Friday, December 31, 2010

Short addition

I just caught up with what's going on with Tudu over here. I'm feeling heartbroken. Please, anyone who's familiar with the case, let me know if there's anything I can do, or any letter I can write.  I'm checking my atlasien email address in the profile.

Happy New Year!

Hello everyone! I'm sorry I never followed through on my last post many months ago. I'm going to try again next year to get back into the swing of blogging and catch up on how everyone else is doing.

Here's a little bit of what happened in 2010.

- BB came to us. I flew to the city and waited at the airport curbside. His foster father drove up and handed him over. I turned around and flew back to Atlanta carrying him.  BB was already very familiar with me due to our visits, but it just felt... strange, as you can probably imagine.

- I took a two-month maternity leave. I also became very depressed during this time. I was functional, and dealt with it in several different ways.  Guy also had some problems with depression, and Sunny did not handle the addition well.  He loves his brother, absolutely loves him, and I'm convinced we have done the best thing for both of them. Nevertheless, in the short term it was very difficult for him to come to grips with the fact that he was suddenly receiving a lot less attention.

- BB is a highly active, dynamic, joyful and sensitive child, much like his brother. He smiles and laughs and dances all the time. He also cries and screams often. He needs a lot of attention. He was behind in several developmental areas such as fine motor skills and behind in speech development: at 20 months, he still hadn't spoken any words at all.  But during his eight months with us, he's caught up a lot. At almost 2.5 years, he's now opening doorknobs, eating with a spoon, climbing everything in sight, saying "Mommy" and "Daddy" and "I want my booties" and "please" and "thank you", answering the telephone, and a bunch of other things I'm very proud of.

- Sunny's behavior at home is more or less the same as it was in the beginning of the year, but his behavior at school took a nosedive. He was kicked out of his summer day camp for defiant behavior.  After one month in third grade at the same charter school he's been going to for two years, he started getting in a lot of trouble. Things like throwing pencils, disobeying the teacher, even telling the principal to f*** off.  We're working with them to do an IEP. Guy has been going to the school almost daily to do things like have lunch with Sunny to make him feel better and more regulated. 

- I don't think the Abilify is really working anymore. We're looking at switching to another medication; I'm going to ask the psychiatrist about Depakote. We're up against the wall when it comes to his schooling. He's already had one "disciplinary hearing." The school is not our enemy in any sense, I really feel like we're all working together, but they don't have the resources right now to do the only thing that works when he gets deep into one of his fits: restraint.  All they can do right now is call one of us to come get him so that he doesn't hurt someone else or himself during one of them.

- Sunny's behavior is also isolating him socially at school. The other students in third grade are starting to avoid him because of his outbursts. He still has great relationships with his friends in the neighborhood, but I'm really worried that he's on the path to hating every part of the school that he was so happy with in first and second grade.

- Our new Georgia governor (makes gagging noise). I don't even want to think about him.

I've been dealing with depression from a lot of stress that comes partly from parenting, partly from finances. I'd really like to make a change in my job, but helping Sunny might cost a lot of money, so now is not the best time to make such a change.  I feel isolated, but not energized enough to take the steps that I know I should take to un-isolate myself.

But overall, I and my family are still holding together well.  I'm on Lexapro now, and although the side effects when I started were really, really rough, I think it's having some positive effect.  My mother has been helping me out a lot, too.

Oh, and for those who remember all the stuff I've written about my dad? The last time he was over here, Guy was talking with him about something parenting related, and asked him what he would do in his shoes... and my dad said "I have no advice for you. I was a terrible father." Sigh. As usual, he's being hyperbolic.  He messed up a lot of things, but he wasn't that bad, really.  But it goes to show that a lot of the challenges we're facing are unprecedented in the history of our families.

I hate to be gloomy at this time of the year, but I want to paint an accurate picture of what's been going on. And like I said, it's really not all that bad, and I'm confident 2011 is going to be better. I'm going to try and make a happy 2011 post by the end of the weekend.

I'm looking forward to our official adoption of BB, which should happen very soon. Everything is filed; we're waiting on a court date.

If you'd like to update me on your milestones for 2010, please comment and link! I'm going to try and catch up, but it'll be an uphill struggle. I've read so many blogs that cover the bad as well as the good, and they've been so useful to me, but it's been unexpectedly hard to keep up communication during my own most difficult times. I'm just going to keep on doing my best.

Love and Peace in the New Year,
- Atlasien

Tuesday, May 04, 2010

I'm OK, and I apologize for the long absence!

I sincerely apologize to those who've been worried and left nice comments.  Actually, to anyone who's been worried.  I really should have put up a post saying I wouldn't blog for a while.

I've been gone from this blog, from Racialicious commenting and from Twitter for more than a month now. I did a volunteer trip to DC, spent a weekend in New York City, and visited BB and Sunny's home state several times.  This weekend, I picked up BB at the airport curbside and flew him back to what should now be his permanent home. 

I've been under a lot of stress, and I had a very, very strong attack of the typical internet paranoia that strikes a lot of foster care bloggers.  There was some drama we almost got sucked into.  I had dipped my toes in Facebook, but now I think Facebook is a bad fit for me and I won't be updating or adding any more friends or relatives to the list. 

I just started a two-month maternity leave. I appreciate the fact that I get leave when so many other mothers don't, but I think this is also going to be a difficult time.  Although I'm happy to finally have BB with us -- and Sunny and BB are fantastic together -- it's very intensive to care for BB.  Luckily his foster mom has been giving me great advice, including tips on how to get him to eat his veggies.  He's taking a nap in the other room right now.

Please let me know if you have any questions and I'll try to get started blogging again by answering them! I'm going to make it my goal to update at least once a week from now on, and slowly get caught up on the blogs in my Reader as well.

Tuesday, March 02, 2010

Rough Weekend - Short Update

Sunny broke a long streak of great behavior by sort of falling apart this weekend.  Guy was out of town on a trip, and Sunny didn't handle it as well as he did on the last trip.

He had a fit on Saturday, and then a huge one on Sunday, where he pushed me in the supermarket because I wouldn't buy him the snack bar he wanted.  We went out to the car, and it took almost 15 minutes in the back seat before he calmed down.

It was quite depressing and tiring for me... but I'm looking on the bright side, as well.  Two steps forward, one step back.

Friday, February 26, 2010

Torchwood Season One Ratings Guide!

Here's a fun post I've been working on here and there, over the past week.

I finished all of Torchwood, plus Captain Jack Harkness appearances in Doctor Who Seasons One, Three and Four. I'm now going back and watching Torchwood Season One over again. So here are my ratings for the various episodes of Season One. They have been rated according to the following categories:

Sexual TensionImageThis category is self-explanatory.
ActionImageExplosions, Chases, Fights, Stabbings, Chompings, Shootings, Decapitations, etc.
DramaImageCharacter development and effective emotional-type stuff.
WTFeryImageAnything off the wall in an especially good or bad way. Includes plot holes and strange hommages/rip-offs.

Image-heavy, so click here for the full post if you're not already on the post page...

Thursday, February 25, 2010

More on Anger, and why Catharsis Doesn't Work

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I've been thinking about this topic on and off all week, and how to respond to this argument of support for the hydraulic theory of anger (though the comment supports the theory as description, not prescription, and that's an important difference)

Ultimately, there can be many different reasons to explain the mechanism of the same pattern - in this case, the anger-release-calm, anger-release-calm pattern.

