Tuesday, June 21, 2011

Words Matter

He's in!

I know a few readers mentioned that you are preparing to foster/adopt and considering an older kid/teenager. So for you guys, I wanted to share a text message that I got this afternoon. It came from T, while he was in the car (with his social worker) on the way to the treatment house where he's quite voluntarily signed up for a 3-month residential program. This is verbatim, as I know he wouldn't mind being quoted here:

"It feels good knowing I can make changes. I realized my decisions and the choices I was making weren't smart and I know I could be doing better but I thank you guys for being here for me and your support. I love you guys."

That feels great! We have been quite careful never to suggest in any way that he should feel gratitude toward us, but he has always found occasions to say thanks in a most genuine way. It occurred to me today that this is the first time he's ever moved from one home to another on positive terms that he elected for himself. I love knowing he does that with a strong sense of connection to us.

I wanted to post his text, because I remember so well that when you're preparing to be a foster/adoptive parent of an older kid and doing all the reading about various challenges and potential behaviors, it can be daunting. And as my posts over the past few months attest, it is! But I feel there's less said about how awe-inspiring the kids can be. I have many, many moments like today when T says something to me that leaves me stunned by happiness and a depth of love that astonishes me. I literally drive along in my car thinking:

"?!"

T is very good at expressing himself (in every medium: writing, speaking and behavior). As he's grown attached to us, I've noticed that he latches on to words and phrases we use and those become part of how he makes sense of the world. I'm sure any parent of a toddler has already learned that the words you use around your kid have a huge impact on their development. The same is true of a kid T's age.

We often talk in terms of choices and behavior, so as to avoid implicating his core being in issues that need attention. I see him using that language now as he reflects on what happened these past few months. He used to talk about his early childhood by saying things like "I was bad." Now he talks about the recent past by saying things like "I wasn't making smart choices." That's not just different language; it's a different sense of oneself and one's possibilities. We didn't give him that - he already had the capacity to believe in himself. We just helped him acquire the language to reinforce it.

We talk about sobriety in the same way, as a difficult and positive choice to be healthy, rather than just a "fix" for a problem - as a highly individual process, rather than an ultimatum. I've learned firsthand that if you hand him a different vocabulary for making sense of his behavior, he will borrow those words and use them to define his reality and that is what he is doing now - telling a new story about himself to the world.

Wednesday, June 15, 2011

Progress

We're making progress. T has spent two weeks in a group home, a situation for which he volunteered in order to simmer down before entering treatment. He's been doing the requisite pre-treatment intake appointments and exams and we've been sorting through the bureaucracy to get him admitted. It's official now that he'll move to the residential treatment program in a few days. We feel really good about it. We miss him, but we communicate about a thousand times a day by text message and occasionally by phone. He is obviously, audibly more relaxed. I believe he is now ready for the intensity of residential treatment.

His adoption is proceeding apace. In fact, the dependency court judge who hears his case every six months was so impressed when T explained his decision to enter residential treatment that she ordered his adoption completed "post haste", congratulated him and us, and reminded him that "the teenage years are rough, and it is very impressive to see a young man who is asking for help, with the support of committed parents." I am so pleased that the system recognizes T's efforts to salvage himself. It sends a great message.

I thought it might be useful to capture my advice based on our experience so far, in case anyone else is ever facing a similar decision. I'll keep the list running, but here's what occurs to me off the top:

1. Trust your gut. I've learned that once you're bonded to a kid, whether they are six months or sixteen years old, nature has set up the "gut sense" as an advanced early warning system. Our sense that something was VERY wrong was accurate and proceeded in kind with the intensification of his crisis state. This kind of knowing-without-knowing feels a little crazy - but in my experience, it is deeply instinctive and reliable.

2. Know who you can turn to for support. My parents were great, and even relieved us for a weekend so we could go away and clear our heads and renew our energy. My therapist friend was, of course, fabulous and confirmed for me that it was time for more intensive care than we could provide at home. My boss, who has grappled with her daughter's ongoing mental health needs, has the unshockable quality of a mom who's been there. Pretty much everyone else is overwhelmed by our situation. I understand. From the outside, it seems like a lot of turmoil. But the bottom line is that this is what we signed up for. We knew when we joined up with T that we'd be helping him deal with trauma and substance abuse. What looks like a disaster to one family is a success story to ours. It helps to have friends who understand that the fact that T isn't at home with us doesn't mean we aren't family.

3. Be prepared to navigate different definitions of normal. Kids like T come from very extreme backgrounds and have experienced things that it's hard for us to even imagine. So their definition of normal is informed by a broader spectrum of experience than I'm accustomed to. It took us two years to absorb this fact. But in order to reach him, and gain his trust, we have to understand and sometimes accommodate his sense of normal. You can lose yourself quickly in that kind of relativism. I've found that it takes a lot of talking and thinking to be both flexible enough to stretch one's own definition of normal to make room for a kid coming from an extreme background and strong enough to assert certain non-negotiable norms in order to keep the family safe and take action when it's necessary.

