Monday, July 14, 2014

Not So Big

Recently we went through a rough patch with E (T's younger brother, see below). He had a few days with us during which he was a remarkably different person, totally beyond any of our abilities to manage him. It ended without disastrous consequences, but it was a close call. (At one point, we had to involve the police and file a missing person's report and spent hours looking for him before he resurfaced.) We're trying to work closely with his group home now to try to develop some strategies in common for helping him manage his behavior, and get him the ongoing services he's going to need to help him into adulthood. The problem is, he's big on the outside, and not so big on the inside.

I'm relieved that his current group home obviously understands kids like him. We couldn't parent E full-time on our own. We would be in way over our heads and unable to provide the constant supervision he requires. E is turning 18 this month, and we're trying to work with them to secure his situation there until he's 21 to give him more time. We're hoping to get a conservatorship and disability services to help support E into adulthood and minimize the risk he poses to himself. T is part of that equation, and we've talked about the importance of the three of us working together, taking time-outs from E when he is too much for us, supporting each other so that no one of us burns out, and maintaining realistic expectations about what E needs and can manage.

As we've pieced together our understanding of how to help him, I've done some reading about fetal alcohol syndrome. I'm not a professional, but by this point, I am a well-trained foster parent, so I feel qualified to say that I have some knowledge of the impact of fetal drug and alcohol exposure. (Important to note: while E has traits associated with fetal alcohol syndrome, he also has a lot of other traits that are his own unique god-given personality, that have nothing to do with FASD.) Among the consequences of FAS that I see in E: he has poor impulse control, unusual difficulty making and keeping friends, a tendency to embellish the truth, and a need for near-constant supervision in order to stay safe and calm.

In these, our first months with him on a regular basis, we've found a few things by trial and error that help him manage:

1. He does best at our house, where things are quiet, relaxed and comfortable. He likes the garden, and knowing he can go someplace and take a time out or a nap when he needs to. He needs a lot of down time.

2. We have a (very) sensitive, snuggly dog, Monte, who works wonders with E. Monte greets him with wild enthusiasm, and they spend hours snuggling. E comforts Monte when he's nervous, and it makes him feel good to be the caregiver. Consistent with what I've read about FAS, E has a lot of trouble making and keeping friends, because his social development and sense of appropriate behavior is underdeveloped. He feels a lot of pain about this. But his bond with Monte is true and steadfast and reciprocal.

3. E sucks up the energy in any situation, so it is a bad mistake to expose him to environments where there is too much excitement, of any sort. He needs LOTS of quiet, fewer people, less noise and activity than other kids.

4. We need to know when we are in the danger zone where his behavior might exceed our ability to protect him and ourselves, and have and execute, quickly and consistently, a safety plan, which involves getting him back to his group home, or, if necessary, involving the police or taking him to a hospital.

One one very helpful website, I read this: "Children with fetal alcohol syndrome are vulnerable, naive, immature, and prone to getting into trouble with their poor communication skills, lack of impulse control, underdeveloped conscience, and poor judgment." That is pretty much consistent with what we see with E.

When E crosses a line, it feels unfair to discipline him for behavior beyond his control. By the same toke, to the extent that he's able to learn, we do want to try to teach him appropriate behavior, and hold him accountable. The trick seems to be to match that to his level of emotional development.

T was such a different kid; he was always supremely rational, and rational consequences worked with him on a lot of occasions. T's issues were post-traumatic stress, substance abuse, guilt and shame, and a lot of suppressed anger about what had happened to him. He always made sense to me, even when he was driving me crazy. He responded to love, high expectations, and tough, fair discipline appropriate to his behavior, combined with lots and lots of love and occasional, deserved indulgence.

E is not that way - his brain seems to be more injured and his development much more delayed. He needs an entirely different sort of guidance and support. But beyond the difficulties I'm describing here, he is such an easy young man to love. He is guileless and artistic. He's incredibly funny, a real comic genius. He's quick to demonstrate affection, and when he's comfortable, he's naturally friendly and outgoing. His smile and his laugh light up the room. He is absolutely worth everything we can give him and more.

