Category: We need to do better

The “Boy in a Box”: Yes, I testified for the Ferriter defense. Let’s talk about why.

I testified as a mitigating witness at the Ferriter sentencing because we must address the flaws in the overall narrative around the case. The prosecution spotlighted the ‘box,’ an 8’ by 8’ windowless room in the garage where Tim Ferriter confined his 14-year-old son. This space, made iconic by the media, and shocking audio of Ferriter berating his son became a haunting backdrop, fueling public perception that a lengthy prison sentence would administer justice—the state asked for 15 years. Let me be unequivocal: Ferriter’s actions were abusive. However, this deflects attention away from the bigger culprit: the mental health system’s failure to support at-risk children and their families.

Early Childhood Trauma and Its Consequences

Ferriter’s adopted son, the tragic victim in this case, endured neglect in a Vietnamese orphanage before he was adopted by the family as a toddler. Such trauma, during the formative first years of life, can lead kids to form a subconscious, instinctual belief that the world is unpredictable and unsafe. This worldview will shape their thoughts, choices, and behaviors throughout their lifetime. Some, like the victim in this case, are diagnosed with Reactive Attachment Disorder (RAD).

A 2023 study found that people with RAD had:
High rates of adult psychiatric diagnoses (73.5%)
Substance use (42.9%)
Suicide attempts (28.6%)
Psychiatric hospitalizations (71.4%).
Low high school graduation (34.7%)
High unemployment (26.5%)
Legal Issues state-funded health insurance (65.3%), and legal issues (34.7%)
Adult Outcomes of Children With Reactive Attachment Disorder in a Non-Institutionalized Sample, The Journal of Clinical Psychiatry, October 18, 2023

Early trauma, known as Adverse Childhood Experiences (ACES), can also affect a child’s brain development, resulting in underdeveloped cause-and-effect thinking, coupled with poor impulse control. This can have tragic impacts on the child’s long-term health and lead to an increased risk of  mental illness and incarceration, among other negative outcomes.

The Struggles of Parents Grappling with RAD

RAD is a spectrum disorder, and kids on the medium to severe end of the spectrum have persistent extreme behaviors, including physical aggression and episodes of rage. Their caregivers face overwhelming challenges, often exceeding their abilities and resilience. The nuanced nature of RAD makes it difficult for others to understand, leaving parents isolated and unsupported. Seeking help can compound their distress because they are routinely blamed and shamed about their circumstances and their child’s behavior when they reach out. The lack of adoption-competent mental health professionals further exacerbates the situation and many parents are left desperate for support and without good options. This is why I testified at the trial.

Well-meaning caregivers, unable or not knowing how to parent a child with RAD appropriately, can exacerbate the situation. For example, some attempt to implement interventions used in residential treatment facilities (RTFs)—aka Ferriter’s ‘box’ and ring cameras. While seclusion rooms and video monitoring measures are standard protocol to manage episodes of violent behavior in RTFs, parents lack the necessary resources and training to implement them safely at home. Unlike in staffed treatment facilities, parents struggle to cope as they face the stress of dealing with a volatile child, often without relief or breaks. In these emotionally charged situations, the risk of interventions turning unsafe and unintentionally or intentionally abusive dramatically increases. This creates a precarious situation for both the child and the family. This is why I testified at the trial.

The Verdict’s Shortcomings as a Deterrent

Contrary to the portrayal of the Ferriters’ situation as an outlier, many kids who are adopted have complex mental health and behavioral needs. Tens of thousands of families similarly navigate these challenges without readily available or adequately funded post-adoption services, which leads to troubling home dynamics. In the absence of viable solutions, support, and resources, the Ferriter sentence falls short as a deterrent for future incidents. This is why I testified at the trial.

It’s important to acknowledge that Ferriter’s conduct was abusive. Let there be no misunderstanding on this matter. However, by not seeking to understand how and why it happened, we inadvertently divert attention away from the broken mental health system. The unintended consequences will be devastating. The complete lack of acknowledgment of the mental health community’s shortcomings throughout the Ferriter trial, along with the fear of potential vilification, will only serve to deter struggling parents from seeking help. This is why I testified at the trial.

Shifting Our Focus to Solutions

As Ferriter begins his 5-year sentence, we must shift our gaze away from the sensationalized images of the ‘box’ to the underlying causes of these tragic circumstances. We must put out of our mind the trial’s disturbing audio recordings and listen, instead, to the collective voices of adoptive families of kids with RAD begging for help. This is why I testified at the trial.

To protect at-risk kids, we must seek to understand challenges and complexities that cause caregivers like Ferriter to become frustrated, struggle to control their temper, and to make grave mistakes. Our collective effort must focus on building robust support systems around adoptive parents if we are to foster healing for vulnerable kids and to prevent tragic outcomes.

“Boy in a Box,” Trial: Reactive Attachment Disorder (RAD)

I have complicated and nuanced feelings about the Ferriter, “Boy in a box,” trial. As I write this post, Tim Ferriter has been found guilty of all charges, including aggravated child abuse, a first-degree felony. Ferriter could face up to 40 years in prison, although sentencing guidelines suggest he’ll likely receive about 3 years. His wife, Tracy Ferrier, is slated to face trial in the future.

The family presented an affirmative defense, claiming their actions were due to their child’s condition, Reactive Attachment Disorder (RAD). RAD is a profoundly serious diagnosis, with some children exhibiting aggressive tendencies, and suicidal and homicidal ideations. I recently participated in a Crime TV panel discussion with Vinnie Politan to delve into this case. You can watch the discussion here.

