Like Attracts Like - What Happens When Mentally Ill People Have Children

Like Attracts Like
I've always assumed this was the case, but this study actually shows that people with a psychiatric diagnosis "connecting" with someone with a psychiatric diagnosis was two to three times higher than for people without a psychiatric diagnosis. They also seemed to be more attracted to people with a similar diagnosis to themselves and are less likely to marry.

"Nonrandom mating is evident in psychiatric populations both within specific disorders and across the spectrum of psychiatric conditions. This phenomenon may hold important implications for how we understand the familial transmission of these disorders and for psychiatric genetic research."

This study from the famous Karolinska Insitute in Sweden examined over 700,000 men and women with psychiatric diagnoses and compared them to over three million people without psychiatric diagnoses. Swedish Study published in JAMA Psychiatriy

“Couples choose each other with an unerring instinct for finding the very person who will exactly match their own level of unconscious anxieties and mirror their own dysfunctions, and who will trigger for them all their unresolved emotional pain.” - Scattered by Gabor Maté

{Marythemom: We definitely saw this with Bear and his "Kleenex Girls."}

Increased Risk Factors
Many mentally ill people live in poverty and engage in any number of risky behaviors such as prostitution to earn money or support drug habits. Generally, the severely mentally ill lack the forethought and coherence of mind to actually take a birth-control pill every day, let alone the medications that help their mental functioning. Many abuse illegal drugs as a way of self-medicating.

Often, mentally ill adults tend to gravitate toward each other due to socioeconomic status and behavioral habits. Mentally ill female patients are exposed to any number of dangerous situations which makes them vulnerable to rape and sexual assault. Thus, there are many pregnancies created out of terrible circumstances and often the father is not known.

It Takes Two
Psychiatric disorders are heritable, polygenic traits, which often share risk alleles - which means that if 2 people with similar diagnoses get together and make a baby...

For example:

Although schizophrenia develops in only about 1% of the population, having a parent with schizophrenia increases the risk to 10%. The odds increase to 30% to 40% if both parents are schizophrenic. Schizophrenic Risk Factors

What Happens When Mentally Ill People Have Children
Teen pregnancy rates among Canadian girls with major psychiatric disorders (bipolar, severe depression, psychotic disorders) were found to be three times higher than the average population.

Such girls were more likely to have more children following the birth of their first; “Services focused on counseling girls who already have delivered one child may also be important because the rates of multiple births are higher among those with major mental illness.”

Statistically, children of the mentally ill have a higher chance of becoming mentally ill themselves.

 Nature and Nurture;
Severe mental illness has a strong genetic factor.
Add to that the stress and chaos of being raised by a severely mentally ill parent, or the child being passed around to foster parents or group homes, and it creates the perfect storm for developing any number of mood disorders, behavioral problems, and juvenile delinquency, let alone the increased possibility of the onset of neurological disorders such as schizophrenia or bipolar disorder.


These conditions can lead the child to a life of illness, poverty, crime, and self-destruction... and future generations of mentally ill children. 

Weighted Blankets

There are many options for purchasing weighted blankets. I've found many sites over the years. You can look at Etsy.  Amazon - http://amzn.to/2gAvwVG Here's a list put out by friendshipcircle.org - 15 Places to Find Custom Weighted Blankets and Other Products

Make Your Own Weighted Blanket - It's a lot easier than you think!

Here are some basic instructions I adapted for making a weighted blanket for those who do not want to purchase one at the ghastly prices some places are asking, want to customize the blanket, or just prefer to do it themselves.  

Determining Size - What Is the Blanket to be used for?

Calming tool - for the car, using TV/computer, at school (although a lap pad or weighted vest might be a better choice), in church, etc. -- Lap blanket (34" x 43")or a Wrap blanket (43" x 52"). These sizes are also a good fit for those in a wheelchair.

Sleep - blanket size depends on the height of the person using the blanket and /or the bed size. For smaller children, it is recommended that a weighted sleep blanket be made to fit on the top of the mattress  and not hang over the sides of the bed, this is not an issue for older children, teens and adults.  In most cases, a  sleep blanket should always have the weights evenly distributed throughout the entire area of the blanket (although it's not necessary to weight parts that won't be covering the body (like the parts over the edges of the mattress or if your child is only 40" tall, there's not much point in putting weights at the bottom of a twin blanket!) and NOT concentrated in one area, although people with Restless Leg Syndrome may prefer the weights to be heavier in the lower part of the blanket. 

What Materials Do I need?

Materials - Scissors, pins, thread, yardstick, a water soluble marking pencil/ marker/ chalk, and a sewing machine.  Fabric and Filler.

Fabric - How much fabric you need depends on what you want to use the blanket for!  You'll need 2 pieces of fabric the size of blanket you've chosen.  Almost any type of fabric will do.

For the inside part, you will want something pretty sturdy, especially for a heavier blanket and/or rougher textured filler.  This piece can be pretty basic, like a simple mid-weight cotton quilting fabric. You can make it two sided with different fabrics for each side.

You can also use something pre-made - like heavy bed sheets.
To make it water resistant (good idea for bed wetters), use a water resistant fabric like a shower curtain (the fabric part, not thin plastic that would tear when you sew through it), or a heavy vinyl table cloth (the kind that has a "fabricy" side). 

• Crib/Toddler Blanket (36" x 52") 
• Lap blanket (34" x 43")
• Wrap blanket  (43"  x 52") 
• Throw (50" x 60")
• Twin size (43" x 75")
• Full size (54" x 75")
• Queen Size (60" x 80")
• King (76" x 80") 

Ex.  For a lap blanket about 34" x 43" , your fabric should be approximately 45" wide and 72" long (you'll want a little extra width and height for seams).  

Duvet Cover

The duvet/cover is a great idea for blankets that are heavy/ difficult to wash.  The cover fabric can be anything you want, even fleece, and can be chosen for sensory properties.  You can even make it two sided with different fabrics

Materials:
Fabric: If you want to make a duvet/cover for your blanket you will need 2 more pieces of fabric  - 2-3 inches wider and longer than the dimensions of your blanket.
Velcro (1/2" or 3/4" width)- Sew-on Velcro about 3/4 of the width of the cover, plus about 8 inches.
Ex. For a twin size bed this would be about 33" + 8" so 41" total.
(The extra 8 inches will be cut into five 1 1/2" pieces to help hold the cover in place on the blanket).
TIP: Make sure you get the sew on kind, not stick on, or you will muck up your sewing machine!  