The cycle starts off when something in the world doesn't go our way. The world intrudes into the boundary of the self. Maybe we feel physically threatened. Or we feel a loss of control. Or we just feel really small all of a sudden. We then respond to the world by attempting to shore up and strengthen the boundaries of the self. These responses can have positive, neutral or negative outcomes for ourselves and for other people.

Driving in Atlanta traffic presents numerous opportunities to understand anger. Let's say I'm on my way to work, and I've managed to achieve an emotional equilibrium within my immediate environment. I'm listening to some rocking music. I haven't hit too many red lights. I'm on time. I'm in a rhythm. Things are going right with the world. Then someone cuts me off and comes dangerously close to hitting my car.

My first, split-second reaction is visceral. I doubt a cat or a dog or a monkey would react differently. There must be a short release of adrenaline, my heart rate goes up, my brain goes into overdrive, and the fight-or-flight response kicks in.

However, since I've been socialized extensively on how to react in these situations, as are most drivers, this reaction doesn't last long. I don't drive off the road or try to kill the person who cut me off. I assess the situation realistically. My heart rate goes back to normal only a couple seconds later. I realize my muscles are tense, so I relax them; I'm holding my breath, so I let it out, perhaps saying a few four-letter words at the same time.

Within a few seconds, I start having a second reaction. This is a much more emotional reaction than visceral. My boundaries of self come into play. I'm not just a bundle of nerves anymore, I'm a human being, and I've been insulted by whatever other human being was driving that other car. They've invaded my space. The world is suddenly out of equilibrium. I imagine their thoughtlessness, their lack of care; I imagine them imagining me, or not imagining me. I imagine that the world has a sense of justice, and now I've experienced the world's injustice. They don't care about me, and I care about the fact that they don't care about me. It's not right for a person to act that way. I wish I could reach out and make them know that. Make them. My control was taken away. I want to reassert control. At this stage, a whole chain of thoughts and imaginings are running around in my head. I'm angry.

Then a few more seconds and I'm over the second stage. I'm on my way to recovering equilibrium. That chain of thoughts runs out, it's not attached to anything... it slips out of my head. I'm not angry anymore.

I don't have a road rage problem, so if you were driving with me in the passenger side, you wouldn't know any of this was going on. The only outward signs would be a short cursing spell and a slight tightening of hands on the wheel. At absolute worst, I'd bang my fist lightly on the steering wheel. I don't know exactly why I curse and steering-wheel bang, but if I had to guess, it's because I've been socialized into that reaction by hearing and seeing so many other people do the same thing.

I called visceral reactions the first stage, and emotional reactions the second stage, but in most other situations, it's not that clear-cut. The second can come first. Or they can feed into each other and go back and forth. That's how we start to see these anger cycles.

Here's an example of the second stage going first. The next morning after the 2004 election was a rough one for me. I'd worked on the Kerry campaign. I was terrified of what George W. Bush would do to this country. The morning we lost, I definitely felt like the world was not only invading my boundaries of self, but burning them down with a blowtorch and then laughing at them. I was powerless, pathetic, depressed, fearful and hopeless. I went out for a smoke break (I quit that year, actually). Another coworker on his smoke break said "Looks like Bush won. I didn't even like him that much, so I'm not happy about it. But I've always voted Republican and I always will, that's just what we do in my family."

I was suddenly very angry. My sense of being under attack by the world was based on social, political and emotional factors, but all those complicated factors had just crystallized into the presence of a human being standing next to me. I had a friendly relationship with this guy, I already knew his stupid political views, and we always had nice conversations, because we never discussed politics. But all this social context was unimaginable in that split second. I was having a visceral reaction: ENEMY ATTACK FIGHT HURT.

My reaction was to turn my face, grit my teeth, walk a few steps away and sigh. The feeling passed. My heart rate returned to normal. I got over it.

I don't want to get pinned down to any one psychological or philosophical theory about the boundaries of self. They're very flexible. You often feel like your self is interwoven with your family and loved ones, your community, even the world itself. In general, I find that it's a useful way to think about issues involving control and anger.

As a teenager I engaged in several violent situations -- basically, short fistfights -- where I became trapped in one of the stages, and it turned into aggression. It's easier to talk about the two extremely mild examples above, because to dissect my emotions at their most violent would be too depressing and embarrassing. I will say that I can look back to those teenage years and pinpoint an interesting variety of reasons why I released that aggression.

1) I had no choice. It was a true fight-or-flight situation, and I couldn't run. Oddly enough, I didn't feel particularly angry when I hit.
2) I had an opportunity to run, or to turn away, but a combination of external factors made me feel so powerless that hitting back was the only way I could regain any sort of emotional control. I felt like I would die if I didn't.
3) I was drunk and it felt good.

With all that in mind I want to touch on the situation that marythemom raised in her comment: the cycle of domestic violence. It's extremely disturbing to try and put myself in the mind of an abuser but I'm going to give it a try. Looking at my own reactions, I can get halfway there, and then I have to squeamishly imagine the rest of it.

Abusers beat their victims (usually a man beating a woman or children, but I'll use the word generically) for two reasons: to gain a sense of control (emotional), and because it feels good (visceral). It must be a complicated mixture, and some tend more to one extreme than another. I can imagine that some abusers are totally conscienceless and do it out of sheer enjoyment. For them, it's like having a really fun boxing match, except that they're not in danger of getting hit back. They get that rush of adrenaline, the raised heartrate, the heightened sensitivity, and they don't think beyond that.

However, I think it's more common that abusers don't get that much physical enjoyment out of the abuse. It's more of an emotional issue. They feel like they're out of control. Their job is getting to them. They're not achieving all the goals that their society tells them they should have achieved. Something is holding them back.

It's accepted in our society, and shown in every type of media, that men can express their anger physically. These expressions of anger don't make you any less of a man. In fact, they make you more of a man. The abuser already has a link between control and aggression nested in their mind. One day, the abuser experiments by hitting someone close. The world becomes crystallized into that person next to them, and a visceral reaction sets in... if they hit that person, they'll reinforce their boundaries of self. They assert themselves as someone with power, someone in control. They hit. It feels good. Then, when the adrenaline fades away, it feels really, really bad.

They apologize and make desperate promises. But the problem is that they've already established a pattern. Feel bad > hit > feel good > feel bad > apologize/justify > feel good > feel bad > hit. Instead of breaking the pattern, they refine it in order to reduce cognitive dissonance. In other words, they don't want to think of themselves as bad people, so they build up elaborate justifications. She was asking for it. He didn't want to do this, but he had to do it. He had no choice. He didn't like it, but it had to be done. She drove him to it.  The abuser has built up a fantasy world that justifies their abuse. They don't want to move outside that world, because then they'd have to face the moral consequences of their actions.

It's a pattern, but it's not a pattern where a unitary force (anger) builds up and then has to be released. It's a complicated interplay between control, the boundaries of the self, imagination and pleasure. There have been studies done that prove the catharsis/hydraulic theory does not work to reduce anger. A lot of modern approaches I've seen explicitly reject the hydraulic buildup-release model as being too convenient... especially convenient when it comes to the rationalization stage. Instead, to simplify the process, they use other models, such as addiction.

I've found that reading about Buddhism is also a great way to approach anger - anger as craving. Many Buddhists work to move beyond this craving. In Buddhism, you can't just say "I am going to control my anger!" You have to ask, who is this "I" in the first place? And why does this "I" feel the need to control, much less the need to control anger?