It’s essential for the RAD community to acknowledge the Ferriters’ actions in confining their son in an 8’x8′ wooden box with no window and a bucket for sanitary needs. The box was equipped with cameras and could only be locked from the outside. At a minimum, this constitutes a fire hazard and is undeniably unsafe. RAD is never an excuse for abusing or neglecting a child with this condition.

Two truths coexist: the Ferriters’ actions in confining their son were dangerous and abusive, and yet they felt compelled to do so due to the system’s failure to support their child and family adequately.

Systemic failure

Once we acknowledge the wrongness of the Ferriters’ actions, we must turn our attention to the “why” behind this tragedy. The desperation of this family is not an isolated case. The mental health, child welfare, and judicial systems are failing tens of thousands of troubled children and the families who care for them.

The coverage of this case has perpetuated two myths about RAD: that treatment is readily available, and that it can be easily treated. Parents of children with violent behaviors struggle to get the help they need. They are not believed because their child’s behavior is genuinely unimaginable. They are blamed and shamed by mental health professionals who may understand RAD intellectually but lack lived experience. The intake process for treatment facilities is arduous, and the cost, ranging from 10K to 60K per month, is prohibitive for most families. Insurance restrictions often limit treatment to a few days or months per year, while many children need year-round care, often for several years. 

RAD is a spectrum disorder, similar to Autism. Kids on the moderate to extreme end of the spectrum, are resistant to treatment. In residential treatment facilities that claim to treat these children’s violent behavior, staff often resort to seclusion rooms and physical restraints, similar to the “box” used by the Ferriters. Despite having trained staff, cameras, equipment, and on-call psychologists, these children still harm themselves and others. Given these challenges, why do we expect the Ferriters, or any family, to keep their child safe and prevent them from causing harm?


Those observing the Ferriter trial should take a moment to consider what solutions could realistically have been offered to the Ferriters.

1. How can a family keep a child safe when they are exhibiting violent behavior every day? Even if this behavior is attention-seeking, how can parents, who also have jobs and other children to care for, maintain constant supervision to intervene? This is why treatment facilities have 24/7 line of sight supervision. Can a family manage this in the home?

2. How can a family ensure the safety of siblings when their RAD kid is trying to harm or even kill them? They can lock away knives, but anything can be turned into a weapon. How can they safety proof the entire house? This is why treatment facilities have padded cell like in treatment facilities. Can a family manage this in the home?

Even if a family and child have access to excellent therapy, there is no quick fix. Reducing violent behavior will require months, if not years, of therapy. What can a family do in the meantime? Remember that these parents have other children to care for, jobs to attend to, household chores, and numerous responsibilities. We are essentially asking them to provide 24/7 supervision and highly skilled interventions. Anything less may not ensure everyone’s safety, and even this level of oversight may not be sufficient.

So, what are the solutions? 

  1. Acknowledge that parents cannot safely manage violent behavior in their home
  2. Believe parents when they ask for help. 
  3. Reach out to families with support before they are in crisis.
  4. Provide accessible residential treatment options.
  5. Invest in research to develop effective treatments for RAD and children with violent behaviors.

Punishing the Ferriters may be justice, but it will not solve this problem. My hope is that trial watchers will educate themselves on RAD and become advocates for supporting families to prevent these tragedies.

Demons and Saviors: The unexplored side of Hulu’s documentary on Christina Boyer

The Missing Piece: Reactive Attachment Disorder (RAD)

Hulu’s documentary on Christina Boyer (formerly known as Tina Resch) raises puzzling questions that seem to defy answers: 

  • Did teenage Christina Boyer possess paranormal powers? If not, what was really going on?
  • How could someone remembered as a selfless mother kill her own 3-year-old daughter?
  • Why hasn’t Christina given up claiming innocence after 30 years, even when it hinders her chance for parole?

The answers to these questions may lie in a little-known but serious mental health disorder called Reactive Attachment Disorder (RAD). 

The Unfamiliar Crisis: What is RAD?

Reactive Attachment Disorder (RAD) is a rare but devastating mental health disorder caused by early childhood trauma. It is most common among people who have spent time in foster care or have been adopted. Newly identified by psychiatry in the late 1970s and early 1980s when Christina was growing up, it was virtually unknown to parents and many clinicians. Decades later, RAD remains relatively unknown compared to other mental health disorders, but is a significant crisis within adoptive and fostering communities. 

Children suffering from RAD struggle to form healthy attachments with adults and display a spectrum of symptoms ranging from aggression to manipulation. They may have violent outbursts, weaponize bodily fluids, or fly into uncontrollable rages. Their indefatigable need for control stems from a lack of safety and trust due to neglect and abuse they experienced before the age of five.

Recognizing RAD in Christina: All the hallmarks

Christina’s story exhibits several key hallmarks of RAD, including: 

Childhood Background: Time in foster care, adoption, neglect, and potential abuse, all of which are high-risk factors for RAD.

Behavioral Traits: Aggressive tendencies, extraordinary destruction during tantrums, superficial charm, manipulation, and controlling behavior. 

Family Dynamics: Parents’ anger and frustration, descriptions of potential demon possession, alleged false claims of abuse, and consideration of re-adoption.

Misdiagnosis: Misinterpreted symptoms, misdiagnosed and treated as hyperactivity (ADHD) instead of RAD

As the parent of a child with RAD, I immediately recognized the intangible and nuanced clues of the disorder throughout the documentary’s clips and pictures. The aftermath of her rages, her beguiling nature, and the enamored reactions of adults who interacted with Christina are all consistent with RAD.