Filler Weight

Weight Calculation  - Weighted Blanket standard formula is 10% of your body weight plus one pound.  This is recommended by most Occupational Therapists as a starting point.  

TIP:  Don't forget to subtract the weight of the materials when determining how much weight that you need!  Heavy fabrics can add a lot of extra weight! Weigh all the materials of the blanket, including the duvet cover if you have one, together with your filler - reduce the amount of filler needed accordingly). 

(Ex.  For a 100lb person the calculated amount would be:
10% + 1lb = 11 lbs calculated weight.  If the blanket materials are 1.5 lb.  The Calculated Weight would be 9.5 lbs.) 

What do I use for Weight?

• Beans/ Rice - Beans are a good weight for the bulk, smooth and rounded to not wear on the fabric, cost effective.  Just the regular dried beans you buy in the grocery store work, Navy or Pinto beans are a good size and inexpensive.  Make sure though if you need to wash it that it is in cold, short cycle, and hang to dry. You will definitely want to consider a water-resistant fabric.
  1 pound of dried beans = about 2 cups of beans
  1 pound of dry white rice = about 2 1/3 cup rice
• Popcorn - another good choice, but may wear fabric out sooner as the kernels are pointed on the end. Should also consider a water-resistant fabric.
  1 pound of popcorn kernels = about 2 cups of kernels
• Poly pellets - more expensive, also a lot more bulk for the weight.  These work better for lighter/smaller blankets (like throws and child blankets).  They are Hypoallergenic and washable.
  1 pound of poly pellets = about 3 1/2 cup of pellets
• Aquarium Rock - great if you can find it inexpensively. Check out thrift stores!
• River Rock* – a pebble-like gravel found super cheap and in bulk at home improvement stores (rinse thoroughly several times to get rid of all the dust and grit), Can be rough so you might want to use a heavy/thick fabric to protect the skin and cover/duvet. Also, will most likely can't go through the washing machine so consider a fabric that can be wiped clean rather than washed, or plan to wash it in the bath tub or outside with a hose.
  1 pound of gravel, dry 1/4 to 2 inch = about 1 1/4 cup of gravel

TIP:  I've made several blankets with river rock.  It's super cheap, but can be a bit rough so I'd recommend a heavier fabric.  My husband likes that it doesn't retain heat, as he tends to sleep hot.

Instructions: 

1.  Prep the Fabric (Add Velcro if using Duvet Cover). It is strongly recommended you wash then dry your all your fabric at least twice, three times is better, before measuring and cutting.  This will help you avoid shrinkage that will make the cover not fit in the future.

If you’re planning on using a duvet/cover, now is a good time to sew on your Velcro to the blanket.  

Attach Velcro. To keep the duvet cover on the blanket and hold everything together attach the fuzzy side of 1 1/2" long Velcro strips to one side of your blanket fabric (you'll attach the rough/ "sticky" side to the inside of the duvet cover later).  On the right side of your fabric, stitch a 1 1/2" strip in each corner (about 2" in from the corner) and one in the middle.  (see figure 1 - Velcro tabs go where the "X"s are located).

X					X
			X
X					X

figure 1

TIP: When stitching Velcro, it's best to use a fresh machine needle in a larger size, like you would use for denim, or a size 14 or 16.

2.    Stitch the Outside Seam. Place fabrics right sides together and stitch the two pieces of fabric together with a 1/2" seam allowance along the edge of the two long sides and one short side.  Use a strong stitch like an overlock, or run a second seam close to the first for more strength. You will then have a rectangular bag, kind of like a pillowcase.

3.    Turn the piece right side out (you can trim the corners first), and lightly press the edges (unless you're using a fabric that can't be ironed, like vinyl!). 

4.    Determine number of needed sections.
        Width - Measure across the width of the fabric. Divide by 5 to determine the number of sections needed
Ex.  For a lap blanket (34" in width divided by 5 = 6) you would end up with 6 sections (each 5" in width) across.
For a twin (43" in width divided by 5 = 8), you would have 8 sections across.

TIP: If you are making a larger blanket (full, queen, king) , keep in mind where the body will be located, and rather than spreading the weight across the whole blanket, you might want to concentrate on where the body will be (could be more on one side of the bed or smack in the middle keeping about 8 sections, approximately 5" in width, concentrated on where the body will be. 

TIP: You can also make your blanket just this width and position it accordingly in a "pocket" in the duvet, rather than have the blanket be the full width of the duvet. This would also allow you to remove it from the duvet for washing and even use it as a throw or lap blanket. If two people share the bed, this would allow one of them to not be covered by the weighted blanket on their side of the bed, or for them to use a blanket properly weighted for them. 

        Height - Measure down the height of the fabric. Divide by 5 to determine the number of sections needed.
Ex. For a lap blanket (43" in height divided by 5 = 8), so you would have 8 sections down.
TIP: If you are making a larger blanket (twin, full, queen, king), keep in mind how tall the body is and add about 2 sections. 
Ex. For a 43" tall child you would want 10 sections (43" in height divided by 5 = 8 + 2).
For a person who is 5' or taller, you would want 15 sections (65" in height divided by 5 = 13 + 2). 

5.  Making the Grid. Now you will mark off a grid on the fabric.  Use a pencil, air soluble marker or chalk, draw the lines in lightly.
Width
Take the actual width of the fabric and divide by the number of sections you just figured to determine exactly how large to make each section (this will vary a little depending on the actual width of your fabric, but each will be approximately 5" x 5).  Mark off and draw lines down the length of your fabric.
Ex. A wrap blanket is 43" in width and your fabric is 45" in width. Your lines across would be approximately 5 1/4" apart.
Height
Measure the length of the fabric - subtract 1" to leave room to fold over the top. Divide the length of the fabric by the number of sections to determine how large to make each section.  Mark off and draw lines across the width.  When you are finished, you will have a piece of fabric with squares marked off on it like figure 1.  (Note - they won't be perfect squares, in any case, the length and height will be different, I just use the word squares to describe the sections we are creating.)