Wednesday, July 9, 2014


T got in the car tonight when I picked him up from his treatment program and said, "My group says I should express myself more." Oh boy!

Turns out, he felt we'd left something unresolved yesterday: upon finding him lying on the sofa watching a movie and glaring at me around midday on a weekday, I suggested he find something to do, and perhaps get out of the house. I may have phrased this in a way that was less gentle that it sounds now that I'm writing about it. :)

He did do what I asked, actually. He left without saying good bye and went for a walk over the hill, to the park, where he took a nap. He came back a couple hours later, apologized for being moody, explained where he'd been, and said he was doing his best to learn to fill his time constructively.

I explained that his behavior - bored, sullen, restless - had, basically, frightened me and made me tense. I dislike admitting fear, but his mood caused me to remember in an instinctive way countless days when he would hang around the house, increasingly listless, until he finally bolted to get high, often with some ensuing chaos.

"Okay, now we're getting to something," he said. He explained that he needs time while he's in treatment to adjust and build up to his reentry into the world. I explained that I was tolerant of that, yet vigilant, because I felt that his long-term reliance on drugs had left him a bit confused about how one might otherwise fill one's time.

From there, we moved on to another topic. I don't remember how it came up, but we turned to the subject of our relationship to him. He said his recovery group had asked if he calls me "mom" and he had replied that he calls me by my first name, which made them wonder why. I said that this had never really mattered to me - that I considered myself part mom, part friend. "That's crazy," he said. "I said the exact same thing!" I explained that "mom" seemed to me a loaded word, and that since he had a "mom" when he met me, I had always been fine with being referred to by name. I said that I figured I was one of his moms - the others are his biological mom, and the cousin he lived with for several years when he was young, who is now part of our daily life. "Mom can be sort of a possessive word," I said. "Don't I know it!" he said. "I respect your mom, because she made you," I said. "That's the only thing I respect about her," he said. "That's understandable," I said.

We also talked about his cousin who parented him when he was young. Recently, I asked him to reach out to her for some paperwork we need for his brother. "I would prefer that you guys handle it," he explained tonight. "We will - I needed you to do this one favor, because sometimes she feels badly about what happened when you guys were taken from her, and I thought she'd have an easier time listening if you asked her," I explained. "She should feel bad," he said, quietly. That's a first - until now, he's been protective of her and reluctant (if not entirely averse) to admit that he was badly hurt and disappointed when she let him go back into the foster care system instead of fighting to keep him with her.

Having him in treatment is interesting. We retread old ground, and ease into some new territory as well. He's brutally honest, both by nature, and as he is encouraged to be by his program. As he gets better, he becomes more like an adult housemate and a little less like a child. He speaks frankly now about things I've often interpreted on his behalf. I don't need to read his behavior to know what he's thinking anymore; he tells me. It's an adjustment, and a wonder.

Wednesday, July 2, 2014

Good at Family, Part Two

Every family is good at something, and ours is good at therapy. Growing up, my mom and dad and my brother and I were good at tennis, tourism, and slipping into church late. Tim, T and I are good at therapy.

With foster/adoption of an older child, you don't have much choice. Inundated from the start with third-party "helpers" and various forms of therapeutic support and intervention, you gain a certain comfort in that climate. When T first came to us, we had a wrap-around service (read: intensive in-home case management) and out-patient services at a local university. Later, we had family therapy, social workers, and multiple court systems to contend with. As his substance abuse issues deepened, we also had out-patient and in-patient treatment programs with all that that entails. Suffice it to say, at times our life together was like living in a shoe box without a lid, with interested parties peering in at us all the time. What's more, as the white parent of an African American child, most everyone had an "opinion," spoken or not. Many, many people have been overt or covert with their skepticism, criticism, or bias. We've gotten used to navigating other people's intrusions, misapprehensions, and questions.

