Saturday, October 24, 2009

Continuing our work with Tortuga

I hope folks aren't tired of me writing about what we are doing with Tortuga which I wrote about here and here but I had a couple of questions which I am going to try to address in this post.

One of the things that has been at the bottom of everything we have been doing with Tortuga is that we have been highly cognizant of his basic physiological (food, water, bathroom, shelter, warmth, sleep, etc.) and safety(security, stability, protection, freedom from fear, anxiety, and chaos, need for structure, order, and limits, etc.) Everything we have done has been to try and get these basic needs met and "overmet" if that is possible. We have seen very little from him until recently that indicates any desire for other things like love, affection or any sense of "belonging" to the family. While this is sad and hard to acknowledge I do believe it is true for him much of the time. I know he has formed some attachments to us (me, especially) but they are a source of confusion, frustration, guilt, and anxiety for him too. So this is where we are.

As I mentioned in my previous post, we started adding to Tortuga's routines as he was ready. Someone asked about this so I will give an example. Tortuga is currently not having meals with the rest of the family so most of the time I feed him before everyone else (and I keep him company sometimes but I do not eat with him.) Originally his "routine" was as simple as possible. 1.) I call him to eat. 2.)He goes into the bathroom and washes hands. 3.) Comes downstairs and sits in his spot and waits. 4.) I give him his food, drink, and vitamins (depends on meal) 5.) When he finished he would wait. I would ask if he wanted more food or not, etc. 6) When totally finished he left plates, cup, napkin right there and go upstairs to wash his hands and go back to what he was doing.

We never changed this and variations on his part had consequences (usually sentences or early bedtime). It may sound mean and rigid but this was a huge trouble spot for him. For example, as part of his control issues, his favorite thing to do in the middle of eating was to announce loudly it wasn't enough food, he wanted more, he didn't like it (even favorites) or he'd wait until I was talking with someone else to yell that he was ready for more food or that he needed to pee. As he internalized this routine we added some pieces by either "slipping" them in or announcing they would be "tests." Now he can ask for more food or let me know he is done without waiting for me, he brings his plate/cup/napkin into the kitchen and leaves them in the right place, he can go to the bookshelf to get a new book for bedtime reading after dinner. These may seem like baby steps but all of these were MAJOR sources of contention for us and we have successfully added these things to his routines so that the breakfast, lunch, snack and dinner routines are each slightly different but he is handling them well.

The most unpredictable aspect of our lives is when we go out. An errand to T*rget can quickly become a nightmare if I have all 4 of them. I mentioned before that I will tell him ahead of time the things that will be a challenge--glaring at your sister, talking my ear off, lagging behind or walking off if I redirect you, hiding, telling your siblings what to do, nonsensical chatter and fighting in the car, etc--and remind him he is working on improving these. When we return I tell him how he did on his "test" if it wasn't obvious and we have sentences for any serious slips.

Every week C. & I have a "check-in" meeting with him to give him feedback (mostly positive) and for him to share anything on his mind about what we are and aren't doing. We also ask him what he "misses" about not being with the family and what "tests" he would like to try. For the first 6 weeks he did. not. miss. a. thing. Nothing. We were sad but it reinforced that we were on the right track with him. In her book, Coming to Grips with Attachment, Katharine Leslie talks about how a family environment is "permeated with love and intimacy" and she points out that is too stressful for some of our kids. I think this is definitely the case for him and so I just removed all those expectations and as many situations where he witnesses this or is, by default, participating in this. And I think removing these stresses really has calmed him down TREMENDOUSLY.

After about 6 weeks(we have been at this for about 3 months) he started naming things he missed and the recurring theme was dinner with the family and getting to do his schoolwork downstairs with the family. We took it under advisement but felt he wasn't ready for either of those things. I directly linked his readiness for meals with the family to how he treated his siblings when we were out on errands and amazingly that started to change. He has started to check himself before he gets baited by Pollito (the usually sit near each other in the car) and he has attempted to be civil and even nice to Corazon. As he has made steady progress we determined that he might be ready for some mealtimes with the family.

So, during our meeting last Sunday we informed him that this week (the one that we are in now) we would select two nights (our choice, no advance notice) when he could join the family for dinner. He would also get Pollito's company at night on two occasions. He was thrilled. He was also terribly upset that we would not budge on his doing schoolwork downstairs with the family and we were supportive and reminded him there are too many unpredictables for him to manage that yet. One of his triggers is whenever I give any other child my attention he MUST demand attention right then and there and then flies off the handle when he doesn't get his way. He cried. Real tears. Real sadness. And he said he missed the rest of the family's company. This is HUGE for him. Remember he gets mine for 2-3 hours each day. I hugged him and held him and told him he was feeling appropriate feelings about this and our goal was for him to experience success and he just wasn't ready. Over the past several weeks we introduced several new "tests" and have adjusted accordingly but he has handled them really well. This week these are some of the things he had as "tests."

I wanted to begin to address his expression of "loneliness" and wanting to be with the family. First, Pollito slept in their room on 2 nights this week. Second, he had dinner with the rest of the family on Tuesday and Friday (yesterday). Third, he got to play with the baby outside twice for about 40 minutes each time. Fourth, he got back one part of one of his family chores. He takes the trash can(s) out to the street on Sunday. ALL of these have been on the list of things he has missed and wanted to try again. He did wonderfully with each of these things. I think I only redirected him once. But this morning, he is not in great shape. He has been angry, rude, defiant, disrespectful, etc. and it is only 10 a.m. I have sent him back to bed to "rest" and I will check in with him later to see how we can "fix" this. I guess some of the week has caught up with him but I have every hope that he will turn it around today. In the past, once a day got started like this it was a lost cause. I am hoping that isn't the case today. Questions?

2 comments:

Christine said...

For some of our kids, making their world smaller and very simple can be a WONDERFUL way to help them slowly work their way back into those trigger situations and be able to handle it.

Mar has had many, many days on restriction lately. Wednesday, she earned her way out, and was able to go to her class Wednesday night. Thursday morning she walked in and said, "Mom, I need a pencil. I left my pencil at church last night."

I'm trying really hard lately to add in more touch (note to self: blog about this). I put my hand on her arm and rubbed her back a little while I said, "You wanted to do something disrespectful last night. You did not need to take a pencil, but you took your new school pencil without permission. You left it there on purpose."

"Yes."

"And, baby, that means you have another 24 hours of restriction."

Her eyes welled with tears. That is the thing we NEVER saw for months and months and months ... just genuine pain and regret ... real tears.

It was SO HARD. I knew she was upset with herself. I knew she wished so badly she could rewind and erase what she did. Yet, I also knew she was progressing GREATLY and I needed to follow through.

Thursday night she was off restriction and has not been back on since. She's trying really, really, REALLY hard.

And a year ago, when she was on restricted mode, she didn't miss anything, either. She has come SO FAR!

Oh ... and when she got off restriction Thursday night, there was a fat envelope on the dining room table with her name on it! Tell your daughter she was elated ... and has already finished the Nancy Drew book! :)

BT said...

This is an amazing course of action you have taken. It sounds like exactly what Tortuga needs. Kudos to you and C for making it happen. I can imagine the kinds of sacrifices it has required, particularly for how long you have sustained it. Great job! I love the idea of the "tests." I also love that you are seeing true progress with him. I hope he reaches a point where he can comfortably give himself credit for his progress and changes. (Our son is still very uncomfortable with recognition. I hate that he misses out on feeling joy at his accomplishments.)

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