Our Journey to Understanding Ellie, Part 2

"If you take a bottle of Coke and a bottle of water, then shake them both up ... you open the two bottles up  in different ways because what is inside the bottles is different.  So it is with our kids."  
Illustration by Jim Harlow, Texas Christian University, presenter at Empowered to Parent.




I'm going to try to pick back up from my previous post and try to 'briefly' share the highlights of what we've been learning about seeing the world through our daughter's eyes and understanding the filters through which she interprets new experiences.  Some of you might smile and nod, "Yes!  I knew that!  Glad she's figuring it out too!"  At the end, I'll share a link to where you can get your hands on the sources of this information.  I want to preface this by saying that these are my words and summaries.  I may have some inaccuracies based on misunderstandings and you should definitely go to the source before citing me! ;-)

"Way back when", early in the stages of adopting Ellie (about 6 years ago), we were required to read a series of books dealing with the unique parenting needs of children who've come from orphanages/hard places.  It's a "must" because everyone should go into adoption with their eyes open.   I admit it was scary at times, and also a bit discouraging, but I think a large piece of your heart thinks that it will be different with your child;  that they'll be the "resiliant" one, whatever that means.  At the time, aside from our social worker, we didn't have anyone to share those new concepts with so I know a lot of it went in one ear and out the other.  I didn't reasonably digest it all in the same way one grasps onto a concept when it's kneaded out in group discussion and/or immediately applied to a present situation. It was a box to check off on the task list and was done.  Now that we are 'on the other side', information like this has completely new meaning.

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In God's original design, babies were to be born to parents happy about their arrival, experiencing good pre-natal care (low-stress, good nutrition, no exposure to yukky enviromental/chemical stuff that would impair healthy development, etc.).  Then, once that child was born, there was at least one consistent person there to hold them, pat them, feed them when needed, attend to illness, provide comfort when anxious moments would arise, provide consistency and security, etc.  In the process, a trust cycle was established, and the child was empowered to move on to higher levels of brain functioning (i.e.cognitive learning).

In our daughter's case, she very likely experienced a stressful pregnancy (from what we know about the circumstances surrounding her birth), then was left in a hospital for about 6 weeks until she was transferred to an orphanage 3+ hours away, never to leave that building for 17 more months.  We know from her records that she endured a serious sickness that afflicted the entire orphanage (2 of the 25 children passed away), not to mention all the other discomforts from developments like teething with no one to carefully monitor her temperature or administer baby tylenol or Oragel.  She only left her crib for a brief clothes changing 1 time per day and a few diaper changes in between.  She was even fed in her crib.  Her caregivers worked odd, random days (2-24 hour shifts per week -- we could never predict from day-to-day who we would see when we entered the orphanage those 4 weeks).  And all the long, long, hours  in between she would lay in eerie silence or listen to the long, loud wail of a child's cry that could not be comforted, echoing off of tile floors and concrete walls.

She developed what researchers call "survival brain".  Survival brain is protective and defensive. It perceives attacks and triggers automatic responses. It operates in extended periods of "fear mode."  When one encounters a stressful situation (say an oncoming car swerves across the center line and is coming right at you), the brain releases neurotransmitters (epinephrine, norepinephrine to name a few) that put our brains at high alert to navigate the situation and survive the episode in tact.

In a driving situation like I described, all your attention is focused on the object coming at you and how to avoid the impending collision  -- you are not thinking about what you want to eat for supper nor are you able to answer a question in the moment like, what is the capital of your home state or what was your grandma's maiden name.  When the fear center of your brain is active, all of your other thought processes go out the door. No brain can operate in survival mode for extended periods of time without incurring deterioration.

When babies are upset and agitated, a parent rocks, strokes, or pats while speaking soothing words in the upset child's ear.  In doing so, comforting gestures help their brains release serotonin, an 'antidote' to the excitement chemicals which are released by the triggering episode.  Serotonin thus helps the child calm down.  As the child grows and learns about how to navigate the ins and outs of everyday life independently, they become more self-regulating, needing the parent less and less. In Ellie's case, she wouldn't have had an external regulator, someone there to help her come down from anxious moments.  To get the comfort and soothing she needed, she started rocking.  (One of the 'light bulb' moments for me was learning that repetitive motion triggers the brain to release serotonin.)  For her, rocking helped her deal with the elevated levels of neurotransmitters in her brain.  (Hence, Ellie's OT's recommendations for swinging in a swing or hammock or rocking in a chair to calm Ellie down from an agitated state.)

