A New label

"A personality disorder is a pattern of deviant or abnormal behavior that the person doesn't change even though it causes emotional upsets and trouble with other people at work and in personal relationships. It is not limited to episodes of mental illness, and it is not caused by drug or alcohol use, head injury, or illness. There are about a dozen different behavior patterns classified as personality disorders by DSM-IV. All the personality disorders show up as deviations from normal in one or more of the following:(1) cognition -- i.e., perception, thinking, and interpretation of oneself, other people, and events;(2) affectivity -- i.e., emotional responses (range, intensity, lability, appropriateness);(3) interpersonal functions;(4) impulsivity."

"Narcissistic Personality Disorder (NPD)
While grandiosity is the diagnostic hallmark of pathological narcissism, there is research evidence that pathological narcissism occurs in two forms, (a) a grandiose state of mind in young adults that can be corrected by life experiences, and (b) the stable disorder described in DSM-IV, which is defined less by grandiosity than by severely disturbed interpersonal relations.

If NPD is caused by infantile damage and consequent developmental short-circuits, it probably represents an irremediable condition. On the other hand, if narcissism is a behavior pattern that's learned, then there is some hope, however tenuous, that it's a behavior pattern that can be unlearned.

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy. The disorder begins by early adulthood and is indicated by at least five of the following:

• An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
• Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
• Believes he is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)
• Requires excessive admiration
• Has a sense of entitlement
• Selfishly takes advantage of others to achieve his own ends
• Lacks empathy
• Is often envious of others or believes that others are envious of him
• Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes"

I believe she has seven of the nine descriptors. This added with her new fascination with writing p0rnn0graffic (altered spelling to avoid spam and freaks) "dreams" and sharing them with classmates makes any progress seem false and our efforts useless. Just a little more disappointment. Checked out a therapeutic camp in Utah that has RAD kids work with horses and requires a one year stay. Appears that only the states of California and Alaska understand that this kind of long-term retraining is critical. Texas Medicaid will not cover it. This place is not on my insurance provider list, but even if they were, my insurance (most insurance companies) will not pay for more than 30-60 days without MEDICAL reason. So, once again if feels like this is a constant, but useless battle.

For more information on this disorder, see http://www.halcyon.com/jmashmun/npd/dsm-iv.html

Adjusting the Atlas

Several interesting sessions lately and definite improvement noticed.

Two weeks ago, TT had DD get up on the table again. This time he had his hands just under her rib cage, looking for her kidneys. He explained that when you are in a constant state of fear -- a fight or flight animalistic survival mode -- your organs tuck up under your ribcage preparing to run or protect the organs in either situation. He could hardly find her kidneys, they were so high.

Through some feedback and getting her to focus on her breathing and calm down and relax, the right kidney eventually dropped, so he moved to the other side of the table. Fortunately, that kidney relaxed as well. And you can see the physical difference. When she first lays on the table (like a massage table) she is very stiff and nervous, and after relaxing her feet fall sideways, her arms sink into the thin mattress, and her spine gives way and touches the mattress.

Since this was successful, he started to hold her neck again, putting some fingertip pressure on her atlas, the highest vertebra in the spine. She never likes this and tenses up again. He explains that this part of her neck, where her spine connects with her brain is very stiff and hard, and should be soft. He always tries to get that part to relax as this is what supposedly keeps her in fight or flight mode. She started to wince and sit up complaining that it hurts. He kept telling her to relax and to lay back, but she could not. He then reached his free arm out and told her to squeeze his arm and try to hurt him (trying to distract her from her discomfort) but she would not, she just became more adamant about her pain. He asked DH to stand closer and for DH to try to squeeze his arm as hard as he could. This didn't distract her at all, but it did distract DH and I, and with this chaos eventually came a quick scream and instant tears. He hurt her.

He immediately started to comfort her and whisper to her that this was good. That he adjusted her atlas and things would get better now. He said "It isn't easy being normal, is it? It is easier to be the crazy girl that nobody deals with, isn't it? You did great! This is great!" as she covered her face with her hands and sobbed. She then complained of a terrible headache. He said this was normal.