So family therapy, with its inevitable airing of the family laundry, isn't so startling to us as it is to some. We go into it like some families go into team sports: we're ready, we know our positions and our respective cues. We even have a bit of a schtick. Usually, T takes the lead. He's our "alpha" in family therapy.  I remember once, in a family group setting at an in-patient treatment program, when T announced to the room that our family likes to go to Korean spas together during happy times. All eyes were on us. I'm sure no other 17 year-old had ever announced a love of Korean spa-going with his parents. Knowing that he had command of the room, T went on and on about it, detailing how I enjoyed the salt scrub, while he preferred acupressure massage and Tim liked to read a book in the sauna. Even the group leader was at a loss for words. "It must be nice," the woman next to me muttered. I was both proud and red with embarrassment.

We also have our in-jokes. Witness: long ago, T and I thought it would be funny to flip each other off during family therapy. I'm sure you're appalled, but to us, it's terribly funny. When the therapist isn't looking, one of us subtly shows the other the finger. Maybe it's the rub of a nose, or the apparent scratching of an itch, but it's unmistakably the middle finger. This private signal has persisted for several years, through many rounds of chaos and recovery, through many different therapists and mental health providers; remarkably, none of them have ever noticed, or admitted to noticing. During our darkest moments, and our brightest, we've found the occasion to flip each other off. It's what my British colleague used to call "taking the piss": a way of deflating pretenses, having a laugh. Just the other day, T snuck in a raised middle finger in the midst of some serious family conversation. It's like we're aliens, as if the standard greeting on our home planet is to flip someone the bird, by way of signaling mutual membership in a private society.

So anyway, we're back in family therapy, this time as part of his Twelve Step program. We started our Saturday group last week. Personally, I don't like to call attention to myself in group settings, but sometimes we have to follow T's lead. He's not someone to hide his light under a bushel basket. First of all, he's very beautiful, with large eyes and long curly lashes, and extra long thin limbs. People stare at him wherever he goes, simply on the basis of the way he looks. Second of all, he doesn't care about other people's opinions of him, or of us. He's been through far too much to fret over a few uninformed assessments. He flies his freak flag high, and encourages us to do the same.

One of his favorite things to do is to make eloquent speeches describing the point of view of the parent, as he did last Saturday. He'll say things like "Sometimes the parent blames herself for the child's problems, but it's not her fault - she has to let the child learn things for himself, and that can be really hard, because she doesn't want to see him get hurt." Of course, the other parents in the room are usually somewhat taken aback. His eloquence, neutrality, and (occasionally condescending) compassion for the parental point-of-view are captivating, amusing, and odd.

Sometimes in family group, I cry. I rarely (very rarely!) cry at home, and I can see that my open display of vulnerability is gratifying for T, besides being a much-needed release of pressure for me. The presence of other people takes some of the pressure off that I might feel in private. We can "leave the emotions in the room", as T likes to say. We can allow each other a moment of candor and of raw feeling that would be too much to manage at home.

Tim has his role too. He is the patient, unconditionally supportive, less sensitive parent. He's the one who gets us to our family group on time, and takes everyone out for breakfast afterwards. He's the one who scratches his head and looks puzzled when too much emotion starts to fly, and the one who can sum up our meanderings and emotional emissions to arrive at some practical plan of action. The therapist usually looks relieved when Tim starts to talk. He's the straight man to T's clown, the much-needed gravity to balance the levity and the tragedy.

In T's current program, so far, we are the only two-parent family group participating.  We are the only bi-racial family, and T is also by far the youngest. But we've slipped right back into it. He is more eager to participate than ever before, and we are so glad to have him back.

First Steps

As I mentioned below, for most of the past year, T was living in another city. At first, he was attending community college. Then he left school and he was working. Then he lost his job and he wasn't doing much of anything except getting high. During this time, we continued to pay his rent (he was renting a room from a family friend) and agonized over whether to cut that off. Eventually, that problem solved itself, because he was evicted. When he was evicted, we refused to let him move home.  He crashed for awhile at the home of his older brother. Eventually, he wore his welcome there thin as well.

