I have been telling myself since the beginning of August that next week will be calmer and slower.  Since the beginning of August Hoty has packed in some insane work days, we had a whirl wind five day family holiday, started full time school for two of my big kids, started weekly appointments of play therapy, psycho-educational assessments, Hoty started going to school all day on Saturdays and I started working. A small amount of work, but work none the less.

It’s staggering how busy I am. Meeting my kiddo’s needs, making their appointments and trying desperately to maintain my marriage, my relationships, and most importantly my sanity.  My grandmother isn’t doing well, there are some strained relationships, some hurts and confusion.

The only thing I can do is hang on and take it moment by moment.
Accept the help that is offered. Ask for help as needed.  There have been nuggets of pure gold during the last couple of months.

Helping a friend make a baby quilt for her first baby coming home in a couple of weeks.

Regular weekly help giving me time to book appointments and take much needed little sanity breaks.

Encouragement from my Dad.

Encouragement from Dr’s.

A really solid connection to Hoty.

Framily who gets me, gets my kids.

How’s life for you in this season? How do you self care? When was the last time you got to run away?

I had some more thoughts on the topic of pee, or bathroom functions, and they are these.

Not having a child successful in the bathroom department can be frustrating, and feel never ending. There can be regressions, it can be physical, emotional, behavioral, etc. It could be rooted in development, fears, trauma, control, and more.

In other words, there are many more options than just working with your family Dr. or an OT. A family Dr. can rule out physical issues and make referrals to other professionals. Depending on the root of your child’s pee issues, their age, etc. there are far more options of help to look at. A behavior consultant. A therapist. Any professional that can help address the root of the issues for you and your child are the people you want to be looking too.

Anyone have specific questions that they want to shoot my direction, leave a comment and I’ll email you.

Happy Tuesday!

Pee.

Some of you know exactly what I’m going to talk about, and others are wondering if I’ve finally lost it after my summer off.

When you have a child with a ‘Hard Background’ or other such things, you may have experienced the oh so fun of the controlling bladder dance. From what I’ve read and experienced, this seems common and frustrating. Often a child will feel that their world is out of control, especially for kids newly home. Everything is new, their world was turned upside down, nothing is the same. These little people have so few options to express how they feel, and even fewer options to feel in control of their life. One way this may manifest is in controlling their bladder and bowel functions. I’ve either seen, or heard it all. Holding it forever. Peeing everywhere. Peeing when mad. Peeing to get even. Hyper aware of the bladder and asking to use the toilet every 5 minutes in the paranoia of being punished if there’s an accident.

It’s no fun. I mean for me, pee isn’t a big deal. I get tired of it, but it’s sterile and not that big a deal people!

What always gets me is the why behind the pee.

I will confess that in the past I have handled this badly. Made dry diapers or undies the hill I was going to stake claim too. Let me save you the trouble right now of all the mistakes I made:

Yelling, shaming, scolding, lecturing and stomping around in frustration do not work. Ever.

Here’s what I’ve learned:

It’s one small thing my child feels control over. So let them have it. I can coach my child. The amount of times I’ve said ‘where does pee go? That’s right! In the toilet!’ is a bit crazy making. I can let it go. ‘Oh well, help me clean up please!’

As for the paranoid bladder? This one makes me cry. A child who is so scared of the punishment of an accident that they are obsessively going to the toilet is hard to watch. A child who will lie about their accidents out of fear. A child who will take off their diaper to pee in the bed and proudly present a ‘Dry Diaper!’ as their success is tough. What works? Loads and loads of reassurance. Lots of coaching. We love us our visuals around here. The toilet routine in little handy dandy visuals (like this one) are fantastic. Draw one up and get it laminated and tape it to your bathroom wall. And the bedroom wall, and kitchen wall…

And if in doubt, get help! Talk to your doctor or even better for us, an Occupational Therapist. It’s so important to walk through this without compounding why our kids feel the need to control this. To use this as another opportunity to remove shame and show our kids respect and compassion.

Happy peeing!

For all 6 of you followers, I figured I better make a reappearance. I didn’t intend to log off for the summer, between having all the kids, all the time, much summer activity, and finally getting an iPh0ne, I just never wrote. Which is no good. I need to write. It’s therapy for me.  I end up writing in my head as I fall asleep, which is good, but not great.