I started to get choked up--I don't ever want to see ANYONE in pain--especially a kid--even if that kid has put me through hell. I grabbed my purse for some ibuprofen, then grabbed some tissues. She laid there for another 5-10 minutes while he tried to comfort her.

When we got home, I researched what it was he just did. It looks like it is an old-school chiropractic method, and while he is not a licensed chiropractor, it seems to have made some difference. He immediately said the atlas area softened. I wish I would have felt the before and after to know what he was talking about. the effect is not permanent though, so this may require multiple attempts.

Then this week, he spent the whole hour explaining the therapy plan to all of us. He said that DD is ready to move to the next phase, which will be a lot less talk and a lot more physical. He drew a fabulous diagram for us that I will try to recreate and post later. It all made sense.

In the meantime, DD has not only started to tell the truth, she tells us that she was about to tell us a lie, then thought about it, and told the truth anyway. This is FRIGGIN' HUGE!!! We make a big, positive deal about these truths, even if they are ugly truths.

Also, we went to a family event last weekend, and had no drama!! We are not sure if this was progress, or because none of the boys were there (it was a girly wedding shower). The wedding is in early April, so it will be interesting to see if we see the improvement then.

Anyway - so much more hope now on the DD scene.

Now if I could get my psycho step-mom to play nice, life might just be peaceful. I won't hold my breath!

Slowing the Mind

So, our therapy session yesterday seemed light--almost useless at the time, but it was not.

TT used Somatic Experience treatment yesterday, which basically entailed DD laying on a table/bed while TT laid his hands under her shoulders and gave her some verbal feedback about twitches and twinges in her body. This is supposedly past trauma meeting "road blocks" in her body. Pretty soon, she became attuned to the twitches as well and they would announce the latest twitch in unison. She slowed her mind and focused on her body and what it was doing without her even knowing. At the end of the hour she was very relaxed and able to think and speak a little more thoughtfully--not quite so hyper and spastic. He was able to quiet her mind a bit and allow her to make more mature decisions in this moment.

OK - so an hour of watching her lay on a table didn't seem like much. We were starting to doze off ourselves, but the effects lasted into the evening. She was able to explain herself, her actions, and her thoughts with a little more ease and we were able to follow along a little better. Homework went a little smoother. The best example--at almost 9:00 PM - bedtime--she came downstairs, grabbed the vacuum and headed back upstairs. Expecting some bizarre, circular, explanation I cautiously asked her what she was doing. Of course her first response was, "I'm going to vacuum my room." So I had to ask the clarifying question of "Why" are you vacuuming at 9:00 PM. She actually told the truth. She stated that she somehow broke her blush (make-up) and that is somehow got all over the place.

Knowing that she destroyed the carpet in her room a long time ago there was no sense of urgency to get it cleaned or to wonder how bad it really was, there was just the opportunity to thank her for her honesty and let her go on her merry way. Which I did. And she did.

May not seem like much, but it showed that she finally felt safe enough to tell me the truth and because of her truth there was no escalation and the night ended peacefully. Hopefully we can continue this trend and hopefully slowing her mind more will allow her to make more good decisions when it comes to telling us the truth.

Small victory with a big impact. :) Oh - and she got all of the blush up from the carpet, too!

Latest Developments...

So, it's been a while since I've updated this blog. Part of the reason for the delay is just trying to catch up with life after the holidays, but part is also because of the "relative calm."

The therapy has been amazing...

The week between Christmas and New Year's was very nice--peaceful, well, until New Year's Day itself, and then things deteriorated for the next week with high drama and a lot of BS from DD. A LOT.

Perhaps we cannot afford a two week gap in therapy at this stage. Or maybe it was too much free time over the holiday break. Whatever it was, it gave our therapist a whole new repertoire to work with--and she did not like it one bit! She totally shut down during one session and refused to speak for the second half. While it would appear that we made no progress in that session, and the therapist (TT) actually declared it "No Progress" before he dismissed her to the lobby, something quite remarkable happened on the way home. She opened up and vented to DH. She was so angry at her new enemy, that DH was now someone she would turn to for comfort.