TIP: For bedding (twin, full, queen, king), don't forget to keep in mind the length and location of the body.  If this is a blanket for a petite person or child, it doesn't make sense to have the the weight distributed all the way down the bed.  

The bottom edge of your grid should stop at the number of sections you already determined above x 5",  plus the one inch at the top.

Ex. For a 43" tall child your grid's bottom edge would be at 51" (43" in height divided by 5 = 8 sections + 2 sections = 10 sections = 10 sections x 5" = 50").    

6.    Sewing the grid. Now, straight stitch along the marked lines that run from the open top edge to the bottom edge.  Stitch along the bottom edge. You will end up with a long row of channels, open at one end like this (the top edge of the fabric is open - sorry about the graphic making it look like it's closed on the first channel):

TIP: Use pins through both layers to make sure that the bottom layer doesn't shift while stitching.

7.  Determine how much weighted filler for each section.
Now to determine how much of the weighted filler to add to each grid square.
First, determine how many squares you have, then divide your Calculated Weight by this amount.
Ex.  Lap blanket is 6 sections across by 8 sections long (6x8) = 48 squares.
For a 100lb person the Calculated Weight would be 10% body weight (10 lbs) + 1 lb - weight of the materials (1/2 lb) = 9.5 lbs. So,  9.5 lbs / 48 = .2 lbs)
TIP: There are 16oz in a pound. So .2lbs is 3.2oz

TIP:  Once you have your gross measurement of weight, rather than measure or weigh each individual amount as you go, I recommend dividing it ahead of time.   I put each section's weight in a plastic baggie.

Options for dividing your weighted filler (using example numbers of 9.5lbs):

• Using a kitchen scale - You can carefully measure .2lbs (3.2oz) forty-eight times (and hope you're right - due to a faulty scale I once ended up with a 30+ lb blanket!).  
• Eyeball/ Approximate* - You can measure out your 9.5lbs then divide it in half (I just "eyeballed" it - approximated). Then divide the two halves in half (approx.), then divide those in half... until you end up with the entire weight divided into 48 sections.
  Ex. I chose river rock as my filler, which needed to be cleaned and rinsed first (it was dusty!).  I spread it on a sheet in my driveway and rinsed it off with a hose, then let it dry in the sun. I then “eyeballed” it, dividing the weight approximately in half, then dividing both halves into halves, and so on until I had 48 little piles, which I put into little plastic baggies.
  *My personal preference! 
• How many scoops in a pound? Using a small scoop or measuring cup (a 1/4-cup measure cup works well).  If you are using beans for your filler, start with a 1 lb bag.  Measure out the entire bag with your measuring cup or scoop; find out how many scoops are in 1 lb.  If you are using something that comes in bulk, like the poly pellets, use a food scale to weigh out 1 lb and do the same thing.
  Ex. Using their scoop, they get 10 scoops per 1 lb of beans.  Then, multiply the number of pounds you want in the blanket by the number of scoops per 1 lb.  For example, for an 8 lb blanket it will take 8 X 10 or 80 scoops.  Then divide the total number of scoops in the blanket weight by the number of squares.  In this example, 80 scoops and 48 squares gives us 80 / 48 or 1.66 scoops per square.  (About one and two thirds.)  It's a little tricky getting 2/3 of a scoop, but it doesn't need to be perfectly exact,  it will all work out. 

9.    Filling the  Channels. In each one of the long channels going across, drop in the measured amount of the filler (or the contents of one baggie).  Shake it all the way down to the bottom of the blanket, below the marked grid line.  Once every channel in a row is full, then stitch carefully across the grid line to enclose the filler in that row of squares.

(oooo - represents filler)

Continue working your way up the blanket, row by row the same way.  Add the scoops of filler to each channel, shake it down, then stitch the row closed, until you get to the last row at the top.

10.    Finishing the blanket. Before filling the last row, fold down a half-inch or so and press well into place (if you can't use an iron on the fabric, then finger press it), then fold again and press well.  Open the folded area and fill each section.  Pin the fold into place over the filled space.  Work your way across, filling and pinning each section so nothing falls out.  Then stitch the folded section closed, removing pins as you go along.  Stitch again to make it very secure.
If you aren't making a duvet cover, at this point you are finished!

Voila!!

DUVET COVER

Instructions:

1.    Attach Velcro.  Spread the finished weighted blanket out with the side with the Velcro tabs facing up. Loosely lay the matching 1 1/2" strips of Velcro (the rough/ "sticky" side) on top of the stitched on Velcro tabs.

Drape one side of the duvet cover material on the blanket (right side up), and position it so the blanket is where you wish it placed inside the duvet (centered, toward the left side, near the top...). Be sure to leave at least 1 1/2" of the duvet fabric around the edges for seam allowance. Pin the rough side of the Velcro strips to the duvet fabric. Stitch the Velcro in place on the duvet cover material.

On the "bottom" short edge of the duvet fabrics, fold over and press 1/2" toward the wrong side of the fabric. Do this for both pieces of duvet cover fabric.

Lay the fabric wrong side up and center each side of the long strip of Velcro (3/4 of the width of the cover) on the folded "bottom" edge of the duvet fabric. The edge of the Velcro should be about 1/4" below the folded edge of the fabric. Stitch around the Velcro. Do this for both pieces of duvet cover fabric.

TIP:  If you choose a fabric with an obvious top and bottom (like flowers growing upward!) then make sure you leave your opening at the “bottom” of your fabric.  You want the Velcro at the bottom of your bed, not near your face!

2.    Stitch the Outside Seam.  Place duvet cover fabrics right sides together. Stitch the two pieces of fabric together with a 1/2" seam allowance along the edge of the two long sides and one short side (the "top" edge), leaving the "bottom edge" open, just like you did at the start of weighted blanket.

3.   Turn the cover right side out (you can trim the corners first), and lightly press the edges (unless you're using a fabric that can't be ironed, like vinyl!). 