I'm certainly not cut out to be a nun, and my particular branch of Buddhism doesn't focus so much on perfecting the emotions. But it's definitely helped me get a greater sense of awareness. Those are the two key terms for me: awareness, and letting-go. I'm not in control all the time, and I'm aware of that. I'm going to feel things that I don't like to feel, and feel things I don't want to feel, but these feelings will pass. I don't need to hold on to them. I don't need to police the boundaries of my self in order to feel whole.

Finally, getting to anger in children: children feel intensely, and lack the adult capacity for self-awareness. Their boundary between the self and the world is constantly shifting. The world constantly intrudes on them. They have their control granted and then taken away for seemingly mysterious reasons. They imitate adult patterns of aggression without understanding the roots of the pattern. They want to explain all these powerful things they feel and imagine but can't find the right words. Habit reassures them and anchors them, even when the habit brings emotional pain.

You could actually say all of these things about some adults, now that I think of it! Anyway, anger issues in children are just ridiculously complicated, and listing it out like this is so frustrating, it almost makes me want to start banging my head against the keyboard... RRRARRR!!

Sigh... it'll pass...

Wednesday, February 17, 2010

A couple responses to the TDD post

I started replying to comments but decided to post the replies here to the main page, since it's such an interesting and new subject.  Several people have left comments on the TDD post; here are my responses to the last two.

@Essie:
I wonder what the social attitude/stigma towards "Temper Dysregulation Disorder" is going to be in five years time.  I do hope it doesn't become the "spoiled brat" diagnosis.  Then again, it would probably have to compete with ADHD for that label.

I was recently discussing with my friend and neighbor how according to the DSM-V, her son doesn't have Asperger's anymore. He now has plain "autism spectrum disorder".  She said she was actually relieved, because Asperger's has been getting a reputation as "not a real problem".  Her son does so well academically that he's in a gifted program, but he's also got some major special needs and just can't function in regular junior high school without extra supports in place.  They've had to struggle hugely, even to the point of getting a lawyer, over the services he needs to stay in school.  They've noticed that over the last decade as the awareness of Asperger's has grown, and the negative stigma has decreased, there's a sort of reverse positive stigma -- "it's just that they're extra quirky" -- that isn't helpful at all in terms of getting him supports.

It's such a fine line. Labels can help us get help for our kids, but they come with such huge baggage... social stigma, inaccuracies, false predictions.

@marythemom:
I've watched some documentaries on childhood bipolar and read some articles, and from what I can tell, true, unmistakeable mania is way beyond what I've seen from my son. There was a little girl talking -- very calmly and with a smile on her face -- about how she wanted to cut off her mom's head with a knife. Children who thought they were invulnerable and could jump off roofs or out of moving cars. Children who kept seeing weird sexual hallucinations during the daytime. These weren't children who had attachment issues; I think all of them were bio kids from regular families.

I have a feeling that future studies are going to show that some anti-psychotics are going to work equally well on TDD and childhood bipolar.  I really hope someone will do some therapy studies as well. When we started out, we had so many ideas for how to manage fits, but I've had to disregard most of them as worthless.  They may work for regular, developmentally appropriate temper tantrums, but they don't work for my son.

And as a side note, I realize a lot of them are based on "the hydraulic theory of anger", a disparaging term I've heard a few times.  It's the idea that anger builds up inside you like steam, and to get rid of the anger you have to express it somehow in order to release it.  That makes intuitive sense -- we want to believe it's true -- but nobody has really been able to back that up. Extend it to other emotions and it doesn't make sense. If you're happy, and you express your happiness by jumping into the air while pumping your fists and shouting "I FEEL GOOD" does that release your happiness like steam so that you suddenly stop being happy?

I do think anger/rage/temper causes extreme physical and mental tension, and part of defusing it is releasing that tension, but we have to figure out how to release the tension in ways that don't involve expressing the anger, even against inanimate objects.  That just creates a habit of expressing anger.

Tuesday, February 16, 2010

Toddlers and Torchwood

I had a fairly productive weekend.  Right now, I'm a bit stressed because I'm neck-deep in a semi-crisis at my agency.  It's a combination of typically high turnover and terrible communication practices by social workers.  Perhaps they practice keeping secrets so much that they forget how to actually tell important things to large groups of people.  I don't talk about my job here, but I will say that I have a bit of experience when it comes to the psychology of communication about change.  You really should not have the junior-most person in the organization sending stakeholders a mass email saying "I'm leaving and everything is changing, but I won't say exactly how, I'll just let you the reader fill in the blanks with the worst-case scenario, but don't worry, nothing will really change."

On the bright side, we finally have a subsidy and reimbursement amount for BB, which means a presentation date can be scheduled soon. I'm happy with the amount. I'm going to regard this as a solid enough milestone to go ahead and buy some general parenting books on toddlers.  I'm especially worried about attachment issues.  I remember reading "Toddler Adoption" a while back, but I need to go dig it up again. 

I've also been watching a lot of Torchwood lately.  It was added to the Netflix Watch Instantly list, and I thought I'd give it a try.  The only thing I knew was that it was a Doctor Who spin-off with more adult subject matter. IT. IS. SO. FREAKING. GOOD.  I'm not typically the kind of person who falls in love with TV shows.  I mean, I like exciting, character-driven, well-written shows like Buffy and Angel and The Wire and Six Feet Under and Big Love and Battlestar Galactica (yes, I cried at the end even though the end was kind of stupid) and so on. But I can't recall a TV show that hooked me in as quickly as Torchwood!  It's like television crack, and I'm totally addicted. Now I'm listening to Torchwood radio plays and buying Torchwood books along with the toddler books.

Here's why.  I'll get the bad stuff on the table right away.  The series starts off a little unevenly.  I thought that some of the first season episodes were too sentimental.  And if you're into serious/hard science fiction (and I am) you need to suspend your disbelief.  Like Doctor Who, it's really more "science fantasy".  Especially factoring in all the time travel, there are often plot holes big enough to drive a truck through.  Much of the basic plot structure clearly comes from a kind of Buffy/Angel/X-Files secret team format.  Plus, you don't really get the full picture unless you're watching Doctor Who, and I was never a huge fan and have only sporadically watched the new Doctor Who series.
 

Image
ImageThe good stuff: the acting is fantastic. The show takes a lot more risks than any American equivalent I can think of.  The subject matter is dark and the body count is high, so even the plots may start off as derivative, they soon get complicated.  You know where the shows start but not necessarily where they're going to end.  The characters are actually changed by what they go through and events are taken very seriously... but there's still plenty of cheeky humor.  And then there's the fact that the team is led by a heroic bisexual cosmic space slut. Captain Jack Harkness is an absolutely fantastic character.  To really get the full story on Captain Jack, you have to jump back and forth a bit between Torchwood and Doctor Who, and luckily Netflix Watch Instantly has them all available.  If you want to start from the very beginning, watch Doctor Who Series One Episodes 9-12 then start on Torchwood Series One.

I only have one episode left to watch: Children of Earth Day Five. Day Four was grueling... and heartbreaking. I knew what was going to happen, but I still cried just a little bit.

At least I know there's going to be a Season Four.  There's also a development to Americanize the show to some degree and put a version on FOX.  I'm rather leery about that.  It's not Torchwood without awesomely gratuitous gay sex, and I don't see that happening on FOX!

Right now I'm trying to get my mother to watch Torchwood too.  She's not really a sci-fi head like me, but she's much more of an Anglophile, so it shouldn't be too hard.  She thinks anything from the BBC is brilliant.  I've argued with her before that there are just as many crappy shows in the UK, it's just that they only export the best of them.  And even those are frequently fishy.  For every "Father Ted" there's an "Are You Being Served". I think my husband is probably a lost cause, though.  His favorite BBC show is "Lovejoy".

