CASE:eNewsletter

February 2006

In this issue

Healing Loss in the Traumatized Child
Gay and Lesbian Adoptive Families
Parent Perspectives: How our children are like their birth parents
Success Stories:Protecting Them

Healing Loss in the Traumatized Child
By Marilyn Schoettle, M .A . and Ellen Singer, LCSW-C

Thomas moved on and off between his birthmother and paternal aunt for the first seven years of his life . He was removed from that unstable situation after his aunt threw him down a flight of stairs, breaking his leg .

Now 10, Thomas has been in his pre-adoptive home for one year . As finalization nears, Thomas seems to be changing from a child who was eager to please, to one who is contradictory and noncompliant . He ignores many of his parents’ directives and becomes anxious when reprimanded in any way . In addition, his school work is suffering, a turn of events that is particularly upsetting to his parents . His parents are wondering… . Who is this child?

Many of the stories of children who enter the foster care system involve abuse – physical, sexual or emotional – neglect or abandonment . Care giving adults may be drug or alcohol addicted or mentally ill, unable to care for themselves, let alone children . In some instances, children have witnessed violence, even murder against loved ones . A large proportion of children lose connections with birth family members; others remain in contact with family members with whom they have ambivalent, conflicted and difficult relationships . For some children, placement occurs because a caregiver has died . Unfortunately, multiple caregivers and moves both prior to and subsequent to placement in foster care compound the experience of trauma and loss .

Amazingly, adults often expect children to move into adoptive placements smoothly, settling into their new lives with relief and minimal disruption . It is hoped that children can understand how the old and the new are separate worlds, and despite the considerable efforts of many people, those two worlds are permanently apart . These expectations, combined with the fact that adoptive parents may have had little knowledge of how prior trauma can cause depression, anxiety or acting out behavior, may be a recipe for disaster .

Fortunately, much has been learned about the long-term impact of trauma on both children and adults . However, not all foster and adoptive parents are informed, and some mental health practitioners are unaware of the powerful, unique complexities of loss for children in foster care and adoption . It is critical that social workers learn how unresolved grief about previous losses can manifest itself in new home environments, and that information must be shared . Fears and worries grounded in former experiences must be recognized and addressed to diminish difficult or puzzling behaviors that challenge new families where safety and nurturing are present .

Last year, Tomas was referred to The Center for Adoption Support and Education, Inc ., or C .A .S .E ., in Silver Spring, MD, with his foster soon-to-be adoptive parents . Their therapist, Madeleine Krebs was not surprised by the route that Thomas had taken to reflect his anxiety and insecurity . She began by asking Thomas, “How did you get to this family?” She created a trusting relationship and a safe place where he could share his understanding of what had happened in his life and process his feelings related to his experiences and the losses he incurred .

Over time, through the use of activities designed to help him express his sadness and confusion, Thomas shared his anger . He made balls out of clay and threw them at the couch in Krebs’ office, expressing fury at his aunt who had hurt him . Sometimes he would get angry at Ms . Krebs, who used the opportunity to help Thomas see that it was all right for him to get angry - healing his sense of trust in adults . He talked about his concern about the fate of a cat that had lived with him at his birthmother’s home, eventually letting Ms . Krebs know that he was worried about his birthmother and wondered where she was .

Ms . Krebs also worked with Thomas’ parents, coaching them to provide Thomas with what he needed, as well as how to respond appropriately to his difficult behavior . Ms . Krebs notes, “I needed to help his parents understand how his traumatic past resulted in a lack of trust which translated into anxiety, insecurity and a hyper-vigilant stance in the world .”