4.   Finishing the "bottom edge" of the duvet cover. Press the long Velcro pieces together. Along the "bottom edge," from each corner to where the Velcro is attached, top stitch the two duvet cover fabrics together along the folds.

Open the Velcro strip, place the weighted blanket inside the duvet cover, match up the Velcro tabs and press them together.  Seal the Velcro strip along the opening.  That's it!

Structure and Caring Support

STRUCTURE, SUPPORT, ROUTINE and BOUNDARIES

Structure and Support -

Children NEED structure and caring support to feel safe and start to heal.   This feeling of safety is usually not based in reality – it is a perceived feeling of safety.

Hypervigilance/ Living in a Warzone
Kids of trauma are often easily triggered, extremely sensitive to emotions, unable to regulate their emotions... causing them to react as if they are in a warzone.  You can't learn and attach if you don't feel safe and you're living in a war zone!  Hypervigilance (obsessively monitoring their environment) is super common among kids with PTSD.  It relaxes when they start to feel safe, but probably doesn’t ever really go away.

Consistency - 
We learned the hard way that when we didn't stick to our guns, even once, the child seemed to work even harder to get what they wanted again.
Ex. Let's say you don't allow dogs on the couch (Yes, I know our children are not dogs. I was looking for an example that people might have already seen or experienced). You have a new dog that loves to curl up on the couch and sneaks up there all the time. 97% of the time you drag him off and tell him, "No!", BUT every now and then, you're just too tired to mess with it and you let it go. You have now guaranteed that the dog will always jump on the couch in the hopes that this time it will get to stay.

When our daughter came to live with us, she knew that if she argued, fought, and cried for long enough then the adults in her life would give in. I felt like the crappiest mom in the world saying, "No" to this poor little kid who'd had such a hard life, but we HAD to break the cycle or we would all be miserable.

When we back down - we let our kids argue, intimidate, and manipulate us into changing our minds, we are sending a mixed message to our child. That message is that we cannot keep our child safe.

If the child feels that they are in control instead of us then their world is not SAFE.

I say "safe" a lot. That's because I believe it's one of the most important motivators our children have. They do not trust and they do not feel safe. An insecure, scared child behaves in increasingly bizarre and scary ways to get control of their world. When they have control, instead of the adults, they get more afraid and things cycle even farther out of control.

Caring Structure
It took me a long time to believe it, but my children actually craved caring structure. Their favorite teacher at school was a behavior staff person who always called them on their behavior - if they were acting like a turd, she said so, bluntly, BUT, unlike the teachers who let them do whatever they wanted, or were super strict but didn't actually care. Even though their favorite teachers were super strict, the kids knew that they legitimately cared about them.

When I began providing Caring Structure, I thought for sure they would rebel and make our lives miserable. They didn't always like it, but it seemed like their few complaints were based on what their peers thought about it, rather than something they were truly feeling. Unlike my neurotypical, biochildren who understandably would have protested the strict structure their adopted siblings required, most of the time, my adopted children just accepted it and moved on.

Without this structure or when we "lightened up," my son would act out until he had to be returned to the stricter structure level. Somewhere deep down, subconsciously, his brain knew he needed that structure to feel Safe. 

Low Tolerance/ Overwhelm
It is sometimes necessary to simplify a child’s life a LOT to lessen the feeling of “overwhelm.”  This can be like childproofing – avoiding and removing things and events that can be triggers.  This can also mean making their world smaller and lowering expectations. Level Chart post.

• School - reducing or eliminating homework, getting the child in smaller class sizes, limiting or removing after-school activities...
• Age-Appropriate Expectations - Expectations are reduced to the child's emotional age. Kitty may be 16, but when dysregulated, emotionally she'd drop to about 6yo. Her daily chores became super basic.
  We had a long discussion with Kitty about being emotionally 6 (still ticks her off to hear that), and that it wasn't fair to expect her to be able to handle certain things, and we felt it was cruel to dangle higher level privileges she couldn't actually achieve over her head. Therefore, I was going to stop "punishing" her for not being able to do things she wasn't ready for yet.
  
  Changing my expectations has helped ME immensely (Finding the Joy).  I'm less frustrated by her inability to do things that would be "normal" for a teen.  I do have to constantly remind myself "She's only 6!  She's only 6!  She's only 6!"
• Chores - 
• • She has fewer chores and they are very simple and concrete.  
  • She does the same chores every day instead of rotating like the other kids.  
  • She gets to go places even if she'd had a fit recently because I don't hold her accountable for her behavior like I would a teen.  
  • If I go places like the grocery store I take her with me.  Period.  The other kids frequently have the option to go, but you don't leave a 6-year-old at home alone.
  • She can have "playdates," but they are well supervised.  
• Room and Environment. At the therapist's suggestions, we stripped the child’s room to only a bed, one or two stuffed animals, a book, and not much else. In times of extreme stress, we moved our child's dresser to our room. The child had to bring dirty clothes to “check out” clean ones.  This helped with hygiene issues, and lessened the amount of overwhelm. It made cleaning the room easier for the child to do him/herself (if they were able to do it alone at all).
  
  Some posts on techniques for stripping/ decluttering the room:
  Decluttering
  Adult Boarder vs "Family Girl"
  Maid Service

FAIR Club - This is the discipline method we used at our house for many years (until we realized that our children with trauma issues were usually too emotionally young for it - Age Appropriate Expectations).  The premise of the FAIR Club is that life is not fair, nor do we want it to be.

The FAIR Club is designed to provide boundaries and additional support while the child practices and gains (or regains) the ability to be RRHAFTBALL.  This involves removing a lot of the distractions and drains of life (like electronics, phone, friends, even where to sit) and adds ways of dealing with stress (earlier bedtime, spending time with parents who can role model, only going places as a family).

Supervision

We stopped telling our children that we were putting them in the FAIR Club, because we discovered that they needed the structure and support of the FAIR Club 24/7. I do feel that the FAIR Club helped us and Bear work up to the stricter supervision that he obviously needed. He wouldn't have tolerated this level of structure and supervision when he first got here. By giving him the supervision when he got in trouble we were able to slowly introduce the stricter levels of supervision, and then not lighten up as much when he got out.