Saturday, February 13, 2010

Snowed In! And other stuff.

We got several inches of snow yesterday, which for Atlanta is quite extreme. My father flew in from Hawaii just in time, or else his flight probably would have been cancelled.

We're planning on spending a quiet weekend at home. I don't want to drive anywhere until this nasty snow melts.

I've been following the New Life missionary scandal mostly via Bastardette. It's getting more and more tangled. They're turning against each other. Their lawyer, Jorge Puello, isn't a real lawyer, and he's suspected of trafficking kids from El Salvador for prostitution. There's this matter of a supposed $60,000 bribe. The ringleader, Laura Silsby, was probably motivated by greed. I do feel sorry for the two teenagers in the group; their parents were criminally irresponsible to have involved them in this mess.

I'm sure there'll be more twists and turns, plus a few tell-all exclusives and books. Sadly, at least some of the New Lifers will make on the profit on this story when they're released from prison.

I'm waiting for the inevitable movie, which will probably be some kind of made-for-TV crap. I'd see it, if was of real cinematic quality. Perhaps the Coen brothers? Or González Iñárritu. Trailer voice: "A nation in peril. Fear of God. Love of money. Desire for children. Combined in one woman. Snaring others into her web and dragging them into the moral abyss." Laura Silsby played by Meryl Streep. Judge Bernard Saint-Vil played by Jimmy Jean-Louis. Jorge Puello played by Benicio del Toro.

On another topic, I remembered recently that I wanted to link to this post from last month at Restructure: "White people’s family roots are deeper than those of ethnic minorities."

I love this post. It absolutely eviscerates a common and irritating stereotype: that minorities have "deeper roots". I run into this all the time. Often, it's very well-meaning and put across in a self-deprecatory fashion. "Oh, I'm not very interesting, I'm just a plain vanilla kind of family, I'm a mutt, I don't have any special ties to another culture..." Even though it's often intended in a positive way, it has the potential to be really insulting and damaging.

I'm certainly insulted by it. I mean, I can trace my white ancestors back 500 years, to York and Hanover, with a few mouse clicks. I'm very connected to American culture, and I feel a strong connection to England as well. The fact that I'm not white shouldn't mean I'm an automatic foreigner to Anglo-American culture. On the other hand, I can't even read or write my father's name in Japanese, much less my Japanese grandparents' names. I don't speak Japanese. And this lack of knowledge isn't wholly by choice, it's because I grew up partly in a racist environment where being marked as non-white meant you were supposed to conform culturally or else face verbal and physical attacks.

Like Restructure says, the stereotype of "deeper roots" masks the responsibility for cutting off those very same roots.

I can think of another, more subtle effect.  White people often talk about being cut off from their roots in the context of feeling a kind of existential angst that propels them into a desperate search for meaning.  That's quite understandable.  Modern American life increasingly isolates people.  Extended families are scattered all over. Family and community ties break apart.  The problem is that people often don't realize that these isolating social forces affect minorities just as much and even more.  I think in a lot of movies and books and art, the angst of middle- and upper-class white people is cast in a really portentous, heroic, important light.  Take that George Clooney movie Up in the Air, which I didn't see, but I heard it was about an angsty white business traveler.  Nobody makes big budget movies about angsty Mexican landscapers or angsty black postal workers or angsty Korean convenience store owners.  When you get into more independent movies, you finally start to see portrayals of people of color addressing complicated psychological pain: Michael Kang's "The Motel" is a great example.  But usually, any minority in a lower-class job is stereotyped as hard-working but happy, or oppressed and sad and noble.  Often, they help the angsty white character discover what's really important in life.  Because they are simple people and they have roots.  Gah!

Anyway, I love Restructure's take on the topic.  I also recommend her post "Libertarianism is rational for rich white people only".  It's short, sweet and to the point.  My only quibble is that libertarianism is increasingly rational if you're a person of color who is very rich, but the core of the argument is awesome.  It's one of my favorite libertarian takedowns, although China Mieville's Floating Utopias article is always going to be #1 for me.  I love the fact that a bunch of libertarians swooped in on the comments and dropped a bunch of awful, awful arguments that were easily swatted aside.

Thursday, February 11, 2010

Helloooo Temper Dysregulation Disorder with Dysphoria

Last night, after hearing and reading this story on NPR, I've been carefully reading through every document concerning TDD at the DSM-V site.  Is that enough acronyms for one sentence?

The new rules are eventually going to have huge implications for children in foster care or adopted from foster care.  These kids are the always the ones that get the most diagnoses and the most medications.  They're really the front line... or more cynically stated, they're the guinea pigs.  The NPR article doesn't address the issue of children in foster care, but they do provide a good summary of the importance of the DSM-V.

Doctors faced with kids struggling with explosive moods felt the diagnosis was appropriate and said that the bipolar medications they gave to children worked. Research psychiatrists worried that the children were being given a label that wasn't right for them, and saddled with the sentence of a serious mental illness for the rest of their lives.

In a move that could potentially change mental health practice all over America, the American Psychiatric Association has announced that it intends to include a new diagnosis in its upcoming fifth edition of the Diagnostic and Statistical Manual — and hopes that new label will be used by clinicians instead of the bipolar label. The condition will be called temper dysregulation disorder, and it will be seen as a brain or biological dysfunction, but not as a necessarily lifelong condition like bipolar.

The DSM is the official dictionary of mental disorders recognized by the American Psychiatric Association. Doctors use the DSM to diagnose patients, and insurance companies use it to decide on reimbursement, so it's incredibly important in the profession of psychiatry.
By adding this new entry, the American Psychiatric Association is trying to use the considerable institutional power of the DSM to curb use of the pediatric bipolar label.
I'm cautiously optimistic about these changes.  I realize that the process of making these diagnoses is sort of like asking a blindfolded person to draw a line using fingerpaint to encircle a seemingly random scattered pattern of symptoms... projected onto a moving target.  But in this case, that line might be drawn slightly more accurately than the previous one.

Here are the new criteria for TDD - Temper Dysregulation Disorder with Dysphoria.  Sunny, when off medication, fits every single criteria.
Temper Dysregulation Disorder with Dysphoria

A. The disorder is characterized by severe recurrent temper outbursts in response to common stressors.
1.  The temper outbursts are manifest verbally and/or behaviorally, such as in the form of verbal rages, or physical aggression towards people or property. 
2.  The reaction is grossly out of proportion in intensity or duration to the situation or provocation.
3.  The responses are inconsistent with developmental level.
B. Frequency: The temper outbursts occur, on average, three or more times per week.
C. Mood between temper outbursts:
1.  Nearly every day, the mood between temper outbursts is persistently negative (irritable, angry, and/or sad).
2.  The negative mood is observable by others (e.g., parents, teachers, peers).
D. Duration: Criteria A-C have been present for at least 12 months.  Throughout that time, the person has never been without the symptoms of Criteria A-C for more than 3 months at a time.
E. The temper outbursts and/or negative mood are present in at least two settings (at home, at school, or with peers) and must be severe in at least in one setting. 
F.  Chronological age is at least 6 years (or equivalent developmental level).
G. The onset is before age 10 years.
H. In the past year, there has never been a distinct period lasting more than one day during which abnormally elevated or expansive mood was present most of the day for most days, and the abnormally elevated or expansive mood was accompanied by the onset, or worsening, of three of the “B” criteria of mania (i.e., grandiosity or inflated self esteem, decreased need for sleep, pressured speech, flight of ideas, distractibility, increase in goal directed activity, or excessive involvement in activities with a high potential for painful consequences; see pp. XX).  Abnormally elevated mood should be differentiated from developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation.
I.  The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder (e.g., Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorder) and are not better accounted for by another mental disorder (e.g., Pervasive Developmental Disorder, post-traumatic stress disorder, separation anxiety disorder). (Note: This diagnosis can co-exist with Oppositional Defiant Disorder, ADHD, Conduct Disorder, and Substance Use Disorders.) The symptoms are not due to the direct physiological effects of a drug of abuse, or to a general medical or neurological condition.
When he's on his medication, he only has 0-3 violent fits a week.  Off medication, he had 1-2 every day.  On medication, he's happy most of the time, except for his rarer crabby days when he seems irritable and looking for an excuse to argue, cry, fight or have a fit.  Off medication, he's irritable and miserable most of the time.  On medication, he's been doing well in school; off medication, we had to temporarily take him out of school so that he wouldn't hit his teacher.