Having run out of options, he agreed to enter an addiction treatment program. Our insurance wouldn't cover residential treatment, but they did offer intensive out patient treatment. And thus, he has ended up living with us again. He goes to group 3 nights a week for 3 hours, and on other days, he must go to at least one meeting. On Saturdays, we go to a family group.

The program is wonderful and the facility is comfortable. It's a classic Twelve Step program. This is his fourth attempt at sobriety. He was in residential treatment when he was 17, and later did two different out-patient programs. But he has never embraced recovery as he is doing now.

I know, and he says himself, that the difference this time is that he really scared himself. His life fell apart and he saw that he had lost control. And he feels that this time, the decision to seek treatment was entirely his own. That said, he acknowledges that we let him "hit bottom" and made a hard choice not to enable him so he could reach that point. He says he's grateful to us for that and knows how hard it was. As I have been so often, I'm amazed at his ability to recognize and appreciate our point of view.

To be honest, it's (mostly!) a joy to have him in the house, although we were nervous about it at first and we still worry that things might take a turn for the worse. But we also really missed him. It's been so long since we have seen him sober, so long since he was able to focus on anything other than the pursuit of his next high, that we are marveling at all the wonderful qualities that we haven't been able to appreciate during his downward spiral.

I'm also working on not being co-dependent - on recuperating and reinforcing my boundaries. That's been a lifelong project for me - I was bad at it long before we met T. And once we became his parents, and his substance abuse began to take over his life, I found it really confusing to try to parent him while setting limits with him around his addiction. Through the program that he's in right now, I've got the opportunity to talk to other parents and family members of other addicts and reset my own priorities. Last weekend in family group, I cried for the first time in years, and realized that our struggles with T's substance abuse have been harder and more confusing than I've allowed myself to acknowledge.

A Twelve Step program and the close community of recovering addicts that the program creates seem so apt in terms of meeting his needs. In the program, he's able to share his whole life story in a way he's never done with anyone other than us. Many of the other people in the program have had significant struggles of their own. Nobody else grew up in foster care, but there are certainly people there who have been abused or abandoned by a parent, who have struggled with depression, or suffered profound losses. One man who befriended him lost his young son in a tragic accident. Among his new sober community, T is not marked as the kid who is "different", the one with the painful past or the tragic family history. Everyone there has a narrative of chaos and pain. He is able to exercise his natural well of compassion and welcome the compassion that the community extends to him. His recovery plan includes several extended writing exercises, in the form of letters to us and to some of his birth family that he reads at his group sessions. Like me, he has always worked out his feelings in writing, more so than talking, so this approach is something that works really well for him.

He talks a lot about how guilty he feels for the suffering he caused us and the ways that he manipulated us into inadvertently enabling his drug use. He's easy to forgive. I try to remember that it doesn't help him or me for me to minimize his wrongdoing in my rush to embrace his recovery.

All of this sounds unfortunate and upsetting, perhaps. But it's actually a time of profound joy for all three of us. In the same way that another parent might wonder at their child's first steps, we are amazed by his rapid development, his sudden maturity and bravery as he makes this foray into sobriety and, for the first time, accepts genuine compassion and support from a community of friends. He is thoughtful, funny, loving, and emotionally engaged with us and with himself. He feels good about himself for the first time in years.

Once, a long time ago, I wrote a post where I mentioned that a social worker once told us that an infant must go through ten thousand cycles of need and gratification with a parent in order to form a secure attachment, which is the basis for growth and development. We felt we were starting so far behind with T - that he had missed those ten thousand cycles, or at least most of them. In this latest chapter of our relationship with him, we see a huge leap forward that we had begun to feel might never happen. I think he finally reached those ten thousand cycles. He was finally ready to take the risk of respecting himself and moving forward in pursuit of a healthy independence. It's a beautiful thing.
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