"I don't like him. He was getting all in my business. He was trying to get into my feelings!" - DD

DING! DING! DING!!! YES!!!!
That is it!!! He IS trying to get into your feelings! We all are!!! That is what this is ALL about! To get you to FEEL your impact on the world. To get you to FEEL empathy, sympathy, remorse, sorrow, anger, happiness, joy, peace, safe, and most importantly --- for you to feel love.

I would so love to lock us all up in a room for two days until she really cracks. I think TT could do it. Now after two sessions since the holidays, she is Miss Merry Sunshine - trying very hard to get along, even with my DS who still does not trust her and her efforts. She has a lot of repair to do there.

The coolest thing is to be able to use his words to define behaviors later at home--"See - you still refuse to own your garbage. You want to blame everyone else and are totally incapable of sincerely apologizing." She gets it. It is like shorthand. She still is unable to apologize for even the littlest of things, but she may just be feeling something inside. Don't know for sure, but we are learning how to better deal with her actions and how to stop things from escalating out of control, like they used to.

Things are not perfect--probably never will be--and we will likely spend years on his couch, but so long as he continues to produce tiny hairline fractures in her armor, we can still hold out hope that maybe one day she will love us---or at a minimum, respect us.

RAD making world news

http://news.yahoo.com/s/time/20071219/wl_time/cananadoptedchildbereturned

So, I don’t know the details of this case, and I obviously don’t know any of the people involved, but if they are truly dealing with attachment disorder, I feel sorry for the family. What makes this case difficult is that they adopted when the little girl was four months old. At four months it is possible that the child is already affected by RAD, but at four months the therapy would not be as difficult to help the child attach—versus therapy for an older child. Unfortunately, if the family is unaware of the disorder, it would be difficult to deliver the right types of treatment.

Having considered the option of dissolving our adoption of a RADish, I know that this decision is not made lightly. Even thinking about it causes great stress and discomfort, but then the first time you articulate that thought to anyone, you know that you have crossed over to a new phase of possibility—a very frightening and disappointing phase.

No one goes into an adoption thinking that one day you may choose to relinquish that child back into the system—it would never cross your mind. Choosing to adopt is not a light decision either. Usually you consider it for months or even years before you ever make the first phone call. Then there are orientation meetings, lots of forms to fill out, interviews, studies, training, and one of the deepest invasions into your personal life you may ever experience. At any stage of this process, you can back out if you don’t think adoption is the path for you. Even going through Foster-Adoption, where during the PRIDE training, the worst-case scenario is played out for you to some extent, you may still decide that you want to do this. Even when the little-known statistic that 90-95% of the kids in Foster Care have been sexually abused is revealed, you may still chose to fight for this kid and try to do right by this child. You have the hope that you can make a difference—that you can parent this child, and you commit to this unknown person long before you ever have a name or a face to connect to this person.

Making the decision to dissolve an adoption attacks that commitment; attacks your efforts, your hopes and dreams for the child and your entire family. Dissolving is an admission of failure—something not easily swallowed or ever invited. The process of dissolving varies across the globe, but it is never an easy process—and rightfully so. So, for someone to make the decision to go forward with plans to dissolve, their lives must already be a living hell; a hell that relates to that child.

The child is not at fault, some adult failed this child to cause this condition, so of course, everyone empathizes with the kid seeming to be discarded again as unwanted. There is nothing pretty about it. There are no winners in dissolution, but sometimes the long term effect can be better for all. The family can start to heal and recover and try to find peace again in their lives and the kid can try a new situation that may not put so many demands for attachment on him or her. While it appears that the kid is being “left behind” or “taken away” from the only family they’ve ever known, the reality is that if there is no attachment, the kid may not feel that way at all. The kid may feel some relief from the pressure to deliver an attachment that they are incapable of providing. The kid may miss their lifestyle or their possessions more than anything.

