by Lansing Wood
On April 28 FAIR presented a workshop as part of a continuing effort to provide training for therapists in the issues of adoption and the needs of todayís adoptive families. FAIR has had a long-term interest in identifying appropriate therapeutic services for families who have chosen to become parents to waiting children, especially those who come with a history of neglect or abuse and who have experienced multiple moves before placement for adoption. The families include those with children adopted from other countries as well as those with children placed through our social welfare system. As a parent support group, FAIR is aware of many families under sever stress from the challenges of parenting these children, yet they are often unable to find suitable professional services.
Ms. Van Gulden-Wicker, a therapist and adoptive parent who grew up in a large inter-racial adoptive family, drew on her professional and personal experience in her presentation as she discussed the needs of families impacted by the addition of what she termed an "AOC Ė (acting out child.)" She prefaced her remarks with a reminder of what many families find when looking for therapeutic help: the attitude of the mental health professional that, "adoption really doesnít work, but since you got into it weíll try to work with you." Families may also encounter the attitude that, "if you need mental health services, you must be crazy." Often the therapist looks for "adoptions issues" without recognizing the importance of what went on before placement for the child and the parents and how that affects the current situation.
Parents, on the other hand, often come to the therapist reeling from the effects of their shattered dreams. Inevitably, adoptive parents held the belief that they could be successful parents to this child, that with time their love and good parenting skills would enable the child to overcome whatever had been lacking in his past.
The parents feel a sense of failure over what they see as their inability to
bring about the change they envisioned with this child who was, after all,
matched by adoption professionals with the particular family chosen to meet his
needs. The parents feel total frustration as they try to parent a child who is
emotionally unavailable to parenting on a day-to-day basis. Often the strength
of the pathological "system" brought to the family by this child has
indeed affected the health of the system he has joined. Ms. Van Gulden-Wicker
alerts parents and therapists to the too perfect child who is desperately hoping
to go back to the people she lost.
Whether the child is acting out violently, or passively resisting parental involvement, the parents may find that the therapist is quick to recommend giving the child up, either through a return to the foster care system, placement out of the home, or termination of parental rights. She feels that adoption is not seen as a permanent, fully legitimate relationship even by professionals in the field, making it even more difficult for children and parents to have the commitment necessary to survive.
Another characteristic of many adoptive parents seeking professional help, according to Ms. Van Gulden-Wicker, is that they feel they must be one hundred percent perfect to make up for the one hundred percent imperfection of the childís previous experience. They may have a hard time understanding that even an abused child probably had only ten percent abusive experience and ninety percent acceptable family life, and that at least what he left behind was known and therefore preferable to the frightening unknown of a new family. The adoptive parents may also feel so unsuccessful in parenting the difficult adopted child that they desperately need the other kids to be perfect and not show any sign of the same kind of behavior. Because the parents feel nothing positive coming from the child who is unresponsive to parental love and can trust no one but himself, they may demand unrealistic responses from other children. Therapists must be sensitive to the reaction of the family system to the entrance of the child into the family. Frequently there is evidence that the child acted similarly in other settings. What must be recognized is the tremendous sense of failure and disillusionment so often felt by parents by the time they approach a professional for help. Ms. Van Gulden-Wicker described her work with a group, aptly named PUSS, or Parents Under Severe Stress. Families were self-referred and could join the ongoing group after telephone contact only. When parents called, often they were considering disruption of the adoption and were in great pain. Ms van Gulden-Wicker emphasizes that there is no easy, painless way out, although there are several options:
The family can continue or increase the pain they are feeling.
They can make the decision to disrupt or terminate parental rights and that will be an extremely painful process. Ms. van Gulden-Wicker asks the family to delay the decision for at least three months while she works with them. She also asks them not to make a decision in the middle of a crisis, even if it is as severe as a child sexually abusing a sibling.
The parents can come to the group to help them understand what has happened and to begin to heal.
The group experience also will be painful but offers a way to change the way their life is going which is unacceptable to them.