Life is a changin’ for us around here.

I have TWO children in full time public school! Gasp! In theory, I have only my two little people with me during the weekdays. In actuality, it’s a bit different. You see, we had a very busy summer.

G.man. He’s growing up. Confidence, articulation, interests. Leaving little boy behind him for good. Loves parkour, loves his new teacher, loves hanging out with Dad and Uncle. LOVES playing practical jokes.

Queen E. continued varies assessments over the summer, so her fall schedule is ridiculous. Seriously, this kid needs a personal assistant. Good thing she’s got me. She has all sorts of fantastic opportunities that are coming available as a result of her assessments. The catch? It means she’ll probably only make it to class for 3.5 days what with all her extra appointments. It’s all good stuff though, and it’s not forever. She’s rocking it and making us proud(er) with her achievements and self awareness.

My two toddlers are no longer toddlers. I’ve been informed that they are now little kids. Hence, my children are now divided into the ‘olders’ and the ‘littles’.

B. man is Mister cool. He can chat up anyone at anytime about anything. This kid keeps me laughing and crazy. He’s our comic relief and keeps us on our toes with new parenting strategies. He’s quite pissed off these days that he has to wait one more year for school.

And Miss Joy? She’s healthy, happy most of the time, and has been home almost one year. Amazing, right? She keeps us amazed at how well she is doing physically, developmentally and emotionally. She’s my baby, and still loves to snuggle in.

Hoty has some work things shifting, some school starting and is still getting out on his motorcycle. It’s almost our tenth anniversary. Crazy!

And me? It’s been a roller coaster. I’ve had some highs and lows, some definite bumps. Enough to make me take stock again of what our priorities are. I will write more on this. For now, this guy is demanding attention. His name is Lentil and he’s a shmooshy boy.

Happy September!

I’m happy in the garden this year. It’s the first summer that I haven’t had a baby, new child, or been trying to get a child home. It feels good. The garden looks better than it ever has and is producing more. Peas that are five seconds off the vine before being eaten are amazing. Basil that is still warm from the sun is fragrant. Salad greens are delicate and buttery.

Happy Summer!

PS. Teaser for my next post. We are going to talk about pee.

So if you have been wanting to do something recently that helps another human, check out my friend Rhonda’s blog post. She needs us to write letters. Email, fax, snail mail! Walk into your local MP’s office and ask them what they know about CIC’s investigations into South Africa. Read about it all here. Check the history of Rhonda’s blog for the wonderful referral story.

And if you have a spare few bucks left over from going out, under your couch cushions, or in your car, how about helping some high school students in Ethiopia get access to better science equipment. This is one of those projects that seems small, but has long lasting and far reaching impacts. Check it out!

Happy Wednesday!

Now in reality, a little harder than it sounds. And certainly not soft or wussy.

I get it all in theory, and I can say that I am getting better at using this as my first response. It takes loads of practice for me. What I wasn’t expecting was that I would need ‘do over’s’ extended to me.

Lately it feels daily that I need to look at a child and say ‘I’m sorry that’s how I responded to you. Here is what I wish I had said and done.’ and then I re do it. My kids are thankfully very gracious and forgiving. It’s hard! Hard work! Which gives me insight into how great every successful do over is for our kids.

Now in our house, do over’s are supposed to be that. Do over’s. Meaning that it’s done. If you’ve fixed it, you’ve fixed it. We might have a discussion as to the what the behavior was, and why, and if there is any further work that needs to be done. But it’s supposed to be an opportunity of grace that allows us put in the hard work to fixing our mistakes. That’s our goal.

We’ve been dealing with a person again who has been dead set against Miss Joy, or rather HIV. We were hoping that time, education, and meeting her would alleviate the fear and anger.

It hasn’t. And before you ask, yes, we’ve kept our kids safe.

I explained the whole situation to a lawyer to works in HIV advocacy and law. She told me about a legal process that is an option to us. I will spare you the details.  I have to say it’s tempting. And I won’t say no to that option if it’s needed. At this time, it would be proving a point, and I’m guessing nothing more.

I have a theory that this person started out with their aggressive stance of anger and exclusion, and now might be doubting their position, but doesn’t know how to get out of it.

Maybe it’s time to offer a do over.

