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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Tuesday, October 2, 2012

Adoption and Post-Adoption: A Guest Post

  1. Marianne Milton wrote the following as a comment on my post about Post-Adoption Depression. I thought it was so substantive and well-put that I asked her whether I could make it a "guest post":

    I like the idea that post-adoption depression can lead to parents looking to extreme (or faddish) forms of child-rearing advice. That makes sense to me, especially considering that (1) raising adopted children is different than raising birth children in some respects, (b) there's a paucity of sound (evidence-based) advice for dealing specifically with adoption-related issues in child-rearing, as compared to the enormous amount of advice (albeit not all sound) related to child-rearing in general (perhaps due to the low incidence of adoption), and (c) raising older, foster/adopted children, often with multiple and severe special needs, which may not be documented or diagnosed prior to placement, is even more of a journey across an uncharted landscape.

    The allure of such approaches as attachment therapy, EMDR, tapping, "training up" a child, love & logic, tough love, etc., is twofold, I believe: it sets the parents apart as special (super-heroes even) because the obscurity of the approach suggests that their children are damaged and challenging beyond the norm (which may, in fact, be true), thus requiring both super-special treatment and super-special parenting; and it gives parents a way to dismiss any criticism that might come at them from outside the particular cult of treatment they've chosen as uninformed because "our kids" are not like other kids, so other parents have nothing to offer us.

    Not only do the treatment providers end up feeling and acting messianic, but the parents can as well.

    However, I'm not sure that it's post-adoption depression that leads parents to wanting (however unconsciously) to hurt or punish their children through punitive/shaming treatment approaches---or through simply nonstop "treatment," of whatever sort, which convinces the child that he/she is broken and in need of far more intervention than any other kid---that "our kids" thing, again, that Trauma Mamas so often bring up.

    Parents who are depressed aren't necessarily driven to punishing or hurting their children. In fact, that may take far more energy and focus than many depressed people can muster. One of the most damaging aspects of being raised by a severely depressed parent is the neglect born of parental depression. I'd be careful about equating depression with maleficent intent.

    Having said all that, I've personally felt the despair (and yes, also, post-placement depression) of raising children who are survivors of a foster care system (and the initial abuse/neglect of birth family) that left them traumatized beyond what I or local helping professionals could help them deal with in the short term. The task is large and can be overwhelming, and there's really not a whole lot of research-based help out there for, say, how to help a sexually abused child who witnessed lots of domestic violence, and then himself became a perpetrator of violence, who now suffers from PTSD, and who has ADHD (likely a genetic gift, given the birth family history) as well as FASD because his teen birth mom was already an alcoholic and drug addict by the time she got pregnant with him, and never got any prenatal care nor abstained from alcohol during her pregnancy, which she didn't fully recognize until after the first trimester, in any case.

    This is a not atypical story, sadly. And if the child has been passed from foster home to foster home, experienced multiple hospitalizations, a stay or two in residential treatment, and a cocktail of psychotropic drugs, reassigned whenever a new placement occurs, with its concomitant changes in mental health providers, no one, frankly, knows what the hell is the best approach to help this child.

    And, I've come to the conclusion, that that's the "gold standard"---that's where we are, currently, in the research. No one really knows what to do, or what to treat first, or how to manage it all, while childhood is speeding by and school calls for attention.
  2. (cont'd)
    So, we do the best we can: we find a psychiatrist who can work on the most flagrant symptoms (PTSD-related insomnia and aggression, for example), we find a nutritionist who can work on the anorexia brought on by sexual abuse, for example, we find a psychotherapist who can work on the suicidal ideation and the externalizing threats and the complete (and understandable) lack of social skills, and we find a family behaviorist that will work on building a sense of safety and consistency in a home that is being torn apart by the effects of the traumatic history of a child who has grown up, for all practical purposes, in a war zone.

    So, yeah, a little holding therapy sounds good, especially if the professional proponents of it say that will cure *everything*---that the root of all the child's problems are attachment, and if we can go back and redo that terrible gap in mother/child attachment, all the rest of the trauma will not need to be addressed, or will be easily and secondarily treated.

    We mess up a few children in our culture really, really badly, and we don't yet have the means to repair the damage we cause. Perhaps we never will. And perhaps that's where we ought to start, when we talk about adopting older children, or any children whose prenatal circumstances we know nothing about (because "only" FASD is no picnic).

    We've adopted severely injured children, and they won't ever be "fixed" fully. All we can do is our best: our best to love them as fully human, to educate them as fully human, and to show them the respect and dignity they deserve no matter where they are currently standing on the injured/fixed spectrum.


  1. Marianne-- hundreds of people are reading your post!


  2. Thanks so much, Jean. I really appreciate it.