In group, the grief cycle (Kubler-Ross and Jewett) is used extensively to help parents begin to understand their feelings. New members are taught the stages and asked to begin to relate their own experience with adoption to the cycle. At first the process is more intellectual but later becomes intensely emotional, as the parents are able to use the group experience. The stages of shock/denial, bargaining, anger, despair, and accommodation or reorganization are useful not only in understanding the parentsí feelings, but also those of the acting-out child as well as the other children in the family. Ms. Van Gulden-Wicker sees the priorities of her work with families as dealing first with the pain of the parents, then with the feelings of the other sibs, and finally with the acting out child.
Ms. Van Gulden-Wicker views parental shock as a reaction to the challenge to their sense of competency as parents. The parents have great difficulty recognizing and admitting their loss of their fantasy child, their ideas about family life, and their short and long term goals for their child. The child, on the other hand, may have difficulty grieving until she actually accepts that there has been a loss. Parents also experience the bargaining phase as they examine themselves about how things might have been if only they had understood something earlier, tried a particular technique, seen a certain therapist, changed the childís school, been a little more loving, stayed home from work longer, etc. An acting out child engages in ongoing bartering as she says in effect, if only I hadnít been a bad baby, or if only I act this way, then maybe they will bend me back, move me on, not ask this of me, etc. Often there is fluctuating acceptance and denial on everyoneís part. Claudia Jewett in her book, Helping Children Cope with Separation and Loss, sees children yearning and pining for what they have lost and a high incidence of running, not away, but back to where they came from as much as that is possible. Parents too can yearn or pine for what they have lost in family tranquillity and spontaneity. A man might yearn for the woman he married who used to be so patient and loving with children. She might pine for the confident man who used to support her and make calm, rational decisions.
The stage of anger can involve depression and aggression, with parents feeling helpless to impact the child, to help the child attach or to ever return to what life was like before the child entered the family. Parents may also feel anger toward the placement agency, therapists who have been unable to help, and extended family and neighbors who donít understand the depth of their problems. After all, they asked for the child, didnít they? Part of the parental rage comes from their inability to get out or, if they do, to get away from the constant weight of the stress. The childís anger can stem from the unfair losses of caretakers, the powerlessness he feels over the events of his life, and the abuse he has suffered.
As parents move from despair to a sense of re-organization they may be at very different stages of the grief cycle. Ms van Gulden-Wicker feels that males and females often express their feelings differently and that this too can be a source of friction in an already strained relationship. For example, the woman may be in a stage of anger/rage and complain constantly while her husband is in denial/shock. The husband may move quickly to an action oriented reaction while the wife is still stuck in the bargaining stage. Teaching the parents about the cycle and helping them identify their own patterns with the help of other group members can be extremely useful in changing non-functional patterns. Parents who feel that they are "nuts" can see why little "cracks" in their relationship have become "crevices" due to the extreme stress involved in parenting an acting out child.
After parents and families have been able to understand and accept their feelings through the group experience, Ms. Van Gulden-Wicker says they can begin to change the way they react to and interact with the difficult child. She counsels them to drastically change the intensity of their reactions around the AOC. Because of the common history of crisis induced reactions, the parents are taught to write and use scripts which they use in typical situations, such as a call from the principal or the police. Nothing is done without allowing time for discussion and planning with the spouse unless the situation endangers the child or others. The needs of the rest of the family are considered first, and the parents are taught to negotiate with each other about who is feeling most ready to respond (go to the police station, school meeting, etc.) based on who is most in denial or in action that day. The parents are helped to express their own needs and to support one another in meeting these needs, rather than always revolving in an ineffectual way around the AOC. The child may escalate typical button pressing behavior and be tremendously jealous of the attached sibs in the family, so parents may need to post scripts in key places in the home to avoid reverting to old patterns.