I think he also has anxiety issues and trauma separation issues and ADHD issues, but these don't fit his pattern of behavior nearly as well as the TDD definition. 


Now that the TDD definition is in place, some serious studies can be done that show long-term outcomes and medication appropriateness and so on.  But reading through the summaries of the existing studies, I'm optimistic that what he has will ameliorate as his brain matures, and that he won't have to be on medication for all the rest of his childhood.  Right now, Sunny's atypical antipsychotic medication is working for him, and we're not going to try to take him off it again until next year.  We're just going to keep trying every year and hope that the therapy and the work that we've done between those times will eventually allow us to do so.

I like the fact that the discussion documents stress that TDD is not at all less serious than "real" childhood bipolar.  Children with TDD end up in RTCs quite frequently.  I could imagine that happening with us. Without his medication, Sunny a) would not be able to go a regular classroom b) would need one of us to stay with him constantly and be prepared to restrain him multiple times a day.  Very few people could handle that.  I don't know if we could handle that.  An older couple with less physical strength definitely could not handle that.

The documents also discuss some of the social ramifications of these disorders.  Childhood bipolar overdiagnoses started partly as a well-meaning response to stigma around Conduct Disorder.  If your child had Conduct Disorder, they were a Bad Kid (and/or you were a Bad Parent) and there wasn't really much anyone could do.  If they had childhood bipolar, they had some genetic or chemical bran imbalance and it wasn't their fault and it wasn't your fault either, and it could be fixed with the right pill.  Kids won, parents won, drug companies won... but it turned out this wasn't such a happy ending.

I do feel lucky that we've ended up in a situation where Sunny is on a medication that really helps him and doesn't give him any side effects (so far), and that we've finally found a therapist, on our fourth try, who's actually helping him get a grip on his behavior.  I know a lot of other parents aren't so lucky.

I'm still frustrated with the fact that I don't really understand why Sunny's med works for him, and why it doesn't work for kids with similar issues.  And, of course, I'm terrified that it's going to cause some kind of long-term issue, sort of like that Halloween III: Season of the Witch movie where the demon masks make the kids' heads explode.

Anyway... hello TDD! Nice to meet you.  I'm sure we'll be hearing a lot more from you soon.

Monday, February 08, 2010

How are you doing in your life?

BB's foster mom has been very irritated with the assessment delay.  At the end of last week, she called up BB's worker, and told her to "sh*t or get off the pot" (in exactly so many words) then threatened to call her supervisor.

As a result of all this pressure across multiple fronts, we're finally starting to see movement.  BB's foster mom confirmed that the assessment agency called her back and said they'd received the referral.  On our end, we submitted a subsidy letter so that we can get a presentation date, but we've supposedly reserved the right to change the amount in case the developmental assessment turns up anything particularly shocking. 

Today, BB's worker asked us what his adoptive name would be.  Like Sunny's name change, it's going to be the same as his old name, but with our last names added at the end.

It's finally starting to seem real.

We shopped a little this weekend.  We need to get a play area ready and set up gates and cabinet locks.  We also need a bigger bed, and one that's lower to the ground.

Sunny got to talk with FFB this weekend.  His first question was "So FFB, how are you doing in your life?"   Since FFB is only four years old, he didn't really know how to answer.  That question struck my mother as drop-dead hilarious.  She's been laughing about it for days.  She says she now lives in fear that someone will ask her, "how are you doing in your life?" and she'll have to struggle to come up with her own epitaph.  Sunny did eventually rephrase the question as "How are doing this week?", and FFB was able to answer that one.

Sunny's behavior has been pretty decent.  He hasn't had a violent fit in more than a week now.

Sunny and I have been watching The Mysterious Cities of Gold together, about an episode every other night.  I watched a few of those when I was a little kid, a long time ago, and I always wished I could have seen the whole story.  Thanks to Youtube, Amazon and the long tail effect, I recently bought the complete deluxe DVD edition of Mysterious Cities of Gold!



This was such a cool show.  It was a combined French and Japanese production; there's a rumor that Miyazaki was involved.  I do notice the characters sometimes doing subtle things that are intensely Japanese (cheerful head-bobbing).  As far as I can remember, it has a not-necessarily-imperialist perspective in that both the indigenous characters and Spaniards are presented as having complicated motives.  The Spaniards are not the automatic good guys... in fact, I think Gonzalo Pizarro is the major villain.

Sunny really loves the story, and it's something that we can both enjoy watching together.  The other show he's watching right now is "The Replacements".  It's one of those horrible screechy cartoons that doesn't seem to have much of a point.

The music to Mysterious Cities of Gold is especially awesome.  I love the theme, and the rest of the music sounds like it was composed by an avant-garde electronic group from 1970s Berlin.

Thursday, February 04, 2010

Subsidy Negotiation Desperation

I'm probably breaking the advice I gave myself on some earlier posts.  I'm facing a very tough decision I didn't even know I had to make until just this week, and I'm starting to get really desperate and emotional and angry about it.

I've been informed that the next step on BB is to request a subsidy amount.  When we did this for Sunny, it wasn't that hard.  The worker told me exactly what to do.  I sat down in a meeting with our worker, and she gave me a list of things and amounts to request.  I added the amounts together and put that in an email I sent Sunny's ex-worker (who is now BB's worker).  They gave us an amount that was somewhat less than the amount requested.  The end.  That is, except for that weird extortion attempt at the end of last year, which we ignored.

BB has more early documented records: for example, his tox screen after birth.  Currently, he's delayed on several indicators.  He has a lot of stomach problems, and has been on antibiotics more than half the time he's been alive.  He may need physical therapy.  But his issues aren't really severe, either.  His foster mom has been trying to get him a developmental assessment for almost a year now.  Anything she tells me that isn't backed up by a medical evaluation is worthless, apparently, for the purposes of subsidy negotiation. 

I thought we were supposed to get the developmental assessment, then we use that to negotiate the subsidy.  Then we move on to visitation and a placement date.  But BB's worker has been dragging her feet on the assessment. She needs to do some special kind of referral.  I think she's been slacking off on that.  BB's foster mom said that she said that the assessment people were supposed to call her two weeks ago but they never did, for example.

A whole tangled ticket of she-said-she-said-she-said has been growing around the process and choking forward movement.  Instead of a clear 1->2->3 process, now I feel like both workers are trying to dump decisions on my shoulders, but refusing to give me any of the information I need to make these decisions. Today, I've been calling up both workers and getting desperate on the phone with them.  Talking with my worker is often frustrating, because when I press her on anything, she starts talking really, really fast, repeating herself and making annoying tautological statements like "Remember, the subsidy is what it is."