I know this sounds really awful and controlling, but Bear really did feel safer knowing we cared enough to pay attention to him. I believe Bear acted out when he felt unsafe just to increase our level of supervision. {Now that he is an adult, he is in prison - one of the few ways to get the level of supervision he needs (jail/ prison is the biggest mental health facility in the country). Another option was the military, but Bear wasn't eligible due to his mental illnesses.}

• Line of sight - Generally Bear was on line of sight supervision at all times unless he was in his room alone. This was a huge deal, and made Hubby and I feel like wardens, but he NEEDED it. We tried to make it feel more like we were spending quality time with him than that we didn't trust him.
• Bedroom door and window alarms - while we did have window alarms (that prevented Bear from sneaking out of the house), I felt like we should have had a door alarm too (still not sure why it bothered Hubby so much).
  
  Bear often left his room in middle of the night - usually to steal food or some other item. I know many parents that had to worry about the safety of family members, and installed door locks on bedroom doors. Not to lock children in! But so they could lock their own doors and feel safe from their sibling.
• Never alone - Bear was NEVER left without the supervision of an adult who was aware of his needs and issues. Since he was too old for childcare, this often meant hiring after school care providers or Grandma, having him in structured volunteer or extracurricular programs, us going to the mall and movies with him... we tried to give him at least the illusion of having his space (ex. when at the movies, we sat several rows away where he felt we couldn't easily see him), and we gave him as much privacy as we could.
• Room and belongings searches - Bear frequently stole things and hoarded food and other items. Usually when searching his room, I gave it a good cleaning and removed all contraband and health hazards. While I usually did this randomly when he wasn't at home, Bear was aware that we did this for his safety, and rarely protested - even when I found contraband and gave him consequences. 
• School - My kids required a LOT of structure at school. We often had to battle the school to get this for them (even filed due process once). Both Kitty and Bear ended up in a special program/ school for emotionally disturbed students. The staff were all trained in special education and behavior management. Most had worked in residential treatment facilities. The student to teach ratio ranged up to 8 to 1 at the most. Even when on his home campus, Bear received extra supervision - at one point even being escorted any time he left the classroom.

Rules, Routines, and Boundaries

Rules are like fences. Kids need them to feel safe. 

Children need rules, routines, and boundaries –Boundaries are like fences, they keep children safe.

Think of children as researchers. Some children are very aggressive researchers; they will continuously test the rules over time to see if they are still firm and clear.

Rules make children feel safe.

Only when a child feels safe can they trust enough to feel loved.

 “No”
 There is nothing wrong with saying, “No.”  Provide lots of structure from the beginning.  Set up the child’s environment so that he/she doesn't hear a lot of "No"s.  There just shouldn't be an option of doing things that need a “no.”  Think of it like childproofing.

 Rules should be simple and few.  
Make sure rules and consequences are very clear and consistent.  Go over rules with the children often!  It only takes 2 minutes to tell the children (or have them tell you!) the rules, and the consequences if they are not followed.

Positive and Concise!

Try to keep the rule to no more words than the age of the child and phrased positively. 

(3 words for a 3 yr old, 4 words for a 4yr old...)

Instead of saying "No running!"
For a 3 yr old you would say, "Use Walking Feet."

Instead of, "Shut UP!  Why are you always screaming?!  You're making Mommy crazy!  Why can't you just play quietly for 5 minutes?!...."  Keep it short and simple, and quietly state "Inside Voices."

Instead of "Quit standing on the furniture!"  Try, "Chairs are for bottoms (not feet)."

“DON’T” 
When you tell a child “Don’t” you just increased his chances of doing what you’ve just asked them not to do tenfold.

Instead of telling a child what not to do, we need to tell them what to do.  

Video on why we don't use Don't! 

Create a positive picture.
The more enthusiastic and happy you are the more likely they are to listen!  Really!
{I know most days this may sound impossible, but this post, Finding the Joy, helped me find the strength.}

Praise
Like most kids with trauma issues, praise was a huge trigger for my kids. Often, they felt they "didn't deserve it" and/or were afraid they'd be expected to live up to it all the time.(Why Do They Act Like That?),  Feeling triggered would usually set them up for a meltdown.

A fellow trauma mama suggested finding a unique thing about this particular child that sets the child apart AND can also be praised. Using "labels" that identified this child, and this child alone. Even if these labels were often a result of their trauma/ attachment issues. This gives the child something to feel proud of without the direct praise that could trigger a negative reaction.
Ex. The "Family Finder" The fact that the child could find anything because she was hypervigilant wasn't the point. This child really could find almost anything someone was looking for. If a sibling couldn't find something, the mom would shout out, "Well the FAMILY FINDER can find anything!"

Especially when delivering consequences, make sure your message is clear and direct.  

Be firm and FOLLOW THROUGH! 

 Stay calm and pleasant.  

Fresh starts
Fresh starts should be soon – a whole week is ineffective.  “I’m sorry you forgot the rule.  Tomorrow (after nap time, after dinner…) we will try again.”

Choices
Never give a child a choice you don’t want them to make.  Give them one or two options (both of which are acceptable to you).  If you ask a child if they want to get in the car or continue to lie on the floor and throw a fit, guess what they’re going to pick?!

 “Okay?”
By ending a statement with “Okay?”, you are asking their permission and sending them an unclear message. Drop Okay? from your vocabulary, okay?

Things to remember

Eye contact

Be Specific

Simple rules

Follow through

Setting Boundaries for Teens
I highly recommend a book called Stop Walking on Eggshells!

I LOVE it for setting boundaries with my attachment challenged teens and young adults (and it helped with the crazy early teen years with my neurotypical bio kids too). It made my Top 10 Things I Couldn't Do This Without list.

Technically it is for people living with someone with Borderline Personality Disorder (which is an "adult" disorder), but there are a LOT of similarities (Some people say that when a child turns 18, and technically "ages out" of being RAD, then it often becomes BPD. Kitty was diagnosed with "BPD Traits" before 18).

The first half of the book gives insight into WHY they act the way they do, which helped me with understanding what they needed and why, so I could better decide what to do about it. The second half of the book is actual PRACTICAL ADVICE! Which I found to be really on target.


