Tag: Therapists

We need to do better

It takes a village

My son Devon has a long track-record of making false allegations against staff at treatment facilities where he’s a patient. “I’m afraid Devon might make up a story about me too,” I recently told his therapist Cathy. “If CPS got involved, I could lose my other kids during the investigation…” In my mind I imagined my youngest son being dragged off to foster care even for one night. It’s a mom’s worst nightmare.

Cathy stammered a response, apparently incredulous I believed my son capable of such a thing. 

When Cathy and I spoke the following week, she’d already discussed the issue with Devon. “I explained to him exactly why you’re so concerned about false allegations.You could be arrested. You could lose your other kids. False allegations could ruin your life,” Cathy said, recalling her words to Devon. She continued, “When I explained this to Devon, he was so upset. Now that he knows how serious this is, you have nothing to worry about.” 

I was dumbfounded. I felt as though Cathy had handed my son the user’s manual for a weapon of mass destruction. And our family was the potential target. Telling Devon just how powerful false allegations are was extremely risky. It gave Devon all the more reason to do so. 

Unfortunately, Cathy was unfamiliar with the nuances of developmental trauma disorder—a result of Devon’s early childhood neglect and abuse. Because Devon lacks an innate sense of security, he can be very manipulative in an attempt to control his environment. “When children’s brains are impacted by trauma during early development, they live in a fight/flight ‘survival mode’, do not trust others and rely entirely upon themselves,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “They will go to great lengths to push others away—especially primary caregivers—to feel safe. Sometimes, that includes false allegations.”

When “help” isn’t helpful

Those on the “other side” of developmental trauma disorder—adults living outside of the child’s home—may want to help the child and family but lack the insight to do so. With DTD, there is often more happening than meets the eye. If therapists, educators, police officers, and other professionals aren’t familiar with the nuances of developmental trauma, their interventions sometimes make already volatile situations worse. This is why parents like myself can seem defensive, inflexible and frustrated. We desperately need support from community resources. Yet, we’re also desperately afraid they’ll exacerbate our child’s condition, damage our hard-won and tenuous attachment with our child or put our family in danger. 

Here are some real-life examples of misunderstandings about developmental trauma that have had a harmful impact on families:

Tom’s Story

Ms. Linda, the school cafeteria worker, was charmed by 6-year-old Tom. He told her stories about how his mom mistreated and didn’t feed him. Ms. Linda always had a cookie or treat for Tom. She even told him that some kids get ‘re-adopted’ if their family isn’t a good fit. In fact, she said, she’d love to adopt a little boy just like him. That afternoon, Billy went home and demanded his mother let him be “re-adopted.”

Things to consider from the “other side”—

Kids with developmental trauma can be superficially charming. Again, it is often a learned survival strategy because they unconsciously feel unsafe in the world. By having this “secret” with Ms. Linda, Tom was bonding with her instead of his mom. Instead of encouraging Tom to build healthy relationships within his new family, she gave him an easy out. Mom needed Ms. Linda to contact her about the situation so they could get on the same page and partner together in Tom’s best interest. 

Janey’s Story

Janey had a bad month. She’d been in a fight and had run away. She’d broken her bedroom window. She’d been suspended from school. During therapy Janey, her mom, and the therapist set some goals for Janey to work on. Then, just as the session was ending, the therapist smiled maternally at Janey. “Look at her, mom,” she prompted. “She just needs love. That’s all this is about. A little girl who needs her mom to love her.” Janey’s behavior did not improve during the following month.

Things to consider from “the other side”—

Kids with developmental trauma need clear and consistent parenting in order to thrive. While Janey certainly needed her mom’s love, that should not be used to excuse her from accountability for her actions. This is not a mindset that will be helpful to Janey in the long run. Unfortunately, Mom walked away from this session feeling blamed and beaten down. And Janey had no motivation to work toward more effective strategies. Mom needed the therapist to do attachment work but also to hold Janey accountable for her actions. 

Nate’s Story

Nate, 13, was enraged and lunged at his mom with a shard of glass. She called the police. By the time the officer arrived, Nate was calm and sitting in a recliner as though nothing had happened. The officer looked between hysterical mother and serene son and made a snap judgement. “This seems like a ‘parenting problem’,” he said. He then reassured Nate not to worry and that he couldn’t be arrested for anything at his age. The next time Nate acted up, he told his mother there was nothing she could do to stop him—the policeman said so.