Parents will eventually be ready to go through a process of letting go, piece by piece, of the dream they had about this child and what it would be to parent him. They can specifically list what they thought life would be like with this kid and then begin to accept reality, what Ms. van Gulden-Wicker calls the child "as is." She helps the parents redefine parenting for this child and find answers to how they can address the basic needs of shelter, food and safety. Parents can then realistically project their thinking about what the child will need in the future and what they can do about these needs. Perhaps this child will need a place to come home to for holidays, someone to visit her in jail, someone to help plan a marriage, a connectedness by name. Some of the necessary steps can then be taken without the tremendous sense of guilt and failure into which parents had been locked. In the group parents are able to move beyond merely trading horror stories to real healing. Ms. van Gulden-Wicker feels that there is no chance of healing the children without healing the families, especially the parents, so that they can have a true, yet realistic commitment to the childís needs. Only within the security of this commitment can the child begin to deal with the adoption and life issues himself.
Ms. van Gulden-Wickerís presentation included a focus on the other siblings in a family with an AOC. She feels that therapists and parents must be aware of the impact not only when the child first arrives but as the intensity of the relationship between the parents (especially Mom, who often spends more time with the child) and the AOC builds. The attached "normal" kids cannot complete with this intensity so the parents must focus on their relationship with the other sibs and avoid using them to meet parental needs. Sibs must be protected realistically from physical, verbal and sexual abuse. They are affected by such events as major school crises, suicide attempts, fire setting, running away, hospitalization, and vandalism. If they are to remain healthy they must know that their needs are also of great importance and that the parents will be there for them and will be able to handle whatever crisis occurs. Sibs often have to live with stealing, lying, destructiveness, and general uncooperative, unpleasant behavior. They may see an acting out sibling receiving consequences for behavior with no effect. They may feel jealous about the time parents spend dealing with the AOC and fearful of the anger of the sib. Other adopted children in the family are especially vulnerable to threats that if they tell something Mom and Dad wonít want them any more. Also, when children see the stress of their parents they may not want to add to it by complaining about their own distress.
Sibs of an AOC often intellectually understand why a child acts in certain ways but they still feel angry and jealous and they feel guilty for that. They too have experienced losses: the family life before this kid arrived, the imagined perfect siblings, the cooperative soccer partner, the understanding pal, the sister to confide in, the older brother to look up to. When the anger build sup healthy, sibs can act out, often fearing that they are becoming just like their disturbed sister. Parents can easily overreact and feed into this fear. The healthy sibs can have fantasies about getting rid of the AOC and again feel guilt about this. Often sibs feel some love and genuine concern for the acting out child and try in their own way to help. Yet they feel frustrated and powerless as they see a decrease in the sense of fun and intimacy between the parents and in the family as a whole. These children too can become hopeless and depressed. They are often embarrassed by the sibís behavior at school and in the community and may not want to have friends over to play.
Ms. van Gulden-Wicker feels that parents must see that sibs of an AOC feel safe in their own family and home. They need to be brought in on all of the issues concerning the difficult child so that they know the parents are dealing with the issues. They need to know how to protect themselves and that parents must know about all incidents involving safety. Kids must be able to say things like, "I wish I could kill him," and not have parent discount or deny the strength of the feeling. She feels parents can honestly say, "sometimes I wish that too," so that the sibs understand that they know how bad it can feel. In some families sexual or physical abuse has occurred and must be faced with the help of a therapist. She feels very strongly about victimized children being given the tools to feel safe and to resist the aggressiveness of the other child. Often a family will be counseled to give an acting out child lessons in martial arts. Ms. van Gulden0Wicker feels that since the AOC canít internalize authority this wonít help him. Rather, it would help to give the sibs Karate lessons. To every extent possible children must be compensated for things that are stolen or destroyed. In moments of crisis, the needs of the other children should be addressed first. Obviously, parents must be in a position themselves to model competent handling of crises and honest recognition and expression of feelings for all of the kids. Therapists can help families develop this capacity if they have a realistic understanding of the unique stresses of some of todayís adoptive families.