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

Wednesday, May 11, 2011

Why does my child act differently away from home?

Lovely, Naughty, Smile, Girl, Child

A friend of mine with lots of kids (including 2-year-old triplets!), has one of them in Residential Treatment for the first time. She's being told by the RTC {psychiatric residential treatment} that he's doing great and is sweet and wonderful. She knows in her head that he's honeymooning, but it still hurts and makes her question her parenting. I want to share what I wrote to her:

RTC Is Not The Real World
How we parent is based on life in the real world... not life as it is in RTC  with 24/7 staff, quiet rooms, and PRN (as needed) tranquilizers. Staff are looking at short-term solutions that will keep the child compliant while they are in RTC. Our kids can often honeymoon for a long time. Things like Level Systems appear to work because the child can "work the system" short-term. 
{Level/ Point Systems and Sticker Charts - Why They Don't Work With Our Kids}

Parenting is Long-Term
Parenting styles HAVE to be different than what works for an RTC. Kids are going to react differently with RTC staff, teachers, other parents... people who are not trying to get them to emotionally engage and are not looking at long-term solutions or how your child's behaviors affect the rest of the family. 
{Prioritizing Yourself, Your Family, and Your Child }

You are a good parent!!!! There is no “right” way to parent our kids (although there are definitely some wrong ways!), but I can tell that you know what works for your son in your home. It’s good that you know that when he plays video games he gets dysregulated, just because for whatever reason it’s different at the RTC, doesn’t mean it’s not true at home. Stick with what you know is right for your child!
{Structure and Caring Support}

Be very aware that this is a tough life and having people telling you that you're doing it wrong is incredibly draining on your limited emotional reserves. Please take care of yourself!! I know it can feel impossible, but look at this time as respite and focus on healing yourself. You can't parent effectively if your emotional reserves are empty.
{Self-Care! Caring for the Caregiver}

Why kids act differently in RTC (or school or anywhere else):

1. YOU are not there (at the RTC). You are the symbol of all mom caregivers, and you dare to try to “inflict” your love on him {See the Frozen Lake Story at the end of this post}.

2. Reduced Stress. In an RTC, our children don’t have to deal with the stress of family and emotions, school is usually easier, and staff and teachers have lower expectations. This may reduce their stress to a point where they can handle it better.

3. Some kids are too “broken” to function in a family and do better in RTC. They NEED an environment without emotions and long-term consequences and need people to keep them, and those around them, safe because they are not capable of doing it for themselves. I’m not saying this is true for your son, but for now, he is not capable of being home.

4. Structure. My son deliberately acts out at public school until he gets sent back to the special school because he needs and craves the structure and support provided by the special school to feel safe. {Structure and Caring Support, Why Doesn't My Child Feel Safe?}

5. It is not possible to live real life like an institution (although it sometimes feels like come close in our house), especially when you have 2 other special needs kids and 2-year-old triplets like you do! We cannot always provide the structure and concrete expectations that our kids need/ crave, especially over the long-term. RTCs have better staff-to-child ratios and back up than we ever could!

6. Staff can avoid telling the kids what they don’t want to hear (like “no”) because RTC is ultimately short-term and our child’s best interest is not their problem. So our kids behave better because they like people who rarely tell them no. They can get away without telling your child "no" because;
  • This is a locked campus that goes way beyond childproofing, so staff doesn’t have to deal with watching him and correcting him when he gets into things that could hurt him or others or worry about him hiding or running away. 
  • No vulnerable people or animals. There are no small 2-year-olds or pets running around that he could sexually abuse, torture, torment, or just be cruel to. They don’t have to protect a whole family, just kids who are not exactly perceived as defenseless.
  • Kids KNOW they have little to no flexibility or “wiggle room” on most subjects because it's "policy" so they don’t bother to argue with staff about bedtime, computer time, respectful words…
  • It’s not personal for staff. It’s just a job. Staff can walk away, they can quit, they can let someone else take over for a while… We have to protect ourselves and the rest of the family and that influences how we handle our child. Staff doesn’t have to do anything that isn’t in their job description. If someone vomits that’s the job of the cleaning staff. If a staff person has the flu, she can take a sick day. We have to deal with everything our children throw at us, no matter what, and it often hits home and gets personal especially when we're under continuous stress. {Continuous Traumatic Stress}

7. Living with your abuser. Unlike an RTC, when a child is rude, horrible, scary, threatening, tries or succeeds in hurting a family member - we have to continue living with this child. If our significant other treated us the way our child does, then most likely the spouse would go to jail, or everyone would be encouraging us to leave him, but when it’s our child, we’re just supposed to handle the emotions and stress, not show it in any way to our child, and be warm and loving all the time.