RAD: A Complex and Nuanced Disorder

Christina’s situation reflects a profound misunderstanding of the impacts of early childhood trauma during her time, particularly as her parents came to believe she was demon possessed and turn to exorcisms. Today RAD is still misunderstood and often not properly diagnosed.  

Though there’s no indication that Christine was diagnosed with RAD, there are specific indicators in her case.

Manipulation: Convincing lies and control over adults and professionals. Learn more here.

Violence: Potential for destructive rages and physical assault. Learn more here.

Family Impact: The frustration, fear, and desperation seen in her parents. Learn more here.

These signs are compelling evidence that Christina likely suffered from RAD, though it remained undiagnosed.

A Closer Look at Christina’s Story

Taken through the lens of undiagnosed RAD, Christina’s story represents a web of trauma, psychological struggles, and societal misunderstandings about early childhood trauma. It challenges us to consider how the system failed her, and continues to fail troubled children and their families.

This is my interpretation of the story, based on my understanding of the facts as well as the potential impact of early childhood trauma.

A tragic tale retold: Christina’s story viewed through the lens of RAD

Born in 1969 to a drug-addicted mother, Christina is abandoned at just 10 months old and placed into foster care. At the age of two, she’s adopted by Joan and John Resch. Despite the love and care Christina finds in her new home, her early months have already scarred her in hidden ways that will shadow her entire life. She’s suffered neglect at the hands of a substance-addicted mother, and erratic care that leaves her emotionally wounded. Even if her removal to foster care rescued her from neglect and abuse, being taken from the her birth mother is a traumatic loss nonetheless. Christina is too young to understand what’s happening around her, but her body and subconscious mind are permanently crippled with feelings of insecurity and chaos.

The prevailing wisdom of the time wrongly assures Joan and John that Christina will be fine because of her young age, but the damage is done. The neglect and abuse Christina suffered during her formative years likely have caused her to develop Reactive Attachment Disorder (RAD).

By the time she turns eight, the signs are unmistakable. Christina’s tantrums spiral out of control. She’s aggressive and disruptive at school. Misunderstanding her condition, medical professionals prescribe medication for hyperactivity which only exacerbates the symptoms. Christina’s outbursts are more than mere tantrums – she “boils over” into destructive rages of extreme emotion that leave her parents bewildered.

Years go by, and Joan and John’s frustration grows as they struggle to parent Christina. Conventional methods fail them, and their home becomes a battlefield of screaming fights. They turn to corporal punishment, timeouts, and religious reprimands. Nothing works.

The year 1984 arrives, and Christina is now 14. Mysterious occurrences begin to plague the family home: lights flicker on and off, the television changes channels by itself. John and Joan suspect Christina of playing pranks, but she eludes them, fueling their fears that she may be demon-possessed. In the grip of the satanic panic of the era, they resort to an exorcism, clinging desperately to any solution. Christina, aware of her parents’ religious beliefs, exploits their fear to gain control over them.

Word escapes to the media, and Christina becomes a sensation. Her alleged paranormal abilities draw attention from journalists, psychiatrists, and investigators. Her flair for manipulation, combined with the public’s hunger for the supernatural, makes her all the more compelling. When psychologist William Roll moves in to observe, Christina’s charm beguiles him and he becomes entangled, disregarding obvious signs of deceit.

Dr. Roll takes Christina to North Carolina for additional research, and she senses his disappointment as she fails to perform paranormal feats for him. She is returned to her troubled home and alleges abuse by her parents. Unable to cope, her family tries to put Christina back up for adoption or in a juvenile detention facility.

At 16, Christina runs away, marries, and gives birth. Independence brings temporary happiness and the paranormal activity subsides. Her marriage becomes abusive, however, and she leaves her husband. When faced with the challenges of single motherhood, Christina leverages interest in the paranormal for attention, support, and empathy. Frighteningly, the alleged paranormal activity threatens the safety of the child.

Christina’s frustration at her situation grows and she struggles with her unresolved anger and trauma. Her discipline of her child becomes abusive. Perhaps she allows her boyfriend to abuse her child as well. Her three-year-old daughter dies of chronic child abuse – and it’s ruled as murder.  

Christina’s grief at her child’s death is wrapped in self-pity. What matters most to Christina, is Christina. She takes an Alford plea to avoid the death penalty and for the next 30 years doggedly maintains her innocence. While those working for Christine’s exoneration see this stubborn clinging to her version of the truth as evidence of actual innocence, extreme denial is common for people with RAD.

What About The “Paranormal” Events?

Christina’s “paranormal” powers became a media sensation. This begs the question: Could a 14-year-old carry out such an elaborate fraud?


Kids with RAD are often clever, manipulative, and extremely convincing in their ability to garner attention and gain control over people and situations.

Photo: ABC News

Debunking the Phenomenon

The Floating Phone Photograph: UPI Science reports that the famous photograph of a phone hovering over Christina is a hoax. The photographer, influenced by his religious beliefs and confirmation bias, chose to hide additional photographs that prove the phone was thrown. A contemporaneous Indianapolis Star article offers further details. 

The Lamp Incident: According to the Hulu documentary, and other sources, a news crew captured footage of a lamp flying off a table in 1984. Later review of the footage revealed Christina throwing the lamp when she thought no one was watching. 

The Lack of Evidence: Investigator James Randi further concluded that the activity was a hoax, as no paranormal activity was witnessed or caught on film, even by Dr. Roll who moved in to observe. He said this paranormal activity “turned out to be so elusive that no one ever actually saw a single object even start to move of its own accord.” 