In cases of chronic trauma, abuse or neglect, the brain (more specifically, the fear center) stays on hyper-alert.  As a result, portions of the brain never become active and overall brain chemistry is affected. At the seminar they showed us side-by-side brain scans of 'typical' vs. institutionalized children; likewise they showed us urinalysis charts of levels of seven neurotransmitters in a child from a 'hard place next to a healthy/typical child -- the differences were shocking (almost two standard deviations).

Imagine a child who doesn't know when she is going to eat next, where she is going to sleep next, if something he says will trigger a violent attack (or no response at all), or if his caregiver today is not the caregiver he will have tomorrow. You have a child living in a constant state of stress.  Schoolwork, peer relationships, appropriate behavior -- none of these issues are important when basic survival and self-preservation is the utmost concern.  It shouldn't come as any surprise that many of these children are significantly developmentally behind their chronological age.  In 2-3 year olds it's exhibited as behavior dysregulation.  In 4-6 year olds it appears like ADHD, in 8-10 year olds it's manifested as agitated depression, anxiety, or depression. As an untreated individual ages, it's exhibited as agression and serious psychological disorders.

When most children are adopted (particularly if they never had a primary caregiver during their first three years of life), it takes time for that child to develop trust and learn how to receive love -- it's contrary to anything they have ever experienced because the instinct to distrust and look out for oneself is rooted in their pre-memory experience.

In looking back, our first year at home with Ellie was largely focused on two things: overcoming her physical deficits (i.e. building core strength, mastering gross motor skills, treating vision issues, and overcoming oral aversion) and transitioning to her new "normal" with Nathan and I as her parents and all that that meant (consistency, routine, social interaction, new foods, etc.).  Her second year home witnessed advancement in  her verbal skills which opened the door for two-way communication.  Her third year home she started demonstrating attachment, calling us Mommy and Daddy (finally!) and exhibiting for the first time a fear in being alone.  These were all building blocks which were necessary before she could really start the process of healing.

One of the simplest, yet most profound statements we learned at the ETP seminar was this: THE ROOT CAUSE IS RELATIONAL.  The lack of relationship has devastating affects on a child because we were created to connect -- with others and with God.  Ellie's physical needs were being reasonably met -- she wasn't malnourished, she wasn't living in squalor (though fresh air and sunshine would have been nice), and she was fed regularly.  The piece she was missing was the social/emotional component and has had major ramifications for her. [I think there is a whole area worth exploring here regarding the correlation between the physiological effects of a broken relationship with God and the physiological effects of a broken parent/child relationship.]

No discussion of this subject can take place without raising the issue of discipline.  But discipline is a very loaded issue in adoptive families, especially when trust has yet to be established. Discipline, if done incorrectly, can potentially set back or damage attachment. What further complicates discipline is the responsibility of the parent to determine whether a behavior is truly willful or if it's simply survival.  Survival behavior is triggered by what researchers called "tripping episodes" and they may be caused by all sorts of different things -- a disruption in the schedule, a crowded room, hunger, or the child being told 'no' (which means a loss of control), to name a few.  Because the train on the track of their thinking process (to use their analogy) is already wobbly, it doesn't take much for the train to derail (which is manifested by a meltdown).  Consequences, lectures, logic, are all usually pretty ineffective at this point because the "Survival Brain" has been reactivated and logic doesn't prevail.

Tripping episodes with Ellie initially seemed unpredictable. Meltdowns were/are embarrassing and traditional "time out" would only deteriorate a bad situation into one worse, fast.  The physical separation from us and understanding that she could not leave the time out chair escalated into moments of terror for her.  Over the course of time, we discovered that she 'tripped up' more easily if she hadn't eaten recently.  We learned that the effects of food as brain fuel wane off after about 2 hours.  Providing regular snacks, serving meals on time, and having high-protein snacks available for times away from home (you should see my purse) would keep her blood sugar from dropping and her attitude more even keel.  What a difference this has made, particularly in learning!

We are glad to report that her 'good days' outnumber her 'hard days' and the meltdowns are less frequent (though we still have a ways to go).  We can't change her 'sensitivity' to certain factors, but now that we are aware of how her brain filters the environment, we can empower her through giving strategies for dealing with situations that might otherwise trip her up.  The goal is that someday she will be an independent individual, capable of living successfully in the world around her.  In the mean time, we are encouraged to see great strides in her own ability to self-regulate.  This is HUGE!

I could go on as there was so much more that they shared, but these were some of the highlights.  For further information including strategies and techniques, I would suggest visiting the website:
http://www.empoweredtoconnect.org and reading the book "The Connected Child."