It's a quick and easy read... except that it's hard to process. Everything hit home so closely, that I found myself reading it in small chunks. (I kept it in my car to read during the kids' doctor appointments, while waiting in line, anytime I had a minute alone. The second time I read it, I put it in my bathroom, and read it when using the potty, getting ready in the morning, and taking a bath.) I'm re-reading it now actually.

Stop Walking on Eggshells - This book also helped me understand why self-care was so important, and made me feel less guilty about prioritizing it.

Self-Care! 
Providing this level of structure is probably one of the hardest things I've ever done. So I can't say enough how important it is. I had to fill my bucket, because kids with attachment disorders are incredibly draining. Especially since others usually thinks you're "overly strict, overbearing, controlling...." I worked really hard at not needing validation, but it took a long time, and I still struggle often.




Guest Blog Post by Traci B, a fellow Trauma Mama

One thing my son said to me a while back,

"It's easier for me to be bad than it is to be good. I've always been that way and it's hard for me to change." 

This hit home for me. He really had no idea how to be anything different. His brain was wired to "be bad." We did not use those words. He did.

This hit home for me. I had to change his thinking and the way his brain was wired! 

This is about my adopted son and what we did to help him:
A little background - we got custody at 11 years 10 months straight from the psyche ward at a local hospital. He knew nothing!!! Walked out in front of a car in the parking lot. Never even looked! The behaviors were through the roof! Getting his some of his behavior under control and making him feel safe were our priority.

As I have written before, Nancy Thomas' book When Love is Not Enough helped with this and other stuff. Then we began working on changing his brain! This post is about that -

Concrete ThinkingTo him everything to him was black and white. He could not think of other ways to do things. To him there was only one way!

If I allowed him to do something one time then he used that other times by saying "But you said or you did" and then whatever it was. It was like just because I got him a drink one time he thinks I knew what he wanted and should just get it for him. Or I let him eat doughnuts one morning so he should have them every morning. I let him watch TV one day when it had been taken away because he was exceptionally good so he thought I should do this every time he lost something. The list goes on!

My son has never earned privileges or rewards. He self sabotages at every turn. He feels he does not deserve them. So rewards were in the moment only. I swear my son's brain/thinking was the total opposite of what you would think.

Changing His BrainI started teaching my son to change his brain. Gave him toys he had to figure out or build (using his brain) and I'd help minimally.

He'd ask a question that I knew he knew the answer too, so I would not answer it but make him. If he chose not too then the discussion ended.

At times, I made him come up with at least two acceptable answers, even if they weren't ones I wanted or the correct answer, but would work.

I limited any electronics. Matter of fact, my son was not allowed any video games, cell phone, iPad, iPod etc up until two years ago and then it's very limited. The only electronic he was allowed was music and TV but also limited.
He would walk around bored so we made a list together of things he could do {For some ideas, see these posts: 108 Alternatives to Being Bored and Trapped in the House} and when he was bored he had to choose one.

To answer the question should you give him things he wants without asking. NO! 

He has to ask He was so manipulative and getting me to do stuff for him and using my brain.

So, we had him ask for everything for a while - to go to the bathroom, snack, what clothes to wear, to go outside, to watch TV and the list goes on.

• If he did not ask to watch then I'd turn the TV off until he did.
• Make him come inside until he asked.
• Put his clothes in my room so he had to ask.
• Snacks locked in my room, and so on.
• One day, I even locked the bathroom door until he asked although I made him use it first thing in the morning, afternoon and at night. He seldom was went more than twice a day so three was good!

Sounds mean, but he had to learn to ask. He had to learn that others will take care of him. 
I got his breakfast, made his lunch, dinner etc. He could ask for what he wanted for breakfast and lunch at times but mostly I chose for him. I had to take total control from him for a while.

Now doing this, I thought he would melt down left and right, and he did some at first, but then he seemed to be glad that he did not have to make any decisions.

Slowly, we added choices in - let him choose between two things for breakfast and so on. Let him get a drink of water whenever he wanted (had to ask for other stuff partly because he'd drink it all), and use the bathroom.

Now at 17 1/2, he has his clothes in his room and picks his own out. He makes dinner sometimes. Basically, he has learned to use his brain a lot more and has a lot more freedoms.

We have lots of discussions, especially now, about behaviors that come up, his refusing, wanting to be independent and demanding (actually this is control issue which is increasing the closer to 18 he gets).

Taking Away ControlHe had to be in control of everything, so we took control away to teach him he would still be safe, get fed, have clothing etc.

One major thing we did was not tell him where we were going (therapist appointments, ice cream, dinner, family's homes, no where!). He'd ask and we'd just say, "You'll see." And answer no other questions about it.

Again, we thought he'd rage/tantrum, but he did not. It even lowered his anxiety. Everything seemed to work the opposite of what you would think it does.

Opposite ParentingSo we learned to think {highly structured parenting}. Our first thought, we seldom did, but instead went with the opposite for the most part.

It's like you have to teach them how to use other parts of their brain because they only use the animalistic part (the reaction of Flight, Fight or Freeze**).

So, those are some of the things we did and it worked for my son. I hope this helps.  ~ Traci B.

** Fight/ Flight/ Freeze
Fight/ Flight/ Freeze - A child who is dysregulated and/or in fight/ flight/ freeze mode is “thinking” with the reptilian part of the brain (survival!). Their behavior is a purely instinctual response to what the brain believes is a life or death situation! The rational part of the brain just isn't online. Their eyes frequently glaze over, they are out of control, and it is like the child isn't "home." Afterwards they do not remember what happened just before or during an episode. Holding a child responsible for what happens when in a true fight/ flight/ freeze is pointless- it’s better to just move on after it's over and try to figure out what triggered it so you can avoid it in the future.