4. Invite the child to be part of the decision about treatment. That sounds obvious. But when you're talking to an angry, intoxicated teenager about treatment, it's harder and riskier than I had imagined. At his age, I cannot commit him to residential treatment without his cooperation. Through his haze, he was able to listen and recognize that it was time. I really respect him for that. I suspect that having been more or less without consistent parents for the first 14 years, T developed the ability to function as his own caretaker at times - if you speak to him as an equal, sometimes you can tap into that sense of responsibility and self-determination.

5. Communicate from a position of love. It has helped me a lot in the past few months to know that T understands that our intervention has been entirely motivated by love. We wrote him countless letters and had many, many talks all of which had the same these: I love you, and I would not be a good parent if I allowed you to continue harming yourself. We tried to tell him at each step along the way what we intended to do next, even before we knew whether it would pan out.

6. Do not aim for perfection. I would have liked to hasten T to the best residential treatment facility in the land the moment he gave his consent. In reality, we needed to slog through a great deal of bureaucracy - obtaining an order from a judge, involving his caseworker, getting his medical history from DCFS over to the prospective facility. That has taken about two weeks, during which T elected to stay in a group home so that he would be basically under lock. I don't love that scenario, but it was the best one available to us and it worked out fine. The legal complexities of adoption out of foster care are such that perfection is often unattainable. I am bad at accepting that. Tim is great at it. He's done a fantastic job of reminding me that we are making steady progress toward the end goal, even if the road is bumpy and unpleasant sometimes.

7. Count on the child's resilience. It took me two years to fully appreciate how resilient T is. I think witnessing his pain perhaps led me to believe on some unconscious level that he was fragile. But suffering and strength are not at all mutually exclusive and I understand that now in a deeper way than I did before. T has both the ability to really sabotage himself and the ability--way beyond any I've ever seen, even amongst adult friends-- to look himself squarely in the eye and do the hard thing in order to make things right.

8. Communicate even the hardest things in positive terms. I strongly believe that T was able to get where he is right now because he saw - through our eyes and those of a few other adults like the adoption court judge - a version of his predicament that preserved his self-esteem. Also, as a child who survived extreme abuse, he detects and rejects anger and disapproval very quickly; if he catches even a whiff of those things, he disconnects. On the other hand, he is very motivated by affection, optimism, and the promise of future return.

9. Call on everyone else who matters and assemble a united front. We worked past and present social workers, teachers, therapists in order to send a consistent message. In the end I pulled out the final stop: I got in touch with T's relative who was his caregiver in early years. I told her exactly what was going on and asked her to help me convince him to get treatment. We have been polite but somewhat distant until now - she has no reason to trust me, and assumed I was naive and indulgent. When I opened up the conversation with her about T's substance abuse, she heard me right away. She responded as a mother. She spoke frankly about the family's problems with addiction that led to T being in foster care in the first place. As soon as she spoke to him, he sensed a united front. There was no crack to slip through, no way to exploit divided loyalties to justify self-destruction. It was powerful. And she and I are close now and we tell each other the truth.

I'm sure I'll return to these themes in the coming weeks as we support him on his path.

Saturday, June 4, 2011

And We're Off

We're off! Here's what we did to get ready for residential treatment:

- Hit the Korean Spa for a massage. T says he "can't go to rehab with dry flaky skin."
- Hit the mall for Polo pajama pants "perfect for lounging in the tv room at the treatment house!"
- Bought an iPod and filled it with music (his last one was confiscated by the school during one of his bad behavior sprees). "I'm gonna be spending a lot of quiet thinking time and music will help me," he said quite convincingly.
- Had a little party with a few good supportive female friends who ordered pizza, straightened up his room for him, and wished him off.
- Swung by the barbershop for a quick lineup. (Hair-tending was an early and enduring bonding thing for us.)

This morning we're listening to the Temptations. He's packing. He made off with my grapefruit ginger body lotion. He left me with strict instructions to paint his room a tasteful shade of grey while he's gone.

I laughed at myself because I keep making lists "Take your meds! Don't forget to meet us at court on Tuesday at 8 am!" "Call me if you need a ride!" and sticking them to his luggage, like he's Paddington Bear. He's lived in 16 homes in 17 years, and got used to moving on short notice with nothing more than some Hefty bags to put his clothes in and a ride from a social worker. He told me to stop making such a fuss.

I figure it's early practice for when he grows up and gets his own place someday. I'm a precocious empty-nester.

Thanks, friends, for your comments this week - truly, it makes a difference.