Lab Testing: According to Christina’s recollections in the Hulu documentary, when she underwent extensive testing in North Carolina, the paranormal events ceased. 

Manipulating Perceptions: “Eye witnesses” in the documentary did not actually witness paranormal activity. For example, hypnotherapist Jeannie Leagle adoringly shows the audience the silverware supposedly bent by Christina’s psychokinesis — but she only saw the objects after the fact. Similarly, a friend tells of how she was sitting in one room of the house and suddenly saw a piece of bent silverware fly through the air from another room. The most reasonable and logical conclusion is that Christina was manually bending the silverware.

But, why would so many people believe her?

Media Sensation: The public interest in paranormal events and confirmation bias led journalists to favor the interpretation of paranormal activity over the logical explanation of a troubled teenager perpetuating a hoax.

Professional Bias. Professionals working with Christina, eager to study paranormal activity, suffered from confirmation bias. They ignored facts and acted unprofessionally, even as RAD children are known for their ability to manipulate mental health professionals. 

Satanic Panic: During a time rife with fear of occult activity, called the Satanic Panic, the community was primed to believe in spiritual causes for the paranormal events.

Parental Desperation: Frustrated and overwhelmed, Christina’s parents found it easier to believe in demonic possession rather than face their own perceived failures as parents. Later, the hype around paranormal activity brought positive attention and notoriety to the family.

Career Benefits: Many who attested to Christina’s paranormal powers saw financial and career gains (selling books, professional expertise, notority), making retraction unlikely as it would dramatically impact their credibility. 

Conclusion: Where do we go from here?

The story of Christina and her supposed paranormal abilities unravels to reveal a deeper and more tragic truth when we consider the early childhood trauma underpinning it. It’s a narrative shaped by human frailty, societal obsession with the supernatural, professional malpractice, and likely an undiagnosed mental health condition: Reactive Attachment Disorder (RAD). 

The key to unlocking this tragic tale lies in recognizing the implications of early childhood trauma and understanding the troubling threads that weave through our child welfare and mental health systems. Even after 30 years, these systems still fail to provide adequate prevention and treatment for the outcomes of early childhood trauma, including conditions like RAD. Sadly, there are too many cases today that lead to similar tragedies like the death of Christina’s daughter.

The story of Christina is not just a haunting tale from the past or a fascinating true crime binge watch; it’s a call to awareness and action. To learn more about Reactive Attachment Disorder, visit and

What are your thoughts on Christina Boyer’s story and the potential connection to Reactive Attachment Disorder (RAD)? Have you experienced or seen the effects of RAD in your own family or community? Share your insights, opinions, or questions in the comments below. I’d love to hear from you!


Blanco, Juan Ignacio. “Tina Resch: Murderpedia, the Encyclopedia of Murderers.” Tina Resch | Murderpedia, the Encyclopedia of Murderers,

Christina Boyer,

“The Columbus Poltergeist.” Skeptoid,

“The Columbus Poltergeist: How a 14-Year-Old May Have Bamboozled Media.” UPI, 9 Apr. 1985,

“Demons and Saviors.” Hulu, 3 Aug. 2023,

Mann, Sophie. “‘demons and Saviors’ Hulu Documentary Looks at ‘Poltergeist Girl’ Christina Boyer Who Claims She Was Possessed as a Teen and Later Found Guilty of Murdering Her Three-Year-Old Daughter despite Not Being Home at Time.” Daily Mail Online, 5 Aug. 2023,

Wiki, Contributors to Unsolved Mysteries. “Tina Resch.” Unsolved Mysteries Wiki,

Attachment disruption and RAD in adopted children

For tens of thousands of children in the U.S., their ‘forever family’ doesn’t last long. USA TODAY investigates: Why do adoptions fail? USAToday May 19, 2022

In a first of its kind investigation USAToday investigates how many adoptions are disrupted and why. Usually the focus of these conversations is on lack of access to mental health treatment. Indeed this is “a” problem, but it isn’t the only problem. This conclusion misses the underlying issue of childhood trauma and fails to recognize that even with access, effective treatments do not exist.

USAToday’s comprehensive study has taken a more nuanced view and discovered what many adoptive families already know. The mental health system does not have effective treatments for complex mental health treatments for many of the problems children suffering from early childhood trauma have. This leads to thousands of disrupted adoptions every year. This is a pivotal study and article because it brings to light this hidden crisis in the adoptive community.

Read the series here.

Parents in crisis can’t parent therapeutically – so stop expecting us to.

My teenaged son called this evening to explain that he’d cursed his teacher out and thrown his desk across the classroom. He was upset because he’d lost his school issued Chrome book because he’d taken it home (not allowed, and not his first time) and had pornography on it. I listened patiently without judgement. He explained how his elopement from school ended in an entanglement in a pricker bush and contact with a concrete culvert which scratched up his arms and legs. He was covered with bloody scratches and scrapes. I expressed empathy as I sipped my coffee. I offered encouragement when he said he was going to try to earn back the Chromebook and even said I’d talk to the school to ask for a clear plan to work towards that goal. I told him I was proud of this choice to make tomorrow a new day.

Today I was a therapeutic parent superstar and here’s why:

Had this situation happened when my son was still living at home, I would have gone nuts. I would have been throwing out consequences and yelling. My anxiety would have been through the roof. I would have been angry, embarrassed, frustrated, and overwhelmed.

Back when my son was living at home, our family was in crisis. The situation had grown toxic. It took several years of his being in treatment programs, and my being in therapy and educating myself, to begin to find a positive way forward.