More posts about Therapeutic Parenting:

Therapeutic Parenting, Behavior Management and Discipline

Chap. 1 Parenting based on Developmental/Emotional Age

Chap. 2 Discipline vs. Behavior Problems

Chap. 3 Structure, Support, Routines, and Boundaries

Chap. 4 Nurturing
Chap. 5 Discipline and Guidance
 Chap. 6 Abuse '
 Chap. 7 Misc.
TBRI

Trauma Bond - Adopting siblings

(Not my kids)

Excerpt from an excellent article about the Trauma Bond by an attachment expert (and trauma mama), Christine Moers - Raising Kids With Trauma Bonds

Well, it means that one child can have an emotionally strong day and really be rocking along quite nicely. Then their sibling starts to crash. The sounds, the familiarity, the flashbacks ... it can cause them both to tank. They play off each other. It can be a very, very toxic combination. And if they are BOTH already having a bad day - yowza.

I have watched it in my home, and it still saddens and fascinates me. The trauma bond between my adopted children Mar and Rocky was so intense that it hindered Rocky's healing for a very long time. Mar took the big sister role, even though he is three years older. He was terrified to stand on his own and move forward without her. She was all he had ever had, and he wasn't sure he wanted to shift the perceived power and control onto himself. He wasn't sure he could trust us. He didn't trust his sister, but she was all he knew.

Then, when he did start to make those emotional moves away from her - YIKES. She was not too happy. That was yet another time of extreme regression. It was u.g.l.y.

 Conditions which may indicate that siblings should be placed separately (Lord and Borthwick - 'Together or Apart' 2001)

• intense rivalry and jealousy, with each child totally preoccupied with, and unable to tolerate the attention their sibling(s) may be getting;
• exploitation, often based on gender, e.g. boys may have been seen and see themselves as inherently superior to their sisters, with a right to dominate and exploit them;
• chronic scapegoating of one child;
• maintaining unhelpful alliances in a sibling group and family of origin. Sibling patterns of behavior may be strongly entrenched and may prevent re-parenting or learning new cultural norms; 
•  maintaining unhelpful hierarchical positions e.g. the child may be stuck in the role of victim or bully; 
• highly sexualised behavior with each other;
• acting as triggers to each others traumatic material potentially re-traumatizing each other. The triggers may well be unconscious, unintentional, and mundane.

Factors in the birth family which can negatively influence the relationship between siblings (Kosonon, 1994): 

• poor attachments to parents which can result in intense sibling confict;

• neglect and parental absence resulting in strong compensatory sibling relationships, often where an older sibling provides some parenting of a young child. Such bonds can become abusive.

Children who have suffered very poor attachments need to develop a secure attachment to a safe adult or adults. That sometimes requires the separation of siblings, because if placed together, they may inhibit the formation of healthy adult attachments. - Burnell, Vaughan and Williams (2007)

"Children need to bond to a loving adult in order to ever be able to deal with issues of trust, authority or real intimacy. A bond with an unhealthy sibling often stands in the way of the parent-child bond. It can be used as a crutch – I don’t need you, I’ve got my brother in much the same way gang members rely on each other for a sense of belonging and security. It’s effective for the youth, but isn’t healthy or good for society." - Becky Malecki

 Our Most Important Lessons (The Potential Downside of Adopting Siblings by Becky Malecki):

1. Rivalry between RAD children is not like normal sibling rivalry. It can take a dimension of intensity that mirrors their past abuse and involves a fierce degree of competitiveness that shadows all else. These are children who cannot be left alone while you’re in the bathroom for they might harm each other, injure a pet or destroy something of value.
2.  Sibling groups carry a collective memory of their past trauma. Through their ongoing interactions with each other they help to keep the ugly past alive. They trigger memories for each other. 
3. Unconsciously, their emotional issues, their mannerisms, even their very physical looks can be triggers of negative feelings of rejection.
4. These children love to sabotage each other and the parents, as they believe there is never enough love.

We certainly saw this with Kitty and Bear. Continued contact with birth family, caused them to have feelings of conflicted loyalty and triggering and reopening emotional wounds - preventing them from healing. Bear not only felt these conflicts himself, but made sure Kitty (who desperately felt the need to keep him placated to feel safe) knew that she was expected to feel the same way. He also was unwilling to give up his role as Kitty's protector/ parent. A role that Birthmom had encouraged in her "Little Man." 


Placating the Powerful Child
If one child is younger, was designated the scapegoat by a caregiver, or perceived weaker, that child will often try to please and placate the more powerful child, especially if that more powerful child is an abuser too.

Why Would a Child Bond to an Abuser?
"If a person is unable to escape chronic, traumatic abuse, they will eventually begin to bond with their perpetrator(s). This has been well documented in the literature. It will occur because of the dehumanization of the victim, who may reach a state of feeling that they are “robotized” or nonfeeling, combined with a disruption in the capacity for intimacy caused by the trauma."

"Many victims of severe and unrelenting trauma, whether domestic violence, incest, or ritual abuse, will find that they feel anxious when alone, and fear abandonment and isolation. The over-dependent characteristics are NOT a personality fault, but a result of the chronic abuse. This is often rooted in the fact that as a child, the trauma survivor was not only a CAPTIVE to their abuse, but they depended upon their perpetrator for food, shelter, or other necessities. In addition, with ritual abuse, a small child will often be abandoned for periods of time, to increase their dependency upon the very people who are abusing them. "

“Trauma impels people both to withdraw from close relationships and to seeks them desperately. The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments. The traumatized person therefore frequently alternates between isolation and anxious clinging to others..." - excerpt from excellent book Trauma and Recovery: The Aftermath of Violence--from Domestic Abuse to Political Terror  (1997) by Judith Lewis Herman, MD

"... the perpetrator WILL rescue {the victim} and stop the abuse, or take the child out of the confines of their pain, but for a price: their unrelenting loyalty and obedience. "
"This will be reinforced by the perceived power of the perpetrator {over the victim}."  Trauma Bonding : The Pull to the Perpetrator By Svali

Selection of Evidence on Adopting Siblings and the Need Sometimes to Separate Brothers and Sisters in their Interests. - Slideshow

So What Do We Do About It?

Rocky and Mar could not say anything in a kind voice to one another. It was rare and usually superficial. Yet they craved being together. They were feeding off the trauma. We had to carefully determine who sat where at meals around the table. They could not be right next to one another or across from one another. They were not allowed to play together. It was just too much. We had to keep them separated so they could practice interacting with people in an emotionally healthy way. Then, when that was much more routine, we started to widen the boundaries so they could practice being together. - Christine Moers - Raising Kids With Trauma Bonds

Living with RAD - (Siblings and that Trauma Bond) Here are some of the things we have tried. Keep in mind we change things up often because nothing works forever.