“Diagnosis are descriptions, not diseases.”

In other words, they are ‘crude approximations’ of what is going on. The state of being that a child is in.

“Relationships are the tool to create change.”

If a child starts to layer many positive experiences in an array of ways, it will start to create a more positive outlook to the world. If a child has many negative experiences it creates templates in the brain that distorts the future experiences. It alters perception.

Intimacy Barrier:

We all have a level of intimacy and a barrier. Also known as personal space. A child who has experienced trauma needs to be able to control who crosses their barrier into intimacy. Because allowing someone across the ‘barrier’ is so often threatening, children will usually show anger and rage to the people that are the closest, safest and most loving toward them. Children who are sensitized to abandonment and intimacy will want to draw close, or want you to draw close, but then will invariable withdraw or lash out. Things for us to do? Be present. When a child has lashed out from feeling threatened, don’t storm out of the room. Simply be silent and present. When the child comes closer, continue to stay silent and present. You can do some calm activity for yourself, even better if it’s parallel to your child, as opposed to in front of them. Examples Bruce Perry gave were: cooking, colouring, playing cards. Doing these activities beside your child mimics the early years of their development when parallel play happened, as opposed to engaged play. It’s very soothing for children to do things side by side with a safe person. Good parallel activities for both caregiver and child to engage in would be: walking, yoga, dance, drumming side by side, running, etc. Anything that can be done side by side and adds repetition and/or rhythm is wonderful. Knowing that I can calm my child down by calming down my own internal state is profound and challenging for me. If I am frustrated, overwhelmed, anxious and angry, it will only escalate the situation. For infants that have experienced trauma, and are sensory seekers, it is recommended to pick one soothing rhythm and to stick with that. Ideally, pick what soothes you. We are often told with fussy babies to keep trying different things, this can be very detrimental to infants that are traumatized.

“Kids need adults to be a consistent therapeutic web.”

Children need:

Relational (safe)

Relevant (developmentally matched)

Repetitive (patterned)

Rewarding (pleasurable)

Rhythmic (resonant with neural patterns)

Respectful (child, family, culture)

Adults should be assessing a child’s history, their trajectory to the present. Create a therapeutic web for the child, a team. This is often a challenge, but so worth the effort and advocacy.Therapies should be gradual and repetitive.

“The brain is a historical organ”

Neglect:

Neglect is the lack of specific patterns and experiences during development which results in abnormal development of core brain function. This will show up for children in their emotions, social, cognitive and motor skills. Neglect can be episodic chaotic, or total global. Our culture has the worst neglect rates in the world. Sensory deprivation is a form of neglect.

Dr. Perry went on a tangent at this point to talk about the benefits of letting our children chew gum. It is a repetitive activity that supports brain stem development and healing. He passionately advocated for kids to be allowed to chew gum in stressful situations and showed that children that were allowed to chew gum during tests had better scores. It helps our children calm down and focus. On a personal note, I grew up with parents who didn’t let us chew gum. We were told that it was rude, gross and basically for those who couldn’t help themselves. I was also told that I would never digest it or poop it out if I swallowed it. If you swallowed enough of gum, it would clog your insides.

Nice, huh?

Needless to say I have been letting my kids access to gum lately (with boundaries) to great success.

Core Clinical Questions:

Is the dysfunction present due to lack of stimulation? The neural networks are present, but undeveloped?

Is the dysfunction due to abnormal organization? The neural networks are present but disorganized? More repetition…

Is the dysfunction due to lack of neural networks because of genetic, epigenetic, or toxic factors? While this sounds dire, often other systems of the brain can take over. Other routes in the brain can achieve the same results.

Find a child’s sensory preference!

Combine therapies, use activities that combine rhythm, movement, repetition, touch, relationships and verbal.

Regulation: we deprive children of most regulation options.

Self regulation starts with dissociation, the state of modulation. Then it moves up into the cortical areas and becomes self soothing habits.

Relational regulation is when regulation is tied into the relationships. Safety is found in people or a person. Relational sensitivity is when a child feels safer alone than around any person.

To use drugs to regulate a child will send a chronic signal to the brain. It will make space for change, but doesn’t change the brain. Patterned, repetitive therapies change the brain.