Unfortunately, this is not uncommon. Adoptive and foster parents aren’t prepared for the early childhood trauma most kids coming into our families have experienced. We usually reach a crisis point before we learn about therapeutic parenting. By that time, we’ve become desperate and demoralized. Our mental and physical health is so degraded that we are barely surviving. Our kids are out of control. Our life is out of control. We can’t even manage to brush our hair in the morning much less use a calm and kind voice after our child spits in our face.

No doubt, our children need us to be that calm and steady, therapeutic parent, but at that point, we simply don’t have the capacity to do it. And given the our current relationship with our kids, it’s likely we aren’t even the best person to do it. Though few dare tell the shameful truth – we likely have come to a point where we really don’t like our kid. It’s a struggle to be nice to them. It’s difficult to not feel adversarial towards them. If we’re really being honest, some days we’re as out of control as our kids.

Unfortunately, few therapists understand this. They usually underestimate our child’s extreme behaviors and the level of crisis our family is in. They assume we have the ability to parent therapeutically and shame us if we don’t. For our families to heal and thrive, this is something that must be recognized and addressed.

The only clinician I know who is talking about this and teaching other clinicians about this is Forrest Lien of Lifespan Trauma Consulting. (If you are a parent, please follow him on social media to support his efforts on our behalf.)

Families in crisis do not have the capacity to parent therapeutically. This is why we must:

1) Get help to families before they are in crisis (this means pre-adoption training and post-adoption support),

2) Support parents and families in a holistic way. Help us get to a place where we can parent therapeutically.

3) Surround families who are in crisis with supports. Stop shaming us for being broken and demoralized. Give us a hand up.

Parents must be healthy and educated to parent therapeutically.

A note about therapeutic parenting:

There are no perfect treatments for developmental trauma. My son hasn’t been able to access the highly specialized treatment he needs. My response to his phone call today doesn’t solve the problem – I realize that. However, consequences, though perhaps “deserved” won’t work, and will only further escalate my son. What I must do is choose the response that is most likely to move the ball forward. My goal is for him to remain in school and to not get kicked out of the group home. My goal is to de-escalate the situation. I highly recommend A to Z Therapeutic Parenting for practical information on therapeutic parenting.

Joker: A warning we should heed

At my teenaged kids’ insistence, I took them to watch Joker in the theater, expecting a typical action-packed, comic book movie – not a genre I typically enjoy. Instead, I sat in the darkness, stunned to near-tears by it’s devastating portrayal of how early childhood trauma and untreated mental illness can spiral into tragedy. 

The poignant film explores the backstory of comic book villain Joker: a man named Arthur Fleck who has a disturbing past and a troubling present. It is a compelling and nuanced portrayal of untreated trauma and mental illness. 

Joker is incredibly violent and disturbing, certainly earning its R-rating, but at the same time reflects a reality we are already seeing in our society today. Early childhood trauma is at epidemic levels. Our mental health system is in disarray. We aren’t meeting the needs of the vulnerable around us and sometimes violence and tragedy are the price we pay as a society. 

There’s a huge amount of controversy swirling around the film and it’s portrayal of mental illness. After watching the movie, I believe the real controversy we should be focused on is why we don’t have affordable, accessible, effective treatment for mental illness and early childhood trauma!

"You think Joker is controversial? What's really controversial is that we don't have affordable, accessible, effective treatment for mental illness and early childhood trauma." – Keri Williams Click To Tweet

*** Spoilers Below ***

In the film, Joker, we meet Arthur Fleck shortly after he’s been discharged from a mental health institution. He’s receiving mediocre city mental health services, living in poverty, and attempting to build a semblance of a life for himself.

While the film does not specify all of Arthur’s diagnoses, his symptoms include hallucinations, paranoia, delusions, and feelings of despair, loneliness, and worthlessness. Arthur’s one obvious diagnosis, Pseudobulbar Affect (PBA), fits of uncontrollable laughter, results in severe bullying. We also learn Arthur was abused and neglected by his mother during early childhood. This included severe head trauma as well as psychological and emotional abuse. Arthur has never been able to access the treatment he needs to manage his condition, much less heal, or thrive. He’s completely lacking social skills, unable to hold down a job despite his best efforts, and even with medication, unable to feel happy or optimistic.

Unfortunately, Arthur is not simply a far-fetched character. We have “Arthurs” living and breathing all around us – in our daycare centers, classrooms, workplaces, and neighborhoods. Early childhood trauma is a hidden epidemic affecting millions of people. While victims of early childhood trauma and/or people who have mental illnesses aren’t necessarily violent, the combination of untreated trauma and mental illness with psychosis can be dangerous. Furthermore, high-risk children are not receiving effective treatments in residential treatment facilities. They are aging out ill-equipped to function in the adult world and at high risk of criminal behavior and incarceration. Like Arthur, most of these individuals want to be happy. They want to have good lives. However, we, as a society, fail them by not providing effective, affordable, accessible treatments for trauma and mental illness. Like Arthur, these people struggle to navigate even the basics of life.

Arthur, though teetering like a wobbling house of cards, is trying to build a life for himself. He’s trying to find some happiness. But it’s obvious to the viewer that he simple doesn’t have the resources or skills to do so. And so begins Arthur’s devastating spiral that should be a warning for us all. 

  1. Arthur loses his services (therapy, medications, etc) due to city financial cuts.
  2. He’s fired from the job he loves – sure he made a mistake, but he’s given no mercy or compassion.
  3. He follows his dream to be a comedian, and falls flat. He’s mocked mercilessly.
  4. He’s physically assaulted for laughing (his Pseudobulbar Affect) and in self-defense shoots and kills two men on a train. In a panic, he kills another.
  5. He’s cruelly rejected by the man he believes to be his birth father.
  6. He learns his mother abused him as a child and anger that has been festering in his unconscious for decades surfaces.