Again, this case is difficult because she was so young when adopted—they could have built a bond with the infant. But if the family never got the information they needed—never got any diagnosis of the potential disorder—then they were handicapped from the beginning. The article mentions that they tried intense therapy, but being in the throws of that therapy now, I can see that the treatments can be exhausting with only a minute trace of possible change. Having such public exposure (through the father’s career) to such a personal trauma cannot make the process any easier—which leads me to believe that this family may be desperate for change. Sounds like they have the means to still take care of her through other resources without having to interact too much with her—through nannies and other caregivers—so to save face they could have chosen to keep her, and keep this all quiet, but the situation pushed them to risk all just to find peace again.

At this point, we are no longer considering dissolution—we are working very hard to salvage our relationship with DD, but we know first-hand how difficult a journey this is, with only two years under our belt. This Dutch family has eight years of this experience. I sincerely hope that they tried everything and that the family and the girl all find peace and happiness in their lives. I hope that those who judge this family without fully understanding the situation learn more about the circumstances and the challenges. Most of all, I sincerely hope that this family is not misleading the public, using attachment disorder as an excuse to relinquish their obligations to this girl when there is really something else going on. They would do a horrible disservice to anyone associated with adoption or anyone working through attachment disorder.

Breakthrough?

We all sat on the couch, facing TT. DH on one end, me on the other, and DD in the middle. He asked her how she was doing. She said she was tired. He asked her how she knew she was tired. She said she was sleepy. He asked her how she knew she was sleepy; what did that feel like? She said she was yawning and her eyes were heavy. He asked what that felt like. She couldn't quite describe it. There was some awkward silence while she squirmed and picked at her cuticles, and she finally said, "I don't know." He then said, "so is that an excuse to not participate tonight?" "No! No!" she exclaimed. This is how the session began.

He then asked how her week was and she answered that it was a fun weekend. He asked her to explain, and as she did, he kept interrupting her to ask clarifying questions, then would take her back a step in the story and make her repeat herself, and explain every detail, all the while he commented on her physical behavior. "You are getting very tense. Do you notice that?" No. "Slow down, breathe. Do you feel how anxious you get and how fast you are talking? I need you to breathe. Go ahead and breathe. I can't hear it. Take a deep breathe. Oh look. There's that face. Wow, we made it 24 minutes before I saw that face. That 'I want to kill you face.' What does that mean?" He called her on everything.

Then she made a gesture with her hands while telling a story and he stopped her and made her repeat the gesture. Asked her to move her hands in that same motion very slowly. While she was starting to do that, he kept talking and she dropped her hands. He pointed out that she quit - to put her hands back up. She did and he started talking, she again dropped her hands. He said, "Wow, you quit on me again. You are so quick to give up. Are you willing to try again?" This went on over and over again for about 10 minutes until she really threw him a look, which he constantly pointed out to her. He asked her how she kept this look from other people because this was a really big part of her. He pointed out how many times she quit and how easy it was for her to quit. Then he said the word "hopeless" came to mind. That she always quit because she thought it was all hopeless, so why try. Why try to get along? Why try to love and be loved? Why try to succeed. Said she needed to stop quitting and needed to try.

We sat there silently watching this all through the corners of our eyes. Occasionally, when she got uncomfortable, she looked to her left, towards DH, like looking for help. Eventually TT pointed out that she kept looking to him, but that in 45 minutes she had not looked at me once. He asked why? Wanted to know what was going on. She gave her usual "nothing" response. He then turned to me and asked if I was willing to participate. I said yes.

He had DH leave the couch and sit in a big chair facing us. He had DD stand up, then had me move to the far end of the couch. He told DD to sit to the right of me. Then told her to put her feet up on the couch and put her head in my lap. This was extremely difficult for her to grasp for some reason, so TT, a very large man, stood up, scooped up DD and placed her whole upper torso across my lap. He grabbed DD's right hand and put her arm under mine and around my waist, behind my back. I basically cradled her in my arms. He grabbed DD's left arm and placed her hand on my right shoulder.

He told DD to look in my eyes and tell him what she saw. She looked at me for a second and said "frustration" then looked away. Then dropped her hand from my shoulder. He put her hand back on my shoulder and told her to continue looking into my eyes. She did for a second, laughed nervously, and looked away again. He told her to keep looking into my eyes. She really couldn't do it for more than a few seconds.