Introduce sensory breaks into your child’s day. Children will be more regulated and learn more when they receive these regular, frequent breaks. Stretching, deep breathing, walking, rhythm, are all simple options for sensory breaks.

Media:

Violent video games can physically change the brain to look like the brain of a person who has seen real combat. That being said, media can provide ideal dissociation. It can be controlled, safe dissociation breaks for children. If media is being used to regulate a child, give them plenty of time to transition out of their media time. Games like tetris have been shown to help remove the effects of PTSD in people.

Another form of controlling dissociation for regulation purposes would be self hypnosis. This is turning a vulnerability of a child, into a strength. A way of reframing a weakness.

Almost all traditional healers in other cultures use patterned, rhythmic, repetitive ceremonies for grief, loss, death and healing. It is also often a parallel and relationally rich experience. These situations often tell the same stories over and over again which makes them become a repetitive tool. Scenarios like this have been shown to have similar effects of EMDR, but are relationally deeper.

Lying:

The average, healthy adult lies frequently. We expect children to be honest all the time. Lying is often rooted in trying to prevent someone from crossing the intimacy barrier. Focus on the insecurities that lead to the lying. Don’t ask a child why they lied, you will be opening up space for them to lie again. Simply address the motivation for the lie. It is important to call children up on their lies, but not shame them. Confronting a child who is lie is rooted in shame, insecurity or fear, will simply escalate them. Be creative with your responses. Use humor, use terminology like ‘we’ not ‘you’, come up with plans, and fix the mess together.

My conclusions:

There is always hope. Be present. Don’t take my children’s behavior personally. Be consistent. Chew gum. Integrate multi dimensional sensory breaks through out the day. Parallel play. Repetition, repetition, repetition. Rhythm. Dance. Lighten up. Shut up. Create a village. Be patient. Ask for help. Skin to skin. Listen. Build and support resilience. Allow for solitude.

I apologize for the silence around here. I have stacks of notes ready to turn into posts, and stories to tell. After today life ‘should’ slow down a bit. For which I’m very grateful.

See you soon!

Attachment can be described as a set of associations. Attachment is memory. The qualities in a caregiver that a child needs in order to form attachment are:

Present, Attentive, Attuned, and Responsive.

A child needs a high quantity of a caregiver being present. Just present. In the same space. Breathing the same air. I always need to let this sink in. It matters to my children’s brain development for me to simply be present. If I am attuned to my child, it means that I can interpret their cues. I know my child well enough to know when they are getting tired, hungry, etc. It I’m attuned, then I can be responsive and respond to their needs.

Skin to skin touch is more important to a child’s health than calories.

Providing this level of care to children is demanding and exhausting and no parent can be this successful 100% of the time. Sadly, in our culture, we do not often have the social support networks to sustain this level of care. (Hello! Communal living!)

Stress:

The highest stress response that we will experience in our entire lives is during birth. Stress isn’t always bad for you as it can build resilience. Unpredictable, severe stress builds vulnerability. Adversity within the first two months of a child’s life can cause the most disruption in adolescence. On a personal note, this freaks the junk out of me. All of my children, even the bio one, had some pretty big stress and adversity in the first two months of their lives. And with having so many children, so close in age,  it could mean that adolescence around our house could be a TREAT.

The stress response systems in the brain are multidimensional – hormones, immune system, nervous system, brain and endocrine. The body makes changes to stress responses based on external and physical situations. All functioning of the brain is state dependent. Motor skills, relational abilities, cognitive function is all state dependent. In other words, try not to subject our children to unpredictable or severe stress as it will affect every aspect of their being. Health (including long term), brain, emotions, relationships, etc.

What is Traumatic?

Something is traumatic when it forces the stress response into a new state and does not return to its equilibrium. We know of the three basic responses to trauma; flight, fright or dissociation (freeze). The spectrum on which we deal with trauma starts at a calm level and works it’s way through vigilance, alarm, fear and terror. Something to remember is that one can be both ‘tuned up’ and dissociative. Personal note: I’ve seen this both in myself and Queen E. It is possible to be both in a space with symptoms of acute fear or terror and be unable to respond in any capacity (dissociation). Usually it is assumed that when one is dissociated you look checked out. You can be exhibiting signs of hysteria, hyper activity and extreme emotions and still be dissociated.