At several points I had to stop with "I'm sorry, that's only making me more confused."  Also, at several points, I said, in a very frustrated voice, "BUT ALL I CARE ABOUT IS THE MONEY!"  That sounds awful, but what I mean is that the assessment has no bearing on whether or not we want to adopt BB.  We are committed to adopting him no matter what it brings up.  All I'm concerned about is getting the maximum subsidy amount in the shortest amount of time!  The subsidy is crucial for anything that Medicaid doesn't cover.  We would never have been able to do neurofeedback therapy for Sunny if it wasn't for his subsidy.

However, maybe it's the case that the state is so strapped that they're going to give him the same subsidy even if the assessment turns up a host of ticking time bombs.  In that case, the assessment would be pointless, and we might as well skip it.

Calling up both workers and getting desperate seems to have kick-started something.  I had the lightbulb idea of suggesting/promising/threatening to pay for my own assessment.  I know how expensive these can be, but it's only a one-time expense.  What I proposed would be to ask BB's foster mom to take him to some independent private clinic, then pay for it myself or immediately reimburse her, and then she would have the documentation to submit to them.  The thought of me doing this seemed to strike the fear of God into both workers.  I guess that's because a) it's a departure from the way things are supposed to work, so they might have to file new paperwork or consult superiors or do something else incredibly time-consuming b) it's logical, so they can't dismiss it out of hand, although they both expressed deep reservations.

I'm prepared to request a subsidy amount without an assessment if things are stalled any longer, though.

Hopefully, they will now argue with each other a bit, then iron it out so that we can move forward.  Or maybe they'll team up against me.  Gah... I don't care as long as we can get this process moving again.

Wednesday, February 03, 2010

The Benefits of "Open" Adoption

A few days ago, when Sunny was mad at me for giving him a consequence for backtalking, he said,

"I can't wait to go to [Foster Mom]'s this summer!"

After he'd calmed down and apologized, I asked him,

"You said what you said about going away this summer because you were mad and you wanted to hurt me, right?"
"Yes. I'm sorry."
"I understand that you were mad, but that wasn't a good choice. Anyway, I'm happy you're getting to visit [Foster Mom]. I'm going to miss you when you're gone for the week, but you're not going to hurt me by talking about going to visit [Foster Mom]. Also, does [Foster Mom] tolerate backtalk either?"
"Oh no she doesn't!"
"OK then."

My only concern about sending him off by himself is the short time he'll be alone on the airplane. I've flown unaccompanied myself as a child for very long flights, and I did well. But then, I've seen other children flying unaccompanied who just sob uncontrollably the whole time. And then there's this story and this story. Yikes! I think he'll be OK as long as he has something to keep him occupied. And we've also had some talks with him about what he should do in case of inappropriate touching.

The trip is going to be great from a financial perspective. I looked into short special needs summer camps at one point, and found a few that sounded awesome and therapeutic, but they all cost about a gazillion dollars. Staying with his foster family, he gets experienced special needs care, at absolutely no cost! If I offered, I know she would refuse. I'm going to send some spending money with him anyway, but she'll probably just send it right back.

NN (Sunny's bio maternal grandmother) has become pretty close to Sunny's foster family. She doesn't have a real visitation schedule anymore, she just comes over when she can to see BB, and sometimes helps Sunny's foster mom by babysitting while she takes other kids to therapy or court dates. So it will be a visit with her as well.

I suppose we have an open adoption, in the sense that we have a totally open relationship with Sunny's foster family. It's been easy to navigate. I check out the questions at Open Adoption Support sometimes, but I really have very few questions I need answered myself. Our relationship with NN is a bit more complicated but still very open. That's really been more like a "classic" open adoption scenario. We have no contact with his bio father and likely will not have any contact for many years. The relationship with his mother, on the other hand, is uniquely challenging because of her death. She's present, but present as an absence. In terms of the logistics of contact and the setting of boundaries, things could not be simpler; in terms of emotions, they could not be more complicated. If she were still alive, Sunny might have more issues about divided loyalties between his "three moms", but he also wouldn't be suffering terribly from the knowledge of questions that will never be asked or answered, words that will never be said or heard...

Sunny is especially fond of his former foster brother, who is now 4 years old. I guess I'll call him FFB. FFB came into foster care as a baby, a little after Sunny started living with his foster family, and they were very close to each other. I think he loves BB in an abstract way, but he loves FFB in a much more immediate way. When I was talking to him recently about BB, he asked if FFB could come live with us too! I reminded him that FFB had another family that he stayed with, so absolutely not.

There's some major drama going on there. Basically, FFB was reunited after a few years with Sunny's foster mom. FFB was no longer a foster child. But the two families kept up a connection. FFB's mother or father would drop him off at his ex-foster mom's home for 3-7 days at a time. Sunny's foster mom has complained about the arrangement to me. She especially complains about that fact that FFB's social skills always got better when FFB was with her, and deteriorated again when he stayed with his mother or father. She talked about constantly giving them advice, but none of the advice seemed to sink in. Then FFB's mother had another baby, and then another baby. She continued dropping them off at Sunny's foster mom's house for long, random periods.

I was at first amazed that Sunny's foster mom kept doing this. She's not a doormat by any means! She explained to me, however, that if she reported the parents for doing this, FFB would probably go into foster care again, and might not end up with her, and she didn't want his attachment disrupted. I don't think I've ever met anyone as pragmatically compassionate as her.

I think a lot of people would want to "teach FFB's mom a lesson" by not giving free babysitting. But Sunny's foster mom doesn't fit that paradigm. She doesn't trust the parents; she doesn't bother trying to control them either, and she doesn't get too emotionally invested in how they live their lives. Que será, será. She's focused more on FFB and what he needs.

Unfortunately, at this point, FFB's mom has too many kids for them all to go to Sunny's foster mom if their case gets opened again. And it looks like the case is about get opened again, from what she tells me. FFB's parents have had years to get their lives back together... years in which they've had a totally reliable source of on-demand, high-quality, free childcare. But it's not happening. It's a depressing situation.  

As a result of FFB staying at Sunny's old house so much, Sunny has been able to keep up a relationship with him. He saw him on our last visit, and he talks to him on the phone sometimes. One of his first questions when he calls up his foster mom is always, "Is [FFB] there?"

I think this goes to illustrate that once someone has been her child for a while, in her mind, they're always going to be her child, whether they live with her or not, or whether they also have other parents.

Monday, February 01, 2010

Talking About Feelings

Last week's therapy was the first time Sunny had a meltdown with the therapist.

They were playing his new SMath game that he'd brought to therapy. I'd warned the therapist in advance that Sunny tends to get a little obsessed and overemotional when it comes to new games. Sure enough, he had an argument with her about the right way to play the game. She said that she wasn't able to play the game with him until he calmed down. He yelled and argued and cried and blamed her. On the positive side, he was able to pull himself out of the state, apologize, and finish up the session well.

He's on a trend recently where he reacts by instantly blaming others. We've been hearing a lot of things like "you just want me to starve to death", "you just want to ruin my life" and our favorite, "you just want me to be bored." Because it's just so much fun for us when Sunny is bored! Ha ha ha.

He had another meltdown before we even got to the parking lot of the therapist's office. She thought that might happen, and came outside for a little bit. We had a good talk about how Sunny needs to label his feelings more, because he's afraid of his feelings and defaults every negative feeling to anger, which then turns into "I'm angry because YOU made me angry."