The spiral tightens. Arthur is drawn to the rioters who praise him as a vigilante for the killing on the train (which was in fact, self-defense). He becomes more violent and murders several people. In his mind, his path has become inevitable as all other doors – all other options – have slammed closed in his face. 

Does this not reflect the crumbling path of so many young people in our society today? People who struggle on the edge of society: to hold down a jobs, to form relationships, to find their next meal, or place to sleep. This instability is the fate of so many people who have experienced early childhood trauma and/or are mentally ill because they are unable to access effective treatment and services. Is it any wonder that they are hopeless, desperate, and caught in a downward spiral? Is it any surprise that some end up engaging in criminal behavior? That some act out violently?

Towards the end of the movie, Arthur has fully transformed into the Joker. Wearing chalky make-up and a sardonic smile, he sits on a talk show stage and casually confesses to the train murders, Before shooting the talk show host point-blank in the face, Joker says, “I’ve got nothing to lose. Society has abandoned me.” And we can’t disagree: He has got nothing to lose. Society has abandoned him.

It only takes thumbing through the headlines to know that far too many of our most vulnerable have been abandoned by society and with nothing to lose have picked up guns and lashed out violently too. Read more about one recent incident here. This will continue until we prioritize affordable, accessible, effective treatment for early childhood trauma and mental illness.

NOTE: In case it wasn’t clear in this post, I am not saying that mental illness or childhood trauma lead to violent behaviors. What I am saying is that untreated mental illness and untreated childhood trauma can put people on a dangerous spiral.

Yoga at school may help your child, but what about mine?

Recently I’ve seen several headlines about schools who are introducing yoga as a way to address student behaviors. The West Fargo Pioneer (link no longer available online) explains this way:

Behavior issues stem from a multitude of reasons. However, studies show that students today are more likely to experience trauma and have mental health needs, increasing the likelihood of classroom disruptions and behavioral issues. 

In a classroom of 20, one or two students on average will be dealing with serious psycho-social stressors relating to poverty, domestic violence, abuse and neglect, or a psychiatric disorder, according to the Child Mind Institute.

This type of stress can shorten periods of brain development and limit brain growth in early years, making it harder for students to regulate emotions and concentrate on learning. 

And while schools can’t control students’ experiences outside the classroom, they can help students learn how to cope with stress and regulate emotional outbursts. Social-emotional curriculum aims to help students recognize and deal with emotions and tackle the increased presence of stress and trauma.

It’s absolutely true that every classroom has children who have experienced trauma. Early childhood trauma is an epidemic. It’s absolutely true that these experiences affect a student’s ability to learn and cope in school. It’s also absolutely true that some students will benefit from yoga. It will help by,

  • Reducing stress
  • Improving concentration
  • Increasing self-esteem
  • And more…

This is why PBS suggests Managing School Stress by Bringing Yoga Into the Classroom. And Education Week applauds Ditching Detention for Yoga: Schools Embrace Mindfulness to Curb Discipline Problems.

Great ideas, however news articles like these give the impression that yoga is an inexpensive, quick fix for childhood trauma. For kids on the moderate to severe end of the spectrum, this simply isn’t the case.

Here’s the problem

Many kids with developmental trauma are so dysregulated they cannot follow instructions or calm themselves enough to even choose to participate in yoga. A 10-year-old who flips desks, curses at the teacher, and fights with other kids is likely not able to safely or effectively participate in yoga.

Furthermore, kids who have extreme behaviors and emotions may be extremely disruptive during yoga activities. This can cause other students to be unable to focus and benefit from the exercises. A 6-year-old who refuses to follow instructions, pesters other kids, and runs around in circles, will disrupt the entire atmosphere.

If a child has a cold, a spoonful of honey does wonders. However, that same spoonful of honey is not able to cure a child who has strep throat. Here’s the ugly truth about trauma: Some kids who have experienced trauma have needs far beyond what a spoonful of honey can heal. Without comprehensive and specialized treatments, these children are unlikely to benefit from yoga at school. They probably won’t even be able to successfully participate.

A spoonful of honey soothes a sore throat, but it can't cure strep throat. Yoga in schools is wonderful, but kids with developmental trauma need comprehensive, specialized treatments. There are no quick fixes or easy solutions. Click To Tweet

I cringe at the “yoga in school” headlines because they minimize the devastating, often debilitating, effects of trauma on our kids. Most people who read the articles, or just skim the headlines, will assume childhood trauma is easily treated.

Don’t get me wrong – I applaud schools incorporating yoga into their curriculum and behavior programs because it can be helpful to so many children. However, yoga cannot curb extreme behaviors caused developmental trauma. It is a far more complicated and challenging issue.

Let’s get our kids to a healthy place where they can benefit from yoga. You can help by learning how trauma effects kids and sharing our video to help raise awareness for the need for accessible, affordable, and effective treatments.

Here’s what “trauma informed” looks like…

Due to startling research on the impacts of Adverse Childhood Experiences (ACEs) on children, there is emphasis on “trauma informed care” in many sectors – education, childcare, health care, justice, and more. Far too often, however, trauma informed care is little more than a buzzword. In fact, many community resources exacerbate problems for families in crisis.

Over the last few months, my family has benefited greatly from several examples of truly trauma informed care. Let’s take a look at what “trauma informed” really looks like.