When undergoing a trauma the body starts to release opiates into the body as a preventative pain killer and the fight or flight response is then subdued. You become internally focused, have ‘out of body’ experiences and the heart rate slows down as a survival mechanism. (technically to minimize bleed outs if you get injured) What determines when, or if, you dissociate in a trauma? Well, women tend to dissociate and men tend to arouse. (ok, take a moment to make jokes…) It’s not known why this is, except that women might be more hardwired to survival for their offspring and dissociation tends to make you live longer.

Sensitization and Tolerance:

A certain level of stimulus gives a certain level of activation. So sensitization is the overwhelming activation of stress response. This causes disregulation. Desensitization is when you can revisit the trauma in a safe, controlled environment, building tolerance to it. Instead of having the PTSD control you with uncontrolled experiences. Sensitization is often seen as reminders, aftershocks, flashbacks, having to retell the story in unsafe relational environments, etc. Another personal note: having to tell my story in Swaziland to the police officer who was a jerk was re-traumatizing, as was living in the same guest house for a few more weeks, etc. All of those were not safe, controlled ways to build tolerance, but rather caused more sensitization. To desensitize, a useful tool is having a controlled script, that when read, is only a few minutes long. Read this script out loud to someone several times through out the day in a safe, relational environment. This is a safe way to tell our story. As someone who has experienced PTSD, finding ways to tell my story in a safe way is much harder than I thought. People don’t want to hear it.

Building tolerance is helpful because trauma has a ‘topography’ in the brain. It isn’t just one moment in the brain. People tend to display one of two ways. We tend to be external or internal. External people tend to have behaviors that we would associate with trauma or other diagnosis. On the more aggressive, hyper, stimulated spectrum, they are often confused with bipolar. Those are the children that tend to access the mental health profession significantly more than internal children. They also tend to be 3 males to every one female.

Internal children tend to present as shy, disengaged, from a different world. They are usually very well behaved, perfect, obedient, docile children. This was me as a child. The severe symptoms can include fainting, seizures, and abdominal pain. When these symptoms exhibit, the heart rate tends to go down, not up.

Traumatic memory is a chain of memory with multiple components. When remembering the trauma, you feel it again as if you were living through it again. Many memories aren’t ‘remembered’, rather they are associations or cues. All information cues come in through the brain stem and get processed up through the brain levels. Brains tend to distort and confuse in order to make sense of brain stem memories. Cues cause you to draw on the adaptations you created during the trauma.

Traumatized children’s brain baseline tends to be an emotional, alarmed, limbic state. Aka ‘street smart’. It’s important to see the difference between a child that is alert, vs. alarmed. An alert child can learn facts, an alarmed child learns things related to safety and a child in a fearful state learns nothing. What’s interesting about this is that a child who is alert can tend to function within the spectrum of time, of days and hours. An alarmed child functions within hours and minutes and a fearful child, minutes and seconds. I find this so helpful when I think of my parenting responses to my children depending on what state they are in.  At this time, Dr. Perry also mentioned that it is better for children to give them 2, ten minute consequences, as opposed to one, 1 hour long consequence. I don’t imagine this is a formula, but rather a reminder that children’s behavior is shaped more effectively with immediate consequences and rewards as opposed to ones that tend to take longer than minutes.

The key to education for children with developmental trauma is SAFETY.

Our kids need to feel safe in order to learn. And, because of the affects on the brain from trauma, the learning window for our children is smaller than most. They most often won’t be acting out, but will simply be too overwhelmed to learn. Things that can help achieve learning for our kids is anything that helps them feel safe. Any transitions throughout the day disregulate our kids. Minimizing the need to change venues throughout the day will help immensely.  We all need, especially these kids, solitude, satiety and safety to maintain calm. Creating spaces in which we are alone, feel safe and are not hungry or thirsty, leads to more creativity. This leads to good brain development. Our culture often doesn’t support this either. It is hard to provide our children with safe, alone time that they can handle. One way we’ve managed this in our house is having boxes of special toys that a child may take into their bed for alone time. We are trying to make sure this is never viewed as a consequence, but rather a time to calm down and decompress.

With that, I shall leave you. I was hoping I could get this all written in three posts, but since we are only finished page 7, we shall see! Having fun still?