Thomas was testing his parents, and needed reassurance that he would be accepted and loved despite his misbehavior . In addition, Ms . Krebs helped Thomas’ parents understand how his emotional challenges may have been interfering with his ability to learn and that throughout time, this might improve as well . In the meantime, she emphasized the importance of providing Thomas with support . The C .A .S .E . model of therapeutic support incorporates understanding of the impact of trauma, grief and loss in foster care and adoption as it relates to attachment . The concept of ambiguous loss, as described by Pauline Boss in Ambiguous Loss: Learning to Live with Unresolved Grief, and the good grief model developed by Maria Trozzi in Talking with Children about Loss, are important theories for treating children who continue to have contact with birth parents, as well as those who do not .

Ambiguous loss refers to loss which is uncertain and often unrecognized by others because it does not follow traditional patterns leading to closure . Unlike the finality of death, for example, ambiguous loss blocks the coping and grieving process because the loss situation may change . Children may believe they will reunite with birth families . Without more absolutes, the “family relationship freezes in place,” Boss states in her book, complicating children’s ability to move on and form new attachments, despite their need to do so .

The “good grief” model outlines the stages of grief for children and teens, and emphasizes that “grief shared is grief diminished,” as stated in Boss’ book . Trozzi believes that grief cannot be rushed, and that children need to be in trusting relationships to work through the pain of their losses .

The first of the four stages identified by Trozzi is understanding . At C .A .S .E ., therapists help children to verbalize their perception of the situation that caused the loss . Sometimes information can be added or corrected, or different perspectives can be provided to help children comprehend why events occurred . Sometimes loss is not of a person, but of innocence, trust or safety .

Lifebooks are helpful tools for concretizing the past for children. At C .A .S .E ., therapists also help children identify “lifelines” that provided support to them at critical points in their young lives . Lifelines are clues for effective coping skills that can be useful again . They may be people, or activities such as playing sports, reading, phoning a friend, or they may simply be thoughts that were comforting or encouraging at a difficult time .

The second phase is grieving . Ms . Krebs notes that children can be helped to understand that painful feelings are normal, they can be expressed in healthy ways, and that they do not go on forever . “We need to help them keep faith and hope for the future .”

The third phase, commemorating, helps children believe that there is value to their loss and that others will acknowledge the loss . Ms . Krebs emphasizes the importance of helping children keep and treasure photos of people and places . In addition, foster parents can maintain respect for children’s losses through language . An example, “I was thinking about your birthfather today, and I wonder if he had a good throwing arm when he was young … just like you!” Or, “I know your sister’s birthday is this month . Would you like to make a card that we can send to her?”

Finally, the fourth phase is, going on, or moving forward with life by accepting and integrating the loss psychologically and emotionally within . However, children are likely to move back and forth through these phases; it is not unusual for them to return to intense grief when it has appeared previously that their sadness had waned .

The nature of loss for children in foster care is deep and often affects their self-worth . Many lose not only their birth families but possibly friends, teachers and pets . Often they have moved form school to school and are unable to keep mementos or schoolwork that made them proud . They may lose things along the way, such as clothing, books and photos . Grieving these losses is no quick or easy task .

The importance of grief work cannot be overstated . When children are not given the opportunity and assistance to effectively communicate their grief as well as the feelings related to other traumatic experiences, the result can be a serious erosion of self-trust as well as trust in others . The result can be feelings of incompetence, and a belief that the world is unfair, unsafe, and unmanageable . These powerful emotions, if not recognized and alleviated, can have a serious negative impact on a child’s ability to attach to a new caregiver .

Shana, 15, was removed form her biological family at age 10 after her mother failed to retrieve her and her 8-year-old brother from a babysitter’s home . After living in several foster homes, she was placed for adoption at age 11 . She entered therapy four years after adoption because she felt unattached to her adoptive parents and was asking to be removed from their home . Shana’s parents had reached the point where they wondered, “She is so insistent about this, is there nothing we can do but let her go?”