Thursday, June 2, 2011

A Happy Unending

The short version is: T has decided to go to residential treatment and we've got the wheels in motion to get him into a really good treatment house next week. They specialize in "dual diagnosis", which, for the layperson, means they don't treat substance abuse in isolation and instead evaluate someone's full psychiatric, educational and vocational needs. It's the kind of place you go when things are falling apart on more than one front. And that's where T has been lately. Expelled from school, placed on probation, anxious, drinking and getting high every day; he's been in a downward spiral for some months.

We had to call an emergency status meeting with DCFS and their advisors (Department of Mental Health) to get to this point. It was a very uncomfortable meeting. I didn't think T would go - he had been awol for days beforehand. In addition, I don't trust his primary caseworker, who still has most of the decision-making power regarding his placement. There were a lot of people in the room we've never met before. They are part of a large bureaucracy that (in our experience) has trouble recognizing foster parents, including pre-adoptive ones, as something more than babysitters. We have no legal status in terms of our right to make decisions regarding T. We can only make suggestions. It was hard and somewhat humiliating.

I called the meeting because I was out of other options. As Tim and I noted later that night, it felt a lot like that movie where Denzel Washington chases down a runaway train by racing down the track in reverse and hitching his locomotive to the full weight of the larger train and tugging in reverse against the odds. It was a crude and imperfect strategy, but we were trying to leverage the physics of the enormous DCFS bureaucracy to stop T's self-destructive momentum. And just at the moment when it seemed like we'd all go down in a big messy tangle, it was as if T woke up from a slumber, looked around, and applied the brake himself.

The strangest part of all of this that I will never be able to fully understand is that the moment he decided to get treatment, he returned to himself. I know this is fragile, temporary and not to be trusted, but it's also awesome to observe and it was the key missing ingredient that opened up a host of opportunity. He calmed down, started communicating; he was warm, reasonable, and confident. Because we have to get a judge's order to put him in residential treatment and the judge can't see us until next week, he elected to go to a group home in another county for a long weekend to remove himself from the influences - the friends, the places, the teenage social pressures - that have been facilitating his decline. He made this decision with a maturity and wisdom I have seen in him before, but not for a long time.

Before the meeting, I sat T down. He was drunk, high and angry, but it was becoming hard to catch him sober during waking hours so I went for it anyway. I told him "You are not going to like some of the things you're going to hear me say in the meeting tomorrow, but I need you to be there and I want you to know that I love you very, very much and I'm going to say certain things in order to make certain things happen so that we can get you some options." I told him I planned to ask that they provide him with residential treatment, and that we had researched a particular program we felt good about. He skimmed the pages of the website we showed him. He looked at me through his haze and said "Do what you think is best."

The next day he was ready to go at the appointed time. He looked surprised at the formality of the meeting when we arrived - nearly a dozen adults sitting around a conference table with name tags in front of each. I cried when it was my turn to talk, and I gave a brutally honest explanation of his recent behavior. I explained that his "status" with us (DCFS talk for pre-adoptive foster placement in our home) was not in question , nor had our commitment to him changed in any way, but we felt he needed to get help beyond what we could provide on our own.

He spoke next. He was warm, awkward, and engaging. He said that he needed to get away for awhile and remove himself from his peers. He explained that he wants to be a nurse some day, and needs to go to college, but he's having trouble making decisions and keeping himself safe right now. He said he thinks something is wrong with his ability to control himself. He said he won't go to therapy if its up to him, but he'd like to go to a place where he has to go, where he doesn't have a choice. At first, they couldn't believe their ears. Judging from the looks on people's faces, he may be the first teenage boy in the history of DCFS to speak articulately in a status hearing about his desire for residential drug treatment. Afterwards, one of the more cynical people in the room told me "He sure is charming, and that's probably part of the problem." I told her she's wrong - I haven't seen him be that articulate in months. He wasn't doing it to be charming - he was using the better part of himself to get help. It was admirable, not suspicious.

In order for him to help himself, I have to separate from him and let him go and accept the risk that it may not work, and/or that he may not be home for quite some time. On some level, I have to recognize that I've failed--not through any fault, but just because he needs more than we can provide at home right now. It feels very...umbilical, to separate from him in this way. I have to recognize that other people will have the authority to guide him and I won't necessarily have a say. I won't be there. We'll be in touch, but he'll be making his own way, and it's sure to be very difficult for him. He'll have to lay down new circuitry for himself based on his own strength of character and the help of professionals I may never meet. He'll be home someday - but we won't know exactly when, and there's risk that this doesn't work for him. I am typically very logical and I knew quite clearly throughout the last couple months that we needed to get him to treatment. But actually seeing him off and giving up our daily life together at home is literally gut-wrenching.

I feel very much like a mom, in a way I never have before. I think it must be a most maternal experience to give up a child to a risky next step with fragile hopes for his future. And also to do so in a way that hurts terribly and yet fills you with the greatest pride.
 
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