Things to consider from “the other side”—

Kids with developmental trauma may escalate until they reach a hard limit. Without limits, they may continue to behave violently and endanger themselves or others in their family. Mom needed the officer to speak with her privately to understand the full story and to express any concerns he may have out of earshot of Nate. Even if the officer was not going to make an arrest, Mom needed him to speak sternly to Nate so he’d understand how serious his actions were. 

Unfortunately, in these examples, well-meaning professionals made the situation worse. They inadvertently derailed treatment, disrupted attachment work, caused confusion and stoked deep resentments and hurts. In some cases, they put the children and families they were trying to help in greater danger. 

Ways professionals can best support children with DTD and their families

The best ways to help children who have developmental trauma can feel counterintuitive and, therefore, requires more than common sense. If you’re a mental health professional, educator, police officer or other community resource, please educate yourself on developmental trauma and therapeutic interventions so you can help families like mine.

Here are some good things to know as a professional working with children and families—

  1. Realize things may not be as they appear. Pause to consider that there may be complex, nuanced mental health issues involved.
  2. Consider that parents’ concerns and fears may be justified – that we may not be overreacting. Our children may be dangerous even at startlingly young ages, particularly if they have a co-morbid mental disorder.
  3. Realize children with developmental trauma may act very differently in front of you than how they behave behind closed doors with their parents. The situations you encounter are likely far more complicated than an innocent misunderstanding.
  4. Discuss your concerns frankly with parents, but always privately. Partner with us—out of earshot of our children—to resolve and manage the situation and present a unified front.
  5. Refer us to local crisis services and community resources. We often don’t know where to turn for help but are eager to follow-through on any recommendations for services that can be helpful for our child and family.
  6. As a clinician, feel comfortable referring clients with developmental trauma elsewhere if appropriate. If you do not specialize in developmental trauma, it is vital to know your limitations. Do your best to connect families with therapists who specialize in the disorder.

We desperately need the community to rally around our families and provide support. To successfully help our children heal, we need to partner with trauma-informed therapists, educators, and law enforcement officers. If our children, who come from hard places, are to thrive and live happy, well-adjusted lives, it’s going to take a village. 

If our children, who come from hard places, are to thrive and live happy, well-adjusted lives, it’s going to take a village.  Click To Tweet

Some names and identifying details have been changed to protect the privacy of those involved and all stories are being told with permission.

We need to do better

When pigs fly: the day my son’s therapist apologized…

Today my son’s therapist apologized to me. (Go ahead, take a moment to pick yourself up off the floor, then keep reading…) If you’re the parent of a child diagnosed with reactive attachment disorder (RAD) you know just how significant this is. 

As parents of children with developmental trauma, one of our biggest pain points is dealing with therapists who don’t “get it.” They blame us, are manipulated by our kids, and offer our families little practical help. At best they’re ineffective, at worst they cause enormous damage.

My son’s current therapist, we’ll call her Amy, has made the classic blunders we’re all so familiar with.

      • She tells my son all he really needs is my love, excusing him from responsibility.
      • She praises his cunning circumvention of rules as “trying really, really hard.”
      • She disagrees with me openly and emphatically in front of my son.
      • She makes me the “bad guy” in therapy sessions.
      • She prioritizes her relationship with my son over mine.

Can I get a show of hands? I sure know most of us are struggling with these very same issues.

But today something unexpected happened. I confronted Amy and she acknowledged she could have handled things better and apologized. We then worked together to come up with a reasonable path forward. I very nearly fell off my chair.

In retrospect, here are a few things that may have contributed to this success:

  1. I was confident, not defensive. When we act defensively, therapists are quick to write us off as unreasonable, close minded and pissed off. It’s important to be in a place where we know our rights and can speak as confidently and unemotionally as we might in a business presentation.
  2. I didn’t get personal. We’ve all been offended and hurt by therapists and it’s easy to become wrapped up in those feelings. But when we do, our confrontation goes off the rails. In the end, the conversation shouldn’t be about our feelings at all. It should be about the needs of our child.
  3. I focused on my child. Don’t talk about what the therapist has done to you, or how they have made you feel. Keep the focus on what’s best for your child. My child needs to be safe. My child needs to build a strong secure relationship with me. These are specific things you and the therapist can agree on.
  4. I was specific and kept it simple. If you walk into these conversation with a laundry list of problems, it’s far too easy to get lost in the weeds. Pick one specific issue that highlights the underlying problems to focus on. Make it specific, actionable, and simple. Pick something as objective as possible.