1. They cannot be in the same room if an adult is not present. So if Taz walks in and Teddy is the only one there, he is to turn and walk out. Does it always happen? NO. They seek each other out intentionally when they want to fight with someone.  And why do they want to fight? Because sadness, fear, frustration, fatigue all turn into anger. It has happened for years. We work on it daily.
2. They are not to speak negatively of the other person to me. "If you can't say anything nice don't say anything at all" is a phrase used often.
   Have them think of two things they like about the other person every time they say a negative. They really don't like that one and often it nips the negative comments because they don't want to say anything nice about the other.
3. Keep activities that involve both kids short and really fun. A going for a "nature walk" and going out for a treat are two of the best activities we have done with our sons. When you are walking everyone is heading in the same direction (sort of) they can stop and explore around the lake. Sometimes we take the camera and look for things that would make neat photos.It burns off energy. If there are any problems I just say I have to be in the middle! When we go out for a treat, they are never sitting across from each other (kicking under table) or next to each other (elbows fly). These activities can be fun.
4. Refuse to get caught up in the drama. Just say "This has nothing to do with me. I hope you two can work it out".  That takes a lot of the fun out of it for them as they really want mom to step in and escalate things. De-escalation is an art form but it is not that tough if you just stay calm, use a calm voice and remember if it is not important just refuse to get involved.

What WE Did:

*ABSOLUTELY no touching.  None.  Ever. The aggressive child (usually Bear) especially, literally had to be out of arm reach of the other kids at all times. They weren't allowed to sit next to each other on the couch or in the car.   

*Line of Sight Supervision. If I had to be in another room then that child came with me or was in his/her room alone. They were NEVER allowed to be alone in the same room. You didn't come out of your room unless Mom said so. You weren't to go in each other's rooms either (this was to prevent abuse, but also to prevent theft).

* Separate rooms. Originally the girls shared a room.  BIG mistake! We converted the playroom to a bedroom to separate them.  

*ABSOLUTELY no "parenting."  The adopted kids (especially Bear) felt they had a right to boss the other kids around (The biokids were good kids they just took it. Kitty was terrified of Bear, so she did whatever he said).  EVERY time we heard anything that sounded like parenting, we reminded everyone that WE were the parents and that was not their job.  We NEVER put the kids in a position where they got to tell the other kids what to do.  Not even relaying a message ("Mom said to come downstairs and do the dishes.") At most, they were allowed to say, "Mom is calling you." 

*You don't do what a sibling says - especially if you know it is wrong. The child telling them what to do got in trouble, but so did the one who blamed it on the other child telling them to do it. "He's not your boss. Who is allowed to tell you what to do? (correct answer is "Mom," "Dad," "Grandma, " or an approved adult)."

*"Walk Away" None of your business. When a child was dysregulated/ having a meltdown, the other children were expected to stay out of it! Talking or interacting with the child or the parent dealing with the child was strongly discouraged. Bear especially liked to trigger Kitty when I was trying to keep her from escalating. 

*FAIR does not mean Equal. We used the FAIR Club for discipline. This meant each child was treated differently. Sometimes the kids, especially Bear and Kitty, would try to bait or trigger the other child into getting into trouble (while staying out of it themselves if at all possible). The advantage of not having a set "punishment" or consequence, was I could mitigate/ even out the consequences. Watching an Inappropriate Movie

*Tattling was not OK - The child was told to ask themselves, "Am I telling mom this to help my sibling, or get him/her in trouble?" (Not that I didn't listen to them first. I needed to know what was going on!). 

*Prioritize the child's mental health - Bear was often asked by therapists to try to make "amends" and/ or "restitution" to his sister (like the 12 step program). It meant nothing to him, and was a HUGE trigger for her so we didn't allow it. 

*Supervise and limit biofamily conversations. Yep. I listened in (although usually just to my child's side of the conversation). My kids had 3 younger sisters that lived with Biomom. I wanted to maintain some attachment (although my kids weren't truly attached to any of their siblings), so I allowed it. The rules were: the siblings had to be visiting Biograndma (Biomom couldn't be present) and Biograndma was not supposed to discuss Biomom or the family's living arrangements (especially not Biomom's abusive relationships).

*It's OK to tell Mom/ Dad anything, even that you hate your sibling. As long as you don't say it to that sibling or anyone else (not even best friends who might share the information). In fact, we encouraged it, to make sure no abuse was occurring and to help the kids process their feelings. 

*Therapy! Family therapy with siblings involved was way too triggering for our kids (although we tried several times), but we did a LOT of discussion in therapy. It didn't really effect Bear (although he did get defensive because he thought he was in trouble a few times), but Kitty has rarely been able to discuss Bear or her feelings regarding him. Once or twice, she was able to admit that she hated him (she blamed him for getting them kicked out of their homes and worried he'd be able to do it again. 

Every time Bear was kicked out of a place - biofamily/ foster home...), within 6 months, Kitty had to move on too. Whenever he began to rage or act up, she immediately became terrified she'd have to leave everyone she'd begun to care about. 

Out of self-preservation, Kitty constantly tried to placate Bear and keep him calm and happy (which of course she had no real control over). Bear loved the attention and took full advantage of it. Bear was also one of Kitty's abusers and prone to violent rages, which also made him terrifying to be around. 

Kitty did an amazing amount of healing while Bear was in RTC for 6 months. I believe because she felt safe, he wasn't constantly triggering her, and we were able to focus on her needs instead of constantly firefighting Bear's. She also did some healing when we brought him BACK to our home, because it meant that he hadn't managed to get kicked out despite his rages, so she could trust us to allow her to stay too. 

We were told that our kids were strongly attached to each other and wanted to be kept together. Considering they both had Reactive Attachment Disorder, (RAD) the former was unlikely. Since our kids hate change and are attracted to the chaos they feel familiar with, the latter was likely, but definitely not in their best interest. 

I used to think siblings should be kept together at all costs. Now I know that isn't always the case.