Treating traumatized teens can be especially challenging because, according to Debbie Riley, Executive Director of C .A .S .E ., teens frequently deny that they need the help of a therapist and that problems exist . Instead, teens may present self-injurious behaviors, depression, anxiety, anger-management issues, substance abuse, and relationship problems that stem from previous trauma . She notes that frequently, the situation is complicated because little information is available about the trauma the teen may have experienced in his or her early life . To heal, the essential components for recovery include the emotional support of the family as well as the therapeutic relationship . The adopted teen may have lived in environments where adults harmed and betrayed him or her, but helping build safe connections with others so that he or she may successfully attach to adoptive parents is crucial .

Ms. Riley describes the process of helping Shana share her story and express her emotions to be complicated . Although Shana tried to push her away, Ms . Riley remained steadfast and worked to slowly build the trusting relationship which helped her describe the sexual abuse she suffered at the hands of her stepfather . Ms . Riley sat with Shana as she poured out her pain, rage and fear that she was unlovable . The experience of sharing her memories led to Shana’s ability to recognize and grieve the loss of the friend and other people she missed from her previous life .

Ms. Riley’s work with Shana’s parents centered on helping them understand Shana’s traumatic past and the impact of the past on her ability to trust and attach to adults . Her parents had been unaware of the extent of Shana’s experiences . Her rejection of her parents was an attempt to protect herself from future harm . Shana’s parents were warm, loving people who did not want to lose her but had been hurt themselves by her behavior . They agreed to “hang in there with her” as long as she agreed to continue with them and her therapy .

“How kids work through the mourning process and grow from it is up to us,” Trozzi notes . Children who are separated from birth parents and those who have been involved with the foster care system have experienced disruptions and losses that affect their ability to adapt to a family environment . It is up to adults – parents, social workers, nurses, doctors, and teachers – to anticipate, accommodate and support these children as they grieve . Many children cannot maneuver through the complexities of their significant losses and their life stories without support that is enhanced by deep appreciation for the unique nature and challenge of those losses .

For information about Debbie Riley’s new book, Beneath the Mask: Understanding Adopted Teens, please see the “Publications” and “C .A .S .E . Store” sections on the C .A .S .E home page at www.adoptionsupport.org

For information about C .A .S .E . training for families and professionals, please see the “Training” link on the C .A .S .E . Home Page at www.adoptionsupport.org.

GAY AND LESBIAN ADOPTIVE FAMILIES
Ellen Singer, LCSW-C

Rita and her partner, Cindy adopted Jackie, 10 from China as an infant. A star soccer player, Jackie was fortunate to be able to have both parents attend most of her soccer games. On one particular occasion, the game involved a new team in an unfamiliar league. As they began walking from their car to the soccer field, Rita began to feel uneasy as a tall, large man, walking with his soccer player son to the field, stopped and approached them. She worried that he was going to say something unkind about their family. Jackie started talking to her teammate. The dad said, “So is Jackie adopted?” and before Rita could answer, he said, “Well I’m asking because my wife and I adopted both of our children from Russia.” Rita states, “This was the start of some wonderful field side conversations over the rest of the playing season between us. Somebody, who on the surface appeared to me as unapproachable and potentially not accepting of my family, actually did not care at all about the gayness of our family.”

Adoption presents many challenges for families . All adoptive families struggle with society’s bias about being “second-best” to biologically related families . Gay and lesbian adoptive families face an extra layer of challenge . Even within the adoption community, it is well known that very often, gay and lesbians face the struggle of being perceived as “last resort” families for adopted children . In domestic adoption, some states, such as Florida, do not permit gay and lesbian people to adopt . A number of states do not permit second parent adoption, as they do in Maryland and D .C . In international adoption, some countries do not support placement of children with gay and lesbian parents . Interestingly, statistics show that in privately arranged adoptions, birth parents do choose to place their children with gay and lesbian parents . (naic)

Gay and lesbian adoptive families not only have to cope with the challenges presented by adoption, including racism if the adoption is transracial/transcultural, but certainly discrimination by people who do not approve of their sexual orientation, known as heterosexism. And they need the support of the adoption community. While some families can rely on the support of their extended family, others may have lost these relationships or experience strained relationships as a result of “coming out.” (Partners may also handle their sexual orientation in different ways – some choose to be more open, others more selective about who they share their status with.) The debate over gay marriage, of course, also strikes at the very heart of recognizing and supporting these families. Rita’s story demonstrates the power of adoption to unite diverse types of families within the adoption community.