After Sunny calmed down again -- and he stayed OK for the rest of the night -- we talked about how he was feeling embarrassed. He didn't want his therapist to see him lose control, and when she did, that made him very sad, and embarrassed, and then angry. I reminded him that maybe if he talked about being embarrassed, he could keep from moving into anger.

This morning we had another episode that could have turned into a hitting fit, but didn't. I asked him not to touch a sausage. He touched it. That's how it started. I just kept a calm tone and told him I was waiting for a real apology. There was a lot of yelling and accusations: I wanted him to be late for school. I wanted him to starve to death because I said he couldn't finish his cereal until he apologized. I wanted to ruin his day. I was a liar.

I stuck to my points:

- He needs to do what I ask him the first time I ask. I didn't want him to get hot sausage grease all over his hands. Contrary to his argument, I don't need to fully explain my reason before I ask him to do something.
- When he apologizes, it's not a real apology if he yells "Sorry" in a nasty tone while not looking me in the eyes.
- It's also not a real apology unless, at the very least, he takes responsibility.

He came close to really losing it at a few moments, but he finally pulled himself out of it. We were able to talk about the fact that we knew he was embarrassed. He knew he was wrong, but he kept inventing excuses, and that caused him to feel embarrassed and hang his head and hide his eyes and refuse to look at us. He agreed that he'd been feeling embarrassed.

I also asked him Sunny if he wanted to push me in the kitchen when he was angry. He paused a little bit before he said "yes, I did." I congratulated him for not pushing me. Instead, he'd come to me for a hug when he was ready to calm down.

It's so hard to know when an issue like this is a pointless power struggle, and when it's important to hold the line to establish consistency. One thing I've decided to give up on is making him wear sweaters or roll up his pant cuffs. It's not worth it. But I still think we have to come down like a brick wall when he starts with the blame routine. I believe Sunny's number one challenge in life is going to be anger management. We can't just let it slide. We have to do everything we can right now to keep it from being a bigger problem later.

Exploring "embarrassment" and maybe talking about shame and guilt as well is a path that seems very promising. It's not hard to tell when he's feeling that way, because he doesn't have any problems making eye contact under normal circumstances.

The "starve to death" accusations are irritating consider the vast amounts of food he consumes! But I think it's much more about keeping his brain temporarily occupied than about the food itself. He often wants to eat small things, just because eating is something to do. For example, he thinks of his tiny multivitamins as a dessert, and sometimes he says he's hungry so that he can eat his vitamins early, and after that he's satisfied.

We're pretty strict when it comes to snacks. He can eat everything he wants at breakfast and dinner; we encourage him to eat second helpings until he says he's full. But he doesn't get any more than one snack between mealtimes. I'm kind of a hardass on this issue because I think that nonstop snacking on candy and chips throughout the day establishes bad eating habits: that is, if you feel bored, you eat something, instead of doing something. It's hard to know when to draw the line, though, because I don't want food to turn into too much of a control issue.

Getting back to labeling feelings, I've watched this video podcast from Welcome to My Brain a few times. It applies so much to Sunny!  Our therapist is obviously on the exact same page.  The game sounds like a great idea.

Sunny went to a birthday party this weekend for his little neighborhood friend who just turned three.  All the other kids were around 3-4 years old, and Sunny played with them wonderfully.  His friend's grandparents kept telling me how much they love having Sunny come over to play.  I just wanted to mention that, so I'm able to end this post on a positive note!

Haiti News Over the Weekend

I said I wouldn't follow up, but I somehow feel obligated.

Medical evacuations resumed late yesterday, thank goodness. There's no telling how many people died because airlifts were suspended for five days.

Then there was the child trafficking arrest story: the ten Americans who were arrested trying to sneak a bunch of Haitian kids across the Dominican border. I read about that here and followed up here at the Baltimore Sun, where there's also video.

Among the many disturbing aspects to the story is the fact that one of the Americans is an 18-year-old girl. Her father back in the States has been talking to the press, but as far as I can tell, he hasn't taken any responsibility for encouraging her to do something so ridiculously outrageous and dangerous. The pastor, also, hasn't taken responsibility as the leader of this effort. All they say is "but we meant well!" repeated ad nauseam.

I'm a little sore about this subject because we just had a long talk with Sunny this morning about the importance of taking responsibility and not blaming other people. He's not that good at it yet, but at least he has an excuse: he's only seven years old.

Saturday, January 30, 2010

Charlie Crist's Priorities

This is heartbreaking.

U.S. Suspends Haitian Airlift in Cost Dispute
By SHAILA DEWAN
Published: January 29, 2010
MIAMI — The United States has suspended its medical evacuations of critically injured Haitian earthquake victims until a dispute over who will pay for their care is settled, military officials said Friday.

The military flights, usually C-130s carrying Haitians with spinal cord injuries, burns and other serious wounds, ended on Wednesday after Gov. Charlie Crist of Florida formally asked the federal government to shoulder some of the cost of the care.

[...]

The suspension could be catastrophic for patients, said Dr. Barth A. Green, the co-founder of Project Medishare for Haiti, a nonprofit group affiliated with the University of Miami’s Miller School of Medicine that had been evacuating about two dozen patients a day.

“People are dying in Haiti because they can’t get out,” Dr. Green said.

[...]

Some of the patients being airlifted from Haiti are American citizens and some are insured or eligible for insurance. But Haitians who are not legal residents of the United States can qualify for Medicaid only if they are given so-called humanitarian parole — in which someone is allowed into the United States temporarily because of an emergency — by United States Citizenship and Immigration Services.

Only 34 people have been given humanitarian parole for medical reasons, said Matthew Chandler, a spokesman for the Department of Homeland Security. The National Disaster Medical System, if activated, would cover the costs of caring for patients regardless of their legal status.

Crist later defended himself.

Miami Herald: But Crist too has denied he's responsible.

In a statement Saturday, he noted that ``between 60 and 80 Haitian orphans arrived at Miami International Airport'' Friday night, and that ``at no time has Florida closed our doors to those impacted by the earthquake in Haiti.

``To the contrary, Florida has been at the forefront of the crisis in Haiti -- caring for the injured, reuniting families, comforting those who have been devastated by loss.''

What a scumbag. Of course Florida is at the forefront, because it's right next door to Haiti. (Just a note... I used to live there, and I even used to have a job in the Little Haiti neighborhood).

From what I can gather, Crist is arguing that as long as they accept airlifts of "orphans", it's OK for them to stop every other medical evacuation. So let's say a Haitian family has one child they were living with, and that child was severely injured in the quake. Their other child was in an orphanage when the quake happened, and is healthy. Guess which child gets a flight to Miami?

The Superbowl is apparently a part of this disgusting mess, as well. Officials need to save hospital beds for Superbowl visitors.

I don't know what to do about this... maybe I'll send an email to the Secretary of State or my representative. I'll try typing something up later.

Friday, January 29, 2010

Foster Care Adoptions: How Not to Give Up (Part II)

Thanks for all the comments on the last post! It's time for some corrections and additions before I move on.

When it comes to religion, at least one parent and one social worker have left informative comments and mentioned that in their experience, they don't see being a non-Christian as a major handicap in their area. That's great. I don't think I need to take back or delete anything I said earlier, but I do need to add quite a bit more qualification.

I live in Georgia, which is one of the Bibliest parts of the Bible Belt. I also live in Atlanta, which is fairly diverse and open-minded, though the city is so informally segregated that it's hard to see that. We elected the first Buddhist representative to Congress, after all. Much of the rest of Georgia complains about Atlanta being full of "gays, blacks, and liberals". So this is an environment where non-Christians are not exactly ostracized, and Christianity is incredibly diverse, but it's still intensely Christian. On Sunday morning, you'll often find the gay black liberals dressed up and on their way to the gay black liberal church.