He then told her to touch my face. I started to get emotional and tear up. She put her closed left hand on my right cheek. He pointed out that she had a fist on my face, and that she was fighting me. She denied it. He told her to open her hand and touch my face, then he noticed my tears. He said, "Whoa! That doesn't look like frustration to me. What do you see now?" She said sadness, and dropped her hand from my face. He said, "Wow. You are quitting again. You keep quitting your mom. This is not your roommate or your caregiver, this is your mom. She is not quitting you, but you keep quitting her. Touch her face without me placing your hand on her face, and look her in the eyes." She did it, but quickly looked away again, trying to laugh it off. He kept redirecting her. She finally lasted about 15 seconds. Then he told her to keep her eyes open, but to touch my whole face as if she were blind. To explore my face. She just couldn't do it. She never did.

He commented on how freaky it was that we looked so much alike. She immediately said, "You should see me and my brother." He said, "wow! you rejected her again. I told you you look like your mom and you immediately take that focus away and talk about your brother. Like - no way do I look like her." You can't look at her. You can't touch her. You can't even believe that you look like her so you keep quitting her."

He made her touch my face again and really stare into my eyes. She looked at me, smiled, squirmed, arched her back, shifted her hips, and he pointed it all out. All her physical reactions to touch, to closeness, to love. Her physical discomfort--her rejection to this closeness. He asked, "Does this feel strange? Are you uncomfortable?" She giggled and bobbed her head shoulder to shoulder like a "sort of" kind of answer. He pointed out how much her body revealed her discomfort then asked if she knew why she was so uncomfortable. She said she didn't know. He paused for a minute.

"Because this is the only mother who's ever held you like this."

She nodded in agreement. She had no other reaction. I was choking from the flood of tears I was holding back. He asked her is she wanted me to be her mom and she shook her head yes. Then he asked her if she wanted to be my daughter, and again she shook her head yes. He then told us to hug. I pulled her close and rocked her a bit while I rubbed her back. We have never hugged like that. Never. She always puts her head down so there is great distance between her body and yours--she tucks the top of her head into your chest. She let go way before I did. He then told her to go wait in the lobby.

He handed me some tissues and asked if we had any questions. He then said he talked to his associate and explained that she misunderstood him completely. He never planned to call CPS--he offered that as a way out for us if this was too hard. This is what my DH thought he meant, but his associate was adamant that he meant to call because of the neglect of this child. He heard us yelling in her office yesterday. He denied everything she told us. He totally threw her under the bus. I told him that we would never see her again. He said we didn't have to. I told him that I came tonight to fire him. He said, "you still can fire me." I told him no, that I liked what I saw, and I think it will have an impact but that yesterday I felt totally attacked and threatened by him and his associate.

We talked it all out, and as he was leading us out of his office towards the lobby, he said, "And if you do want to fire me, just do it over the phone, don't come say it to my face, that would just hurt too much." Told him "Sorry, you will know if I am going to fire you. I just don't know how else to be, but honest, so I would probably tell you to your face." We laughed about it, but I am serious.

I am totally emotionally drained. My eyes are glassy and puffy and my nose is all red and I have a headache. I am once again cautiously hopeful that this guy might make a difference. He said she will need years of therapy, probably all the way through High School. I said that is OK, as long as there is progress, growth, learning. I just cannot face years of therapy with no change. I again said I need a Helen Keller/Miracle Worker water pump moment. She doesn't have to know sign language fluently, she just needs to understand that it exists. She doesn't have to be fluent in "human" she just has to know we exist and she has impact on us outside of her busy head.

We also have an appointment with a neuropsychologist on the 13th--just DH & I for the initial assessment. Then we will see if insurance approves testing and maybe later, therapy. I'm not putting all my eggs in TT's basket just yet.

More Disappointment

So last week, when TT asked DD how her Thanksgiving was, DD stated in her session that she lost 12 pounds in a week and insinuated that we don't feed her, saying she only gets one portion at meals, and that she is hungry at lunch. The therapist asked her if she asked for more, did she get it, and she said yes and said that she was fine. He asked what she eats at lunch and she listed 4-5 items, and said she was fine.