Leaving class to call home

My 12-year-old son Brandon recently lost his father under traumatic circumstances. As a result, he constantly worries about my safety. I receive these types of text from him multiple times a day:

Sometimes he’s texting from a friends house, sometimes just upstairs in his bedroom. If I don’t immediately see the text and respond, he becomes panicked. This posed a serious problem with the start of school where he has to leave his cell phone in his backpack.

When I explained the situation to the school counselor she immediately put in place a practical, trauma-informed solution: Brandon’s teachers have been instructed to give him a pass to Student Services whenever he asks for one. He’s then allowed to go into the office and make a short call home to check on me. While this could be viewed as disruptive, it is no where near as disruptive as his anxiety mounting for hours until it becomes debilitating. This way he checks in – 5 minutes – and is able to go back to learning. Shout out to @nwsarts

Protecting siblings from viewing an arrest

As my kids sat eating snacks at the kitchen table, I had no idea the police were on their way to my house to arrest my 17-year-old son Devon on outstanding assault charges.

When the police arrived they pulled me aside and explained they were about to arrest Devon. Then the officer added, “Do you have a place you can take your other kids so they don’t have to see their brother arrested? We’ll wait for you to take them.” Dazed, I took Devon’s siblings next door.

Once I recovered from the shock of the arrest, I was deeply grateful to the officers. They realized the potential for secondary trauma and were proactive in preventing that. They could have just swept in and handcuffed Devon. Instead, they were trauma informed and acted in the best interest of the whole famiy. Shout out to @CMPDnews

A private place to eat

Food issues are extremely common for kids who have been abused or neglected. My adopted daughter Kayla, now a teenager, has always struggled eating in front of other people. This poses a significant problem in school as she cannot concentrate when she’s hungry. In addition, during basketball season this can become a serious health concern.

Instead of diminishing this very serious concern, my daughter’s teachers have gone out of their way to create an accommodation that is both practical and helpful – one that is truly trauma informed. Kayla is allowed to eat her lunch in one of the teacher’s classrooms. As a result, she gets the daily calories she needs to thrive in school. This has been a simple and effective way of removing a barrier to Kayla’s academic success. Shout out to @LNCharter and @corviancourier

Each of these solutions is straight-forward. Simple even. So what makes them truly trauma informed?

  1. They recognize the underlying trauma
  2. They don’t minimize the issue
  3. They are practical and effective

Families like mine need more community resources who are educated about developmental trauma and willing to implement practical, sensible, trauma informed solutions that will enable our kids grow and thrive.

Video: Early Childhood Trauma – we need treatments now!

Learn more

Aging out of RTF and into the real world: A dangerous proposition

Raising a child with Developmental Trauma

Immigration isn’t the only “system” that’s harmful to children

Why adoption stories aren’t fairy tales

It takes a village

How Racism, Trauma And Mental Health Are Linked

Research shows African-Americans are less likely to access treatment for mental illness.

Cultural norms and the stigma associated with having a mental illness are partly to blame, according to Shardé Smith, assistant professor of human development and family studies at the University of Illinois at Urbana-Champaign.

Smith studies the role that race-related stress and trauma has on entire families, and what strategies people use to cope.

She spoke recently with Side Effects Public Media about the barriers to mental health treatment for African-Americans and the relationship between racism, trauma and mental illness.

This interview has been edited for length and clarity.

What are some of the barriers that prevent African-Americans from seeking help for a mental illness?

Mistrust of the therapeutic system stems from events like the Tuskegee experiment and other systemic injustices where African-Americans were treated unfairly. There’s also shame and negative beliefs about mental health care, and the assumption that an individual or community failed in some way, which led to these issues. And for those who are part of a religious community, sometimes mental illness is seen as not having enough faith in God.

What is the role of systemic racism in all this?

Systemic racism is the institutionalization of racism through policies and practices that show up in all of our systems. And it’s through systemic racism that mental health issues arise and are maintained.

For example, living in an impoverished community with less access to proper food and nutrition can be very stressful and can create mental health problems among individual family members. Another example could be the funneling of black youth through the justice system, where they’re more likely to either go to jail or be a part of the system than to receive proper mental health care.

There are also inequalities in our education system that can create gaps in wealth. This can lead to mental health problems, and systemic racism also means there’s a lack of access to proper mental health care, cultural biases from health providers, misdiagnoses such as attributing certain behaviors to delinquency as opposed to survival coping strategies for the trauma people have faced.

What role does trauma play?

Trauma plays a huge role. The disparities that we see cause trauma, and a lot of times that trauma goes unaddressed, and it’s not named as such. So it’s difficult finding treatment for the trauma because we don’t have a name for it.

What are some examples of trauma?

Race-related trauma could include the traumatic experiences, emotionally, psychologically, physically that manifest as the result of experiencing one or multiple events. Sometimes we think of traumas, such as natural disasters, sexual trauma, or car accidents, which are traumatic events. But sometimes we don’t think about race-related trauma as a part of that, and it’s important to include that in our understanding of trauma and how it can effect marginalized communities and African-Americans.

To loosely quote Kimberlé Crenshaw, if there’s no name for a problem, you can’t see a problem. And if you can’t see a problem you can’t solve it. And sometimes we don’t name these traumas as racial traumas that black and African-Americans are experiencing.

This story was produced by Side Effects Public Media, a news collaborative covering public health.

Follow Christine on Twitter: @CTHerman

Documentary exploring the school-to-prison pipeline

The PBS documentary, The Kids We Lose, explores how discipline techniques in schools feed the school-to-prison pipeline. It effectively argues for ending punitive practices in schools, but where are the viable and realistic solutions?