While gay and lesbian adoptive families need the validation and support from the adoption community, heterosexual adoptive families can learn a great deal from gay and lesbian adoptive families about children and resiliency in the face of unkind questions/remarks about adoption. Amber Adams and Kristen Benson write in Family Therapy magazine, “Children are teased and discriminated against in our culture for many reasons, including gender, skin color, the size and shape of their bodies, their names, and the way they talk. Considering the presence of teasing and even bullying that occurs in schools, it seems children of gay and lesbian families may actually be better prepared to face these struggles than other children….many may have developed coping strategies to help their children adjust and thrive in a heterosexist culture. Some…prepare their children through open discussion about sexual orientation and the possibility of experiencing heterosexism…and encourage their children to learn that (people’s negative attitudes) has nothing to do with their inherent worth.”

Like all adoptive parents, Rita’s concerns center on how Jackie will process the experience of being part of an adoptive family. As Rita says, “Our conversations with Jackie have been much more about adoption than about our sexual orientation. Early on we helped Jackie understand that some people will not respect our family and that they don’t matter. We’ve protected her as much as possible by lessening the risk of her being hurt by the choices we’ve made about where we live and what school she goes to. But we cannot protect her from the very personal pain she feels about the losses inherent in adoption. In this, we’re like every other adoptive parent who must validate their child’s feelings and be there to help them work it through.”

RESOURCES

Gay and Lesbian Adoptive Parents: Resources for Professionals and Parents, National Adoption Information Clearinghouse www.naic.acf.hhs.gov/

Perceptions of Social Support Among Heterosexual and Homosexual Adopters, by Peter Kindle and Stephen Erick, Families in Society, Nov./Dec. 2005

Considerations for Gay and Lesbian Families, by Amber Adams and Kristen Benson, Family Therapy magazine, Nov./December 2005

The Lesbian and Gay Parenting Handbook: Creating and Raising our Families by Dr. April Martin

Upcoming two part series on Gay and Lesbian Teens in Adoptive Families and Adopted Teens in Gay and Lesbian Families by Debbie Riley, Executive Director of C.A.S.E. in Adoptive Family Magazine – May/June 2006

Parent Perspectives: How our children are like their birth parents
by Ellen Singer, LCSW-C

Question: While my daughter has many qualities that are similar to me and also to my husband, I believe that some of her talents, such as her musical ability, clearly come from her birth family . I have always expressed pride and appreciation for her ability, and she knows those talents are not ours . I am wondering if and how I should I talk with her about how this talent may come from her birth family .

When adoption experts advise adoptive parents on the importance of claiming their adopted children, they are referring to the task of identifying ways their children are like them . Experts agree that this process is essential in order for adoptive parents to feel positive about their experience as adoptive parents . In turn, parents are encouraged to share with their children how they are all alike . Holly van Gulden points out in Real Parents, Real Children:

“Attachment is built through mutually positive interactions, in conjunction with the parent’s claiming of the child and the child’s feeling she belongs with the parent and fits as a member of the family . A child who can identify how she is like her parents –if not by looks, then by talents, abilities, behaviors, or common interests – is able to internalize or claim her adoptive parents .”

Adoptive parents usually have little difficulty meeting this challenge . Most are proud to share how their child is like them .

What about the ways children are not like adoptive parents, but like their birth parents? Children also need to know that adoptive parents value the parts of them that probably came to them through their genes . When parents communicate positive feelings about an attribute and can suggest that it is, or may be, directly linked to the birth family, they foster a positive connection for the child with his birth parent (known or unknown) . An example: “You are a terrific artist . That is a skill I certainly don’t have! I wonder if someone in your birth family has those talents and passed them on to you!” Parents can emphasize that two sets of parents may provide an EXTRA set of positive influences to aid them in life!