8. RTCs are easier for the kids!
  • School is easier, with lowered expectations and lots of one on one instruction.
  • Concrete expectations (there are very few gray areas to figure out - or manipulate).
  • Fewer decisions to make (bedtime, where to sit, what to do next, during what little spare time they have there are very few choices).
  • No social/ emotional skills needed or required. No one expects the child to care about anyone else’s feelings.
9. Blank Slate - 
  • If the child messes up… he/she gets to start all over again with a blank slate the next day.
  • NO long term expectations at all. No one cares about long-term consequences (except you!).
  • No history – no one cares what the child did last Summer (no grudges, no expectations, no hurt feelings, no holding the child to a higher standard because you know what he/she has accomplished in the past…)
  • The child knows that if someone doesn’t like him, or he doesn’t like them… just wait, they’ll leave and/or go home soon.
  • No one knows your family. They mostly only know what the child tells them. If he says his parents beat him every day or won't let him have a cell phone because they are unreasonably strict ... well, as far as the staff and other kids know, it's entirely possible. The staff and other kids will validate the child's every entitled feeling.
  • The child has "rights." Rights to refuse meds. Rights to refuse to see parents. Rights to refuse treatment.
10. RTCs can be fun. Tiny successes are celebrated and rewarded. Even with almost no positive behavior, they get to go on field trips, go to the playground, have dessert… get to go out to eat with parents, and can eat all the fried foods they want. Things they get to resent you for because you don't allow them to do it all the time at home.

11. RTCs feel normal. My adopted kids grew up in an environment of chaos, and that feels normal to them. Nice, quiet homes feel abnormal and “boring.”

12. RTCs are scary. Tranquilizers, lockdown, big scary kids who fight back… RTCs are scary places. It’s not safe to fight.

13. Honeymooning:  My daughter will lie, shut down/ dissociate, “talk the talk” (which she knows from years of therapy and being in hospitals)… anything to get out. With the right meds and enough motivation, they can hold it in for months – up to a year depending on whether or not their honeymoon behaviors are successful.

14. Trust: The kids trust you enough to “let their hair down.” They finally believe that you love them enough to put up with the behaviors. Which is true, but sometimes I wish mine didn’t trust me that much! My daughter “holds it together” all day by cramming everything inside and ignoring it – then, she gets home and lets it all out on us. Those feelings have to go somewhere, but they can also hold it for a long time when they know it’s life or death (which it usually feels like it is). {If You Find Out I'm Not Perfect, You'll Leave}

15. Different expectations. I always forget that staff’s definition of “normal” and “sweet” needs to be taken with a truckload of salt. Remember who they are comparing your child to – NOT neurotypical children his age! Children who are in a program for kids with issues.

My son is the best-behaved kid in the school for emotionally disturbed youth that he attends. They’re always trying to promote him back into regular public school, but that’s because they don’t even notice his “minor” behaviors, like crying, cussing, punching lockers, being rude and oppositional to staff but complying in the end… because they have kids that are listening to the voices in their head that tell them to kill, spitting in people’s faces, constantly screaming and cussing in the middle of class at other students (because he broke up with her to date her twin – yes this was my son *sigh*), destroying property…

16. Superficial Charm. The staff is used to being treated like scum, so any child that is nice to them… The staff doesn’t necessarily recognize or care that it is manipulative. 

My kids are what I call “Charming” RAD – they hug and are warm and sweet to everyone (as long as they aren’t family!). This helps them feel safer. They don’t actually trust or care about these people, but they are pretty believable, so the staff, case managers, teachers… have no clue. They want to protect this sweet, loving child from obviously crazy, overly strict parents with Munchausen by proxy syndrome. Which feeds right into what the child wants.

17. They don’t know your child’s history or what is normal for him or her. They don’t recognize his anxious behaviors. We were told our daughter was “a little homesick,” but other than that was doing great. On the same day, they gave her an anti-anxiety med PRN because our daughter told staff that she wanted to hit a girl for telling her to “shut up.” They don’t know violent behavior is totally out of character for our daughter.

18. They tend to believe the child if he tells them that you beat him daily, or “hug him too much” (yes, my 14 y.o. son told the staff that was one of the main reasons he was there – even though we’d known him less than 6 months at that point and he was in an RTC for violent behavior… let’s just say that was NOT why he was there). They’re not used to working with kids with loving, involved parents. They’re not used to working with kids with attachment issues. The staff and other kids will validate your child's every entitled feeling and pressure the family to give the child the same privileges a normal teen "deserves." Example of how we handled this once.