One strength of the film is showing how incredibly serious (and dangerous) these behaviors can be. However, it focuses on ADHD, Dyslexia, and Autism as the underlying causes. It’s important to note that the most significant underlying cause of these school behaviors is complex trauma – with nearly half of Americas children suffering at least one adverse experience hurting kids are in every classroom.

One of the highlights of the film is Dylan, an adult man now reflecting on his behaviors as a school aged child. His problems began in 6th grade when didn’t want to do what he was told to do. “I wanted to do things my way,” he says. When discussing his interactions with law enforcement in high school, Dylan says he was rebelling and acting out because he was unhappy. However, the experts on the film don’t address this type of willful behavior. In fact, they specifically say the kids have the motivation, but not the skills to succeed.

While it’s frowned up on in our society to say – some of our kids do have serious, willful behaviors. These children likely also have emotional issues, are disregulated, and may be hyperactive. They may lack the skills they need to succeed. They may also lack motivation and be willful in their behaviors. To find real solutions that work we have to start looking at children’s needs more holistically and realistically. When we deny a child’s control over their behaviors we steal their agency and cripple their chances of sucess in the future.

Photo Credit: The Kids We Lose, PBS

My thoughts…

Teachers need to teach

The film does a great job of showing just how serious and dangerous kids’ behaviors can be. However, it seems to unfairly put the onus on teachers with a focus on the need for teacher training so they can mitigate and manage the behaviors. In my opinion, behavior management (at this level) is not a teacher responsibility. We need support staff that will allow teachers to teach.

Restrains aren’t therapeutic, but we need an alternative

The film effectively shows how shocking and disturbing physical restraints can be. It goes on to explain that restraints are not therapeutic or educational – and therefore have no place in schools. However, the film doesn’t offer an alternative solution. There are cases where a child is completely out of control and unsafe to themselves and others. If we are do do away with physical restrains we must have a realistic acute solution – while continuing to provide long term treatment.

Teachers and peers matter too

It’s often forgotten that these types of extreme behavioral problems create a toxic environment for teachers and peers who are entitled to a healthy environment. The producer argues, “Instead of kids being taught to behave in school they are removed from school.” While this is a valid point, we must consider the needs of everyone – the struggling child, other students, teachers, and support staff.

It’s complicated

Photo Credit: The Kids We Lose, PBS

When my son Devon was in 5th grade he didn’t want to come inside after recess. All the other students were lined up at the door waiting as teachers called for Devon to come. He finally walked over with a large rock in his hand. He slammed the rock into a window and it shattered. Then Devon walked down the line of his peers punching them. When his teacher rushed over to stop him, he punched her in the stomach.

Here’s what I know:

  • Devon’s behavior clearly signaled mental health issues that needed treatment.
  • Physically restraining Devon wasn’t therapeutic or educational, but absolutely necessary.
  • Devon’s teacher had a right to work in a safe and healthy environment.
  • Devon’s behavior was traumatic and disruptive to other students.

These are complicated situations and we will not solve them by painting with a broad brush or focusing on only one prong. To find real solutions for behaviorally challenging students we must be willing to honestly define the problem(s), view the child holistically, and balance their needs along with the needs of others.

The Kids We Lose is a thought provoking film worth your time to watch. After you view it please leave me a comment to let me know what you think.

Understanding the long-term effects of Reactive Attachment Disorder

J.D. spent his teenage years growing up in a residential treatment facilities. He celebrated his 18th birthday by walking out through those doors – free to make his own decisions and live life his way. Within days, J.D. was causing a public disturbance. Police were called. They told him to put his hands in the air. He laughed. He mimed a gun with his fingers. The officers open fire.

J.D. fell to the ground – dead.

For those of us who’s kids have spent years in residential treatment facilities (RTFs) – growing only more dangerous and violent – this story strikes like a death bell in our chest.

My son Devon has been bounced trampoline-style from facility to facility since he was 10. He’s been in these facilities because he cannot live safely at home. He poses a threat to himself and to his younger siblings. However, instead of getting better in these therapeutic settings, his behavior has become worse. 

Because of the polices of these facilities, Devon has committed assaults and serious vandalism with no consequences. 

  • He’s created thousands of dollars of property damage –  no consequence.
  • He’s made false allegations of abuse – no consequence
  • He broke a woman’s thumb – no consequence.
  • He stabbed a kid in the back with a pencil – no consequence.
  • He punched a girl in the back of the head – no consequence.

Unfortunately, this is how treatment facilities work. The underlying idea is if you consequence kids, that’s all you’ll ever do and they won’t be able to receive therapy. This is true, but on the flip side, what if the “therapy” the kid is receiving in leu of consequences does not help? What have they learned?

My son will turn 18 in a handful of months. He’s itching to leave and at one-minute past midnight he’ll bolt. He won’t have a high school diploma or have any job skills. Worse, he won’t understand that there are consequences in the real world. He’s come to believe that, with a bit of fast talking, he can turn any situation into a ‘therapeutic incident’ and deflect consequences. 

I’m sure that’s what J.D. thought too – before he was shot and killed by police. He expected them to beg him to calm down, offer him coping skills, and at worse drop him to the ground in a physical restraint. I have no doubt that J.D. did not understand the danger of his behavior.

For the safety of our kids, who will someday age-out of residential treatment and into the real world we must find a balance. I don’t pretend to know the answer and there are no quick and easy solutions to this problem. But here’s what I do know: Our kids must have effective treatment AND understand that their choices have consequences. 

My kids’ pediatrician told me this story. He personally knew this young man and the incident happened several years ago.