Tuesday, December 21, 2010

Love our Pharmacy Tech!

Our pharmacy tech worked for over an hour to figure out why suddenly Medicaid denied Seth's medication. Bless his heart he figured it out and I was able to pick up the meds last night. Of course by then we had had one heck of a day, followed by a terrible bedtime and a horribly ugly morning before the meds kicked in. It's almost like now that the meds help him so much that without them he is ten times worse. Maybe that is just my imagination or maybe I am now used to the good behavior and didn't realize how bad it was.
I tried to go to sleep starting at 10pm, but could doze briefly and then would wake up and struggle to fall back asleep. It felt like my nerves had been rubbed raw by coarse sand paper. Every little sound and every little touch on my skin had me on high alert. I finally fell into a good sleep after 3 am, so I did get a few hours of rest. Today I am sluggish and dim-witted. Not the best scenario when trying to keep up with the kids all day.
I did finally get packages shipped to family and without paying an arm and a leg they should be there on Friday. I also got a box of hats that I knitted for charity finally shipped off to the wonderful lady who runs Sweet Hope, the awesome (candy and more) charity. Elle, I am SOOOO on the road to hell, what with all my good intentions. There are 24 hats winging there way to you as we speak. They are just a small thank you for all that you do!

I have a question for all of you with RAD kids on the lower ends of the spectrum. (I think kids with high levels of trauma need different approaches than those who are on the milder ends of RAD) Do you think that 'immersion therapy' works? As in, if we keep exposing them to normal social situations that eventually they will learn that things turn out OK and they stop freaking out? Can they be de-sensitized to the triggers? It's something I have been wondering about. Of course, each triggering event would have to be paired with lots of talk and re-assurances, lots of therapeutic moments, and lots of careful planning and consideration. But is it possible for the good memories to eventually outweigh the bad ones?????


Reba said...

I am eagerly awaiting approaches. We have pretty much done the immersion thing only because it was all I knew to do. And our life has good days, and recently a lot of not so good ones. :(

redghia said...

I want to think so. But the personality and opinion of the kid seem to matter more than anything I try.

Diana said...

Well, I'm not sure where you consider me on the RAD scale, but I'll weigh in here anyway. Having been through the wringer and now starting to see some real healing taking place with my kids, I've seen a whole lot of the spectrum. Obviously, not everything is going to work for every kid every time, but I actually don't think severe cases need a different approach than mild ones. RAD is RAD (and so is “insecure attachment” to be quite frank.) As far as I'm concerned, the only difference I see between severe and mild is how loud the kids scream, how hard they bite, and the length of time it takes to get from point A to B.

Obviouly, there isn’t one foolproof method that will work all the time for every kid. There isn’t one person who has all the answers. There are always going to be lots of three steps forward, two or ten steps back moments. But with time, patience, and consistency, even the most severely hurt kids can heal and learn to function normally in the world.

As I'm sure you already know, I'm not a fan of immersion therapy. The more I've learned about attachment and RAD and PTSD and how trauma affects the brain, the more I've come to realize that there really isn't any way it CAN work for our kids. We'd like to think it will because it makes us feel all warm and fuzzy and we want so much for our kids to be able to have fun and make friends and find joy in life.

Unfortunately, because of how early trauma affects brain function, in 90% of situations, treating them like “normal” kids and tossing them into “normal” situations with their neurotypical same age peers and expecting them to be on the same developmental playing field with those kids will most likely only make things worse. Until our kids brains are rewired and those neuropathways consistantly moving in the right direction, our kids simply aren't going to get it and they're going to keep on REACTING to the stress and stimuli of the situations. That's what RAD is. REACTIVE attachment disorder. Their brains are literally wired to react as if everything is a high alert and dangerous situation and process the reality of it later...usually MUCH later...and the older they get, the harder that processing becomes.

Can positive experiences replace the negative ones? Eventually. Kind of. But our special kids won't get there the same way neurotypical kids will. First of all, nothing can change what they've already experienced. It's part of who they are and every detail of the trauma they've experienced, whether they consciously remember it or not, is stored in perfect detail and clarity in the subconscious. They won't ever forget it. They can out heal it, but they'll never outgrow it, nor will they forget it. It’s these subconscious or even unprocessed and unhealed conscious memories that drive the reactive behavior. Unfortunately, at this stage of the game, our kids don’t know why they’re acting or feeling the way they do and most likely won’t have any idea what they're really reacting to.