Holly van Gulden points out that “a child may lack a sense of belonging even if the parents have a strong sense of claiming if he feels his uniqueness sets him too far apart from the rest of the family . “Therefore, parents might want to identify traits that may have come from the birth family that are SIMILAR to the adoptive family . An example: “You are getting so tall! It looks as though your birth family may have been tall, just like your father’s side of the family .”

Sometimes parents neglect to discuss genetic gifts from birth parents because they don’t have much information about them . As mentioned above, they can still voice their thoughts, which in turn will send the message to children that their uniqueness is valued . In addition, when children are experiencing the normal grief over loss of their birth parents, they often want to know about what their birth parents are like . In the absence of information, they can be helped to guess what their birth parents are like by looking at themselves .

In some cases, parents do know considerable information about the birth parents . For example, a mother may know that her daughter’s artistic ability and allergies are inherited . She may not know about some of her daughter’s other characteristics, but expresses curiosity about those that might come from the birth family .

Another important part of this issue is how adoptive parents feel about the differences that may relate to birth parents . If the difference reminds them of the loss of having biological children, (the belief that biological children would not have that difference), they may inadvertently communicate disapproval for a particular quality . An example would be a child with average academic performance adopted into a family of high achievers .

All children, as noted above, can be hurt by their parents’ attitudes in the development of their self esteem and identity information, but adopted children may be especially vulnerable to parental criticism and disapproval . Family counseling can help to adjust expectations on both sides .

Success Stories: Protecting Them

Greta Rosenzweig is a social worker and adoptive mother of two children .

Pre-kindergarten conversations with my daughter, Gillian, nine and then two years later with my son, Jacob, seven included talking about different kinds of families, pointing out that to some people our family composition was unfamiliar and different and that she/he might be asked questions . Both children looked questioningly at me … clueless as to why I would suggest that some kids might say mean things about their family or ask them questions that they weren’t comfortable answering . Armed with a new look at the world and WISE UP, I sent them off to school . Why would I need to have this particular discussion? Not because Gillian is adopted and not because she is a beautiful Chinese little girl in a Caucasian family, but rather because she and Jacob have two moms, me and my partner of 18 years, Sandy .

I can honestly say that five and half years later, they still haven’t received any mean comments or questions that made them feel uncomfortable or bad about themselves (I know that other children of lesbian and gay parents have not been so lucky) . The fact that we are a lesbian family is a non issue for them . Our children have been lucky and Sandy and I are aware that we are in large part responsible for this good fortune . We have protected them and shored them up in many ways . We have carefully picked the schools and churches they have attended and the neighborhoods where we have lived insisting on diversity on many levels, progressive thinking, and a strong sense of community and openness .

We have also done what we can to make them confident, secure and open to the world around them . They are surrounded by grandparents, aunts and uncles, cousins and friends who adore them and see our family as “normal .” We make sure that we are an active and visible presence in their lives, volunteering in the classroom, attending sports events, serving as PTA co president, co-chairing the school Fall Fair, skating with them and their school friends every Friday night in the winter and making friends with their friends’ parents .

They hopefully see me as a confident and secure person who is comfortable with whom I am because this has not always been the case . I have grown a lot since I was in my late twenties and early thirties when I didn’t always share personal information with other people . I was afraid of rejection and didn’t like being and feeling different . My children have given me a huge gift . I have to be out; always one of two moms . I am learning to keep my defenses down and it is easy most of the time . My wish is that my children never have to put up the walls of protection that I have and that they continue to see their family as being as good as everyone else’s . Knowing that this will probably not be the case, Sandy and I will continue to do all the things we have already done to have our children, greet the world as the strong, loving and well adjusted young people they are .