19. ALL the kids in RTC have poor social skills so no one will notice that your child is not “good friend” material. Now he can have lots of friends if he wants. Plus my kids are naturally attracted to other kids with issues (probably because kids with issues are more tolerant of the poor social skills or maybe because they crave chaos since that’s what they grew up with) so they have a large pool of choices… who can’t escape! It's all short term too so they can even appear to be popular. {Like Attracts Like}

20. Validate the child's beliefs. The kids in RTC will reinforce your child’s beliefs, and make them feel better about themselves (usually at your expense), based on whatever the child chooses to tell them. Ask my daughter how many of her “friends” think we are evil, strict parents, and have offered to kidnap my daughter and let her live with them – most of them call us names (which she loves to share with us) and some of them have offered to hurt us for her.

21. There’s always something to do and people to entertain you. For example, if we try to stick to a schedule that says we have dinner at 6pm, of course, we have to leave the child(ren) to their own devices for ½ an hour or so while we make the dinner. In an RTC, there is staff with them entertaining them all the time, and then they get up and walk to the cafeteria where dinner is magically ready. The child rarely has to self-entertain in an RTC.

22. My daughter feels “safer” when someone who knows her issues is monitoring her 24/7. The child is so well supervised that they don’t have to stress about making bad choices. They can’t suicide, self-harm, use drugs or tobacco (supposedly anyway – my son found a way to sneak chewing tobacco). {Why Doesn't My Child Feel Safe?}

23. Safe med changes. RTCs can make dramatic med changes, whereas we have to work with small increments and don’t have access to 24/7 nursing/ psychiatric care if our child has a reaction.

There’s more I’m sure…

What we did: 

I constantly reassured my kids that I would help them deal with these feelings (and find others to help) and that I wouldn't allow them to push me away. I also reassured them that I knew these behaviors and feelings were caused by their "issues," and that as they healed the behaviors and feelings of fear and wanting to hurt us would get better.

At the same time, I set up boundaries/ rules/ structure that let them know they were safe (this is a perceived sense of safety - nothing to do with real life physical safety). I let them know that while they were healing, I would be there to keep them and the rest of the family safe. That hurting me and the family was not OK, and that I would not allow it.

I took away most of their control (even about little stuff like when they would be eating and where they sat in the car), and by doing so they knew that I was strong enough to handle them and love them despite their issues. It took me a long time to understand that they didn't just need someone to love them unconditionally - they didn't believe in that, they needed someone to make them feel safe. Their favorite teacher was the strictest teacher, one of the staff in the behavior unit at school. She tolerated no nonsense, but they knew she really cared about them.

They were afraid (deep down) of the teachers/ people that they could manipulate, that they could fool into not realizing that the child was not perfect and was "unlovable and unworthy of love." People that gave them a blank slate every day, that forgave them every time, that didn't hold them accountable for their actions... those people weren't strong enough to keep them "safe."

I think me staying, no matter what they did, was a big part of what helped them heal, but I think a bigger part of that was providing the structure and support needed to make them feel safe and know that someone else was in control. That was, I think, one of the hardest things I have ever done. It was not the way I had parented my other children, most of the people involved in the kids' life thought I was overbearing and controlling, and it was NOT my personality (I'm a pretty laid back unstructured person), but they NEEDED that structure and loving support to heal.

The Frozen Lake Story
"In order to understand what an unattached child feels like, one must understand his perspective. Imagine that you are the young child who must cross a frozen lake in the autumn to reach your home. As you are walking across the lake alone, you fall suddenly and unexpectedly through the ice. Shocked and cold in the dark, you can't even cry for help. You struggle for your very life, you struggle to the surface. Locating the jagged opening, you drag yourself through the air and crawl back into the woods from where you started. You decide to live there and never, never to return onto the ice. As weeks go by you see others on the ice skating and crossing the ice. If you go onto it, you will die."
"Your family across the pond hears the sad news that the temperature will drop to sub-zero this night. So a brave and caring family member (that is you, the parent!) searches and finds you to bring you home to love and warmth. The family member attempts to help you cross the ice by supporting and encouraging, pulling and prodding. You, believing you will die, fight for your life by kicking, screaming, punching and yelling (even obscenities) to get the other person away from you. Every effort is spent in attempting to disengage from this family member. The family member fights for your life, knowing you must have the love and warmth of home for your very survival. They take the blows you dish out and continue to pull you across the ice to home, knowing it's your only chance."
"The ice represents the strength of the bond and your ability to trust. It was damaged by the break in your connection to someone you trusted. Some children have numerous bonding breaks throughout their young lives. This is like crashing them into the ice water each time they are moved, scarring and chilling their hearts against ever loving and bonding again." By Nancy L. Thomas

Other posts:
Why Do They Act Like That? - If You Find Out I'm Not Perfect, You'll Leave
Prioritizing Yourself, Your Family, and Your Child 
Structure and Caring Support
Chores, Responsibilities, and Other Things My Kids Can't Handle
Document, Document, Document!!!

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