  5. I was reasonable. What can you expect out of a confrontation? You’re not going to change the therapist’s style or philosophy. You’re unlikely to educate them on RAD and DTD, although you might crack open the door for that. What you should be able to do, is come to an understanding and agree to some ground rules.

It sure felt good when Amy apologized to me, but that mattered far less than the action plan we put into place. With a common goal established we agreed to:

  • Meet prior to family therapy sessions to agree on how news will be delivered to my son and how to approach what will be discussed in the session.
  • If  a topic comes up that we need a sidebar on, before discussing in front of my son, I’ll use a code word and she’ll put off that topic until after we’ve had a time to talk privately.

Every therapist, family, and child is different. Some therapists are easier to work with than others and this isn’t a one-size-fits all formula for every situation. Still, I hope reflecting on my experience may provide a useful starting point as you work hard to advocate for your kids and help them get the therapy they need.

Today my son’s therapist apologized to me. If you’re the parent of a child diagnosed with reactive attachment disorder (RAD) you know just how significant that is. In fact, you might have to pick yourself up off the floor after reading that. Click To Tweet

How have you been successfully able to work with therapists?

Most Popular, Resources, Tips to navigate "the System"

Open letter to a therapist from a mom of a child with Reactive Attachment Disorder

Dear Therapist,

I am desperate for your help. I apologize ahead of time if I seem angry and defensive. I’m just burnt out and afraid you won’t understand. My son is completely out of control and nothing works.

I’ve tried to get help before from therapists and teachers, even police officers, but no one understands. They all think I’m exaggerating, or maybe even lying. My own mother says, “He’s just a kid,” and can’t understand what I’m dealing with is way beyond normal, way beyond safe, and way beyond what I can handle. My son went through trauma at a young age and has been diagnosed with reactive attachment disorder.

I’m not exaggerating when I say my son screams for hours. He’s torn his bedroom door off the hinges and put holes in his walls. His siblings are afraid of him. Sometimes I’m afraid he’ll burn down the house when I’m asleep.

When you meet my son, he’ll look like a very different child than he is with me. You’ll think I’m overreacting. I’m not. You see, my son is an expert at triangulating the adults around him. Due to his early trauma, he manages his surroundings and the people in them to feel safe. In doing so, he’s good at making everyone think I’m mean and crazy. Sometimes I start to believe it too.

I have a secret I should probably share with you—it’s true that I’m not perfect. I’m very aware of that fact. I’ve screamed at my son and lately I’m always angry and frustrated. I’m afraid to tell you this because you’ll think I’m a bad mom and blame me for everything. Most people blame me for my son’s problems. Yet, I’m the one person whose life has been turned inside out and upside down to try to help him.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Click To Tweet

I’ve turned into an unhappy, negative, impatient person whom I don’t even recognize anymore. Sometimes I wonder if I have post-traumatic stress disorder, but feel stupid suggesting that dealing with a child could cause PTSD. It would be helpful for you to encourage me to get some therapy for myself.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Before we get started, here’s what you need to know (because my son will tell you otherwise):

    • I feed my son three meals a day, plus snacks.
    • I don’t hurt my son.
    • I’m not the one who rips up his homework and throws it away.
    • He locks himself in the closet under the stairs. I don’t and wouldn’t ever do that to him.
  • Our house isn’t haunted, he’s not best friends with Justin Bieber, and he’s not going to live with his birth mom next week.

My son will tell you things in individual therapy that will take up all of our time to untangle.

In the meantime, we’ll be distracted from working on the really serious problems for which we need your help. This is why I’m going to insist on being present during all therapy sessions. Please understand it’s not because I have something to hide. I just want to keep things from getting worse than they already are.

Typical parenting strategies like sticker reward charts don’t work for my son. We’ve already tried all sorts of behavior modification strategies. I can’t ignore my son’s negative behavior either. I can’t just watch him hurt himself, his siblings, or destroy everything we own.

Please understand, our family is in crisis.

This is an emergency. We need help and we need it fast. That play therapy you do in the sand…I don’t know, maybe it works for some kids–but not for him. I’m not trying to be unreasonable; I just know what doesn’t work. If you don’t have experience working with trauma-exposed kids, please refer us to someone who does. I understand this is a very specific and serious issue that not all therapists have expertise in.

I’m willing to do whatever it takes to help my son heal and to fix our family. Please help us.

Sincerely,

Keri

Originally posted by the Institute for Attachment and Child Development.