If you're a non-Christian prospective parent who lives in, say, San Francisco or Manhattan, and you're signed with a county agency and are not doing any interstate, then you should probably just ignore all my dire warnings in that section. But if you are doing interstate, you might want to plan for the worst-case scenario... a child's social worker in rural Oklahoma might have a totally different perspective on what makes the right kind of family than your local worker does.

SocialWrkr24/7 also left some great information on family ranking. Ranking is definitely subjective and will vary enormously according to your region and the kind of child you are submitting your homestudy for. Single dads and single moms may be preferred for children with specific kinds of histories and issues.

Matching

Once you're licensed and homestudied, the agonizing wait begins. More than anything else, you'll want to know, HOW LONG? But no one can tell you. According to Page 32 of the Adoptuskids.org report, this is the stage at which the majority of families who drop out will drop out.

Each agency does things different ways. When you're working with state and national photolistings, you'll follow this general procedure:

1) register (usually a quick process)
2) search the photolistings
3) submit inquiries on children. You might do this through the site, or perhaps the site will give the child's worker's phone number and.or email address.
4) submit your homestudy. Usually, you cannot do this yourself. Your worker needs to do it for you.

This is an emotionally draining process. It can start to feel like bargaining at a swap meet. You quickly realize that the younger, healthier children will have had a ton of studies submitted on them, and you have a minuscule chance of being accepted. Then you feel guilty not submitting it for an older child with more special needs who might not have any inquiries at all. You begin to feel an uncommon mixture of emotion: humiliation mixed with guilt and inadequacy.

The process isn't helped by the fact that many of the photolistings are poorly run. At one point, it took me about three months of calling before I got in touch with someone about a particular listing. Then they told me the boy had been adopted six months ago. Apparently, this is very common.

At this point, your time networking and being in touch with other adoptive parents is hopefully starting to pay off. You'll probably need to just give up searching on certain states and certain locations. You'll begin to realize that some of the photolistings are really phantoms and no one will ever actually adopt interstate out of that location, anyway.

If you're working with a county agency, your search will most likely concentrate on local placements. Many children won't be photolisted at all. You're relying predominantly on your worker to network for you.

Another path is meeting children at adoption events. We never went to any of these. However, if you're looking at older children (roughly 10-18) you need to think really long and hard about going to them, even though nobody ever wants to go to these events. Social workers hate them, I'm sure the children hate them, parents hate them. You'll imagine your nightmare scenario... a child walks up to you and asks "will you be my mommy?" Then you break down and start sobbing uncontrollably.

There is only one ethical, positive thing about these events: these older children deserve some say when it comes to their future family. This is a chance for them to gather information for themselves, to choose, and to have some small degree of control over the future of their childhood. You can't expect a 13-year-old to pick their own family based only on a pile of homestudies, so meeting their potential future family at some point in the process, in some way, before final decision... this is absolutely crucial.

I also think that many of these events are highly structured, in recognition of the chaotic emotions involved, so it's not like the workers just throw the two groups into the same room and yell "PICK ONE".

How long is too long?


The only way to answer that question is to ask other people who've gone through the same agency. Is your wait time still in the average, or starting to stretch to the extremes?

It took us eight months to get full homestudy approval. Then it took another eight months to go to committee, and we were matched the first time we went to committee. Towards the end I was seriously considering starting over again somewhere else.

A very rough guide might be that if you never even get to committee in a year, you should re-evaluate. Once you get to committee, at least you know that people are considering you seriously and the process is working somehow. Going to committee doesn't mean you have to accept the placement. It does mean you will have the opportunity to get a lot more information on the child(ren), so you can make a truly informed decision as to whether you should withdraw your application, or stay.

Here are some reasons you might not be getting to committee:

1) Your worker is doing a bad job because they are a bad worker. They are not submitting your homestudy or not getting in touch with any other workers. The solutions are to switch workers at the same place, or leave. You might also try to do much of the worker's job for them in terms of contact, but this is an exhausting and dangerous project.
2) Your worker is doing a bad job because they think your family isn't that suitable. Maybe you have alienated them for some reason. This could be your fault, or their fault. Ideally, social workers would tell you to give up and go away outright, but sometimes they might not want to deal with the confrontation. If you can't repair your relationship with the worker, you'll have to switch or leave.
3) Your expectations are not realistic. You are not applying for a wide enough population of children. This could be out of entitlement, or simply out of naiveté. For example, if I'd restricted my applications to Asian children only, I doubt I'd be matched today.
4) Your homestudy is bad.

If you think it's because your homestudy is bad, and your agency can't or won't fix it, you have some hard choices. If you think it's their fault, you should go start the process again with another agency. If you switch, do it politely and without burning bridges. Social workers from your old agency might be friends with social workers at your new agency.

Also, try to be as objective as possible, without beating yourself up, and consider the possibility that maybe your family is just not suitable. If you make that determination, I still don't think you need to give up. If your passion for the goal is still burning, then take a break for a year. Work on yourself, work on your family. Then start fresh. I know that sounds really insulting. But not everyone is suited for this. You can't be perfect, but you have to be strong.

Facing Change


You may realize that you're changing many of your attitudes and parameters. All kinds of things can change. Some people even start the process married, and then end up reapplying as single parents.

One common thing that happens is that you radically reevaluate your attitude towards contact with birth/first parents. According to the report I've been using, it seems the majority of foster care adoptive parents (about 2/3 of them) do have post-adoption contact. You might not understand why at the beginning. Aren't these the people that have abused and neglected their children? By the end, you will probably have changed your mind and realized that the issue is a lot more complicated. Most trainings have a strong focus on the importance of some kind of contact for the wellbeing of your child. Sometimes, of course, contact is absolutely out of the question, but there's usually at least one or two extended relatives who represent a safe connection.

It's hard to know how much you can and should change when it comes to special needs and number of children. Sometimes, you need to trust your instincts and hold to your original parameters. You are the person who knows yourself best.

What to do during the wait


- Don't put your life on hold
- Join internet support groups and keep doing research
- Go to extra trainings. Sometimes you can satisfy hour requirements by online study and book reports, but it's so much more useful to go physical events and meet other people
- Keep the healthy relationships with your partner, friends and family; don't shrink into yourself and become isolated. It might feel like you've walked through a door into a totally different world, and everyone else has stayed behind on the other side of the door.
- Be aggressive about contact with your worker. Follow up and stay in touch. Don't let them forget you. Ask for rough timelines on anything they promise. If they get irritated with you, try to manage this irritation. You can remind them that you just want to be "proactive" and you will be equally proactive on behalf of your child(ren) when they are placed with you.
- Don't be too aggressive! And don't contact them just because you happen to be feeling especially pissed-off and depressed. Put down the phone, take a deep breath, and ask yourself if you really need to contact them at that very moment. You might mention in general ways that you're feeling a bit stressed, but keep your inner turmoil to yourself. They are very busy and it's not their job to be your therapist. They also need to know that you can manage difficult, stressful situations. If you think the wait is too stressful, then how are you going to handle placement, which might be 10x as stressful?


To be continued

I was reminded that two things I should have brought up in Part I are a) partner issues and b) a history of abuse or trauma.  I'll try and get back to them in Part III.  Any other topics I should cover?  I think I'm going to stop the series pretty soon after the matching process.  Post-adoption support is just such a massive topic...


(link to Part I)