Diana said...

As they are ready to process those traumatic events on a conscious level, and they learn that not everyone is bad, not everyone is going to hurt them or leave them, and generally speaking, people are good, they can learn to cope with the triggers, find joy in living, and move on. It will have to be in their time and their way, though. No matter how tempting it is or how much we want to, we simply can’t force it.

In order for good memories to be able to "replace" (or at least become stronger than) the bad, OUR KIDS have to recognize those memories they are making as good and positive and valuable as opposed to something they don't deserve, they aren't worthy of, or try to sabatage because it's too overwhelming, overstimulating, and frightening for them. If they're reacting either at the time or later to events, they're still fighting against them and telling you this is something they aren't quite ready for yet and they need to you to make their world much smaller and much safer for them.

The tried and true method that really does work is loving them unconditionally, not keeping score, making their world small, focusing on making sure THEY feel safe and secure, and consistently maintaining VERY strong boundaries, even when it is difficult or awkward socially for us. In fact, those are the times they need us to keep those boundaries strong the most! Our kids need to know we are strong enough to keep them safe and love them enough to put up with their antics, NO MATTER WHAT THEY DO. We won’t pass just one test. Until THEY feel they can trust us, they’re going to test our patience and resolve over and over and over again. Once they finally figure out that they really CAN trust us, they will start to heal and settle down.

As they begin to heal, boundaries can be safely enlarged, new situations can slowly be introduced, and new, fun, happy memories can be made...and yes, they really will eventually look back on them fondly. My kids are finally starting to do this. Even though it warms my heart to watch, I have to be really careful about celebrating (at least outwardly.) The last thing I want to do is kabash the good things that are happening.

Hope that explanation at least kind of helps!

Deb said...

Aidan is not RAD, but the therapist believes he has insecure attachment. So take my words with a grain of salt.

for Aidan, I have no idea what will really trigger him at any given time, but I know there are situations that will always trigger for him:
1. changes in environment- this includes changing his room or other rooms in the house
2. lossing people- so the switch from my sister's care to school was VERY HARD
3. large crowds- this means he wants and needs to be in the stroller, it is his safe zone
4. too much stimulation- I am still learning the warning signs on this one, but it can be too many lights, noise, etc.

EXAMPLE: last night we went out and looked at Christmas lights- to got to be too much for Aidan and he started being mean to Mam and Pap but when challenged on his behavior, he took at nap at 6 pm. He slept until 7:30 last night.

This is new for him to realize that he has control over the stimulation by going to sleep and avioding it.
But he has not gotten there when the activities include other kids.

For Aidan it has taken 3 years to get us to the point where he does not view every experience as a potential loss of me or all that is familiar. I know RAD is much different.

If you have not started reading this blog, I strongly recoomend it. Cindy has adopted 38 kids!!!! and has or is dealing almost every behavior you can imagine. She is full of words of advice and encouragement.


She is linked on my blog roll as "Big Momma Hollers"

Hugs and love to you,

BT said...

I'm not sure where I'd put our family on the RAD spectrum. P was pretty severe at one time, or so I thought until I heard about some of the stuff others have dealt with. e.g., We never had extreme property destruction on a major scale. However, we had a lot of running away, tons of raging that didn't destroy major amounts of property, and tons and tons and tons of seemingly endless drip drip dripping of defiance, nonsense chatter, lying, stealing, sleep issues (ongoing), and so forth -- general craziness. We have seen signs of tremendous healing. P is now nearly 11 yo and has quite an awareness of himself and is actively involved in and committed to his own healing. The new twist lately -- just over the last two weeks I've been letting myself even use this terminology in my own mind -- is that he seems to view himself and us as actual partners in working toward his healing. So amazing. What seems to have worked, in terms of when I think we really started to see significant healing and consistent improvements in behaviour, was making/keeping his world small with only very gradual and very very small increases over long time periods. Sort of anti-immersion, if you will. Prior to that, we had no diagnosis and no idea what attachment issues looked like (we were clueless, poor P), and we tried the immersion in normal for about two years, and I would say it didn't work toward any healing, but rather worked in the opposite direction. So I tend to agree with Diana. The only caveat is that I don't know how you separate out the improvements that may come with the various aspects of actively therapeutic parenting that we have engaged in versus just the passage of time of being in a family versus the particular kid's own innate resilience and all the other variables that may contribute to healing.