She DID NOT lose 12 pounds that week--which by the way was Thanksgiving week and oh yeah - she stayed at my father's for the week because school was out and he watched her for us. We took all sugar out of the house a year ago and I have lost 40 pounds, my son lost 30, my DH lost 20 and she lost 12 at the most! AND we took her off all the meds that were making her gain weight. She was OVERWEIGHT a year ago and gorging on foods--eating the lunch we packed and getting another lunch in the cafeteria. She would eat three plates of food at dinner and still claim to be hungry. BIG plates of food.

So, in our first and second session the therapist told us just how terribly damaged she was and that he saw four personalities and that she had a lot of trauma to overcome, and he took DH in the hall and literally said, "She is fu_ _ed up." but we went in today to find out that he considered calling CPS because she said she lost 12 pounds. He's never weighed her, she is not sickly skinny AT ALL, and he has no proof of neglect but considered calling CPS.

THIS is the support we are getting. THIS is the help we are getting. I am supposed to not get angry, but when I feel that my family is threatened by a LIE from a RAD kid and that someone with authority is prepared to take action on that lie without even ASKING us about it first, this doesn't help anger subside. How can an acclaimed RAD-specialist act on a false accusation like that--especially when she kept ending with "but I'm fine" and when asked clarifying questions she stated that the portions were big and she could have more if she asked for it?

Thing is, I am not even mad at her--this is what she does, and this is why we are begging for help. I am mad at the so-called specialist and his associate for even talking about calling CPS. She is RAD! One of the primary descriptions of a RAD kid is LIES and FALSELY ACCUSES. The associate that we see talked about neglect because of the 12 pound loss and because she hangs out in her room watching TV. She is 12. What do 12 year olds do? This is how we keep peace in the house - we don't engage too much because of the lies and the manipulation attempts. We are holding out, waiting for a breakthrough before we get too involved with her more and while she is upstairs watching Hannah Montana, and listening to her Cheetah Girls CDs and doing homework, we are being considered neglectful. We drive her to school everyday, pick her up most days (some days the kids have to walk home) and we go to therapy twice a week, and we are neglectful. She has Attachment Disorder. I cannot make her attach--I do not know how and I am desperately looking for a way to do that, but until then, I cannot make things right between us.

When we go out with other people, she instantly takes off with the new people. We went to a school sports activity on Friday night and she took off with another girl. No biggy, but at the end of the night came the request to spend the night with a stranger. Saturday we went to an extended family Christmas party out of town. As soon as she walked in she took off with newly met second-cousins and we never really saw her again until we left. On Sunday, we went to a surprise party for a friend I worked with 10 years ago. DD ran to be up front to open the big barn doors and yell surprise to a woman she never met. She ran outside to be with others. Then she told the owner of the ranch that she worked with horses quit a bit and the owner let DD run all over the party pulling a big horse behind her. She has NOT worked with horses quite a bit, but she led the woman to believe that she did, so she could get what she wanted. She never sat or stood near us--most probably didn't know she was with us. She is detached. She leaves us constantly. Probably since her second month with us she has preferred to hang with strangers--this is what RAD kids do. But her hanging in her room means we neglect her.

These are therapists numbers 5 and 6, psychiatrist number 3, and psychologist number 2 in two years. NEGLECT?!?!? If we neglected her would we be trying so hard to make this work? The countless hours we've spent reading, researching, filling out forms, driving to therapists and doctors all over a 50+ mile radius, leaving work for sessions, for phone calls, for school meetings, etc. NEGLECT!?!?!? We are begging for help and we get accused of neglect. I could easily quit this all and just go underground with her--seeing no one, just waiting out the time until she grows up and moves out, or runs away, or whatever, but that is not what we are doing. We are allowing all kinds of people to ask us all kinds of questions, we are opening ourselves up and getting analyzed by all kinds of people and trying to find a solution to help DD and to help our family and we are getting no where. Extremely frustrating.

Tomorrow is her session with TT. Both DH and I will attend. This will be our final session with him. We will now pursue a neuropsychologist. I'm done with therapists.