4)

I have often wondered if one of the reasons you are there is to help and comfort those around you.

Love always,
Mom
(And Hubby, and Bob, Ponito and Kitty)

The RAD Stink

We call it the "RAD Stink." You've heard of the "smell of fear"? Well, the smell of dysregulation in attachment-disordered kids can smell like feces and the worst body odor you can imagine. 

"This is just a thought and not based on any scientific anything but, if our body uses/produces hormones when under stress and stress is a toxin to the body - then that toxin overload having a bad smell is not too surprising, is it? I sometimes think of our RADlings as a wild animal that has gotten cornered with no way out. Think of what that wild animal would look like - think of how that wild animal would respond to any attempt you would make to get close to it - now think if that animal was a skunk - yeah.....that folks is our Radlings!! Poor babies!! We are trying to care for the love child of a porcupine and a skunk....and we don't want to get hurt or smell bad in the process. It just can't happen."  ~ A Trauma Mama

When we first smelled this foul odor coming from Kitty, we assumed Kitty was lying about bathing and hygiene, wearing dirty clothes, and/or not wiping well (all behaviors that are typical for people who have been sexually abused)... and there was certainly evidence of that. In her former foster home, she’d had major problems with encopresis that was determined to be behavioral (but we discovered later could have had a physiological source).

One year when Kitty was really emotionally unstable, her school sent her home several times because the other kids and teachers couldn't tolerate the smell (to the point that they were gagging and nauseous).  We did everything we could think of to help her. We kept a change of clothes at school and the school sometimes had her use alcohol-based waterless hand soap on her underarms (which did help).  At home, I supervised her showers (as much as possible without invading her privacy), making sure she shaved her armpits, used soap everywhere, and used shampoo. We also checked her bedding (she would often wet the bed and continue to sleep in it night after night).  While she did have issues with all of these, none of them really explained the stink. 

We finally connected that the more dysregulated Kitty became, the worse the stink. That year, she was in and out of psych hospitals. Kitty's smell issues may have improved because we changed her meds, she's slowly healing from the trauma, she's becoming more attached to the family, feels safer, she's older, she's learning to take better care of her body... who knows?

You've heard people say, "He reeked of fear." Her smell was like anxiety pheromones were oozing out of her pores. When she finally got emotionally regulated, the stink dialed back to normal levels (well, "normal" for a teenager with hygiene issues). 

"My kid with RAD (age four at the time) had BO like a teenager. It could knock you over. She only has it now during high anxiety times. She's 8 and not hit puberty, but she can smell rancid, and no amount of showering or deodorant covers it up.

My other kid with less RAD, more FASD, has a different kind of body odor and is often drenched in sweat from high anxiety. His is more of a sweet stench than the other that will make one dry heave." ~ A Trauma Mama

Possible Causes:

• Special Diets/allergies, intolerances - Individuals who are vegetarian, vegan, and omnivores often have distinctive odors from each other. People suffering from allergies and intolerances can have somatic reactions. 
• Change in diet or parasites - particularly children adopted from foreign countries. 
• Medications
• Hormones! You've got to love puberty. *sigh*
• "RAD odor" - A lot of people talk about a specific RAD odor that ALL RAD kids have whether from an orphanage, foster care, or family of origin- sometimes compared to animals who use smell defensively. It's in their hair, their skin, their used clothing, and doesn't alleviate until they've been in attachment therapy for a long time and are attaching to their family. The theory being that they subconsciously want to push everyone away.  It's often worse when they are dysregulated.
• "Smell of fear" - you've heard people talking about the smell of fear, I imagine this would be particularly intensified in a child of trauma
• Stress/nervousness - many children interpret the world differently and feel criticized and attacked constantly. The body does strange things under stress (hand and body sweating, intestinal gas, nervous tics...). Gassy/ potty smells  - stress can cause the digestive system and gastrointestinal issues to flare.
• Waste disposal - our bodies also release waste through the skin, particularly the soles of the feet and the palms of the hands.
• Underwear issues - many kids don't wipe, Kids who are frequently constipated might "leak" during the day.
• Hydration issues - many parents talked about the fact that their child's urine was much stronger smelling than normal. This could be in part to not drinking enough which would concentrate the urine,
• Hygiene Skills - maybe the child doesn't know how to properly clean themselves, brush his/her teeth, or when to change undergarments. Kitty once went almost 6 months using only conditioner with no shampoo (we found out when she told the hairstylist who was cutting out the ratty knots in her hair). Can unwashed hair grease go rancid? How can we be sure the child is washing his/her hair all the way down to the scalp?
• Forgetful poor self-care/hygiene. The child might forget or get distracted from taking care of themselves and their hygiene. 
• Deliberately poor self-care/hygiene. Some children deliberately don't take care of themselves because of control issues, poor self-worth, trying to prove parents will reject them by making themselves objectionable/unappealing...
• Sexually abused children often try to make themselves "less attractive" with poor hygiene. Kitty would sleep in urine-soaked sheets for weeks if they weren't discovered. Bear wore multiple layers of clothing at all times and usually only changed the outermost layer (I refuse to think about how long he wore the same pair of underwear, undershirt, and socks. 
• Stubborness! - Bob once went 6 months wearing Crocs with no socks. The school called me and asked me to pick her up because the other children were complaining of her foot odor (we had to throw the shoes away - even Febreeze and washing them couldn't get the smell out). She ignored me when I told her that kids need clean socks, and more than one pair of shoes to give the other a chance to air out. My kids often got obsessed with one pair of shoes and refused to change them (Bob's Crocs, Ponito's Heelys).
• Laundry - even my neurotypical child is comforted by wearing the same clothes over and over (without washing). He also just reuses socks over and over rather than trying to find clean ones.
• Inability to let go - just like Bear never throws anything away, a lot of children feel that what comes out of them is part of them (flushing BMs can be a traumatic part of potty training). This can lead to food hoarding, pack rats, and even the inability to allow laundry to leave the room to be washed.
• Allergies - food, seasonal, environmental allergies. These can cause all sorts of body reactions - hives, gastrointestinal, foul breath due to sore throats, ear infections... Hubby and Bear are both allergic to underarm deodorant (and all shaving creams), causing big problems, as you can well imagine. Hubby is also allergic to Bromine so most carbonated beverages give him gas issues.
• Masking odors - Bear tends to cover up smells with layer after layer of deodorant/ body wash/ cologne... rather than actually doing a good job cleaning. He frequently walks in a cloud. Not sure why he does this.
• Somatic issues - I know most people would rather not talk about itches, rashes, sores, and pain - especially in "private areas." Our kids often won't tell us anything (whether it's "private" or not). Whether it's because they don't trust us to take care of it, don't feel worthy of proper care, or they actually don't have enough somatic feelings to recognize body pain/discomfort (which is why Kitty's constipation went unrecognized for so many years). We found out about Bear's hemorrhoids because he told the doctor at the RTC - he would never have told us.
• Control issues - there are often very few things children have control over. What goes into and out of their bodies is usually one of the few areas they have control over. Anorexia is VERY common in kids of trauma - not only because they hate their bodies (they often hate themselves, so it's only natural that they hate their bodies), but it is also a major control issue - no one can make you eat (well, not until you get to the hospital stage).

Things that might help:

Attachment Therapy  

Calming/Relaxation Techniques 

Handling Dysregulation and Meltdowns

Underarm - One thing we like is that waterless antibacterial soap. It works well for underarm issues and other stinky areas because it seems to kill the bacteria that make the smell and have fewer allergens (depending on the kind you buy).

Stinky feet - We used the waterless antibacterial soap. Someone suggested soaking smelly feet in black tea or vinegar. I've used bleach water to cure fungus and athlete's foot. Socks and shoes that "breathe" and have as few synthetic materials as possible. Multiple pairs of shoes to give them time to completely dry/air out. Try laundry sheets (like Bounce) in them. Something called Gran's Remedy is supposed to work well.

Laundry - Half a cup to a full cup of vinegar or ammonia in each laundry load might help. I often add hydrogen peroxide to my whites.

Breath and general BO - change in diet, watch for allergies (lactose intolerance is a common one), and carbonated beverages. Check for parasites. Try acidophilus (sp?) which can be found in yogurt and can also be taken as a supplement.

Talk To Your Child's Doctor -  Unusual smells are significant and should always be mentioned to a doctor so they can check and make sure all is well.

"They make hunting products that are very good at removing any scent or stink. Heck, the stuff I use will take the onion or fish smell right off your hands!  

Bleach water will take the stink out of anything plastic!" - a Trauma Papa"

Here's a funny commercial for an "anywhere" and "everything" all-natural deodorant.

Another post on the RAD stink.
Good article about high stress and cortisol.