Thursday, January 28, 2010

The Intervention

As I was thinking about the decrease in many of Tortuga's problematic behaviors I realized that part of what we have been able to accomplish is to reduce the interference. These behaviors interfere with his ability to communicate with and connect with us on many levels. They prevent him from listening to us and engaging with us on any but the most superficial (and contentious) levels. In working so intensively to change these behaviors part of what we gave up was trying to get him to understand the problem or need for change but simply to get him to "perform" better. It didn't matter to us if he remembered that it was disrespectful to talk/look at us that way or if he understood that it was disrespectful. Well, of course, it mattered on a deeper level to us but we began to understand that for him performing it was our first priority. In some ways it is similar to what Katharine Leslie discusses when she reminds us that our traumatized children don't have the scripts for the plays they are performing in so they don't know how to act in a family context.

So we shifted our focus as much as possible. In the process we have been able to uncover more of the deeper issues and hurts and of course, the next set of things that need to be worked on.  One change I didn't mention in my previous writing was that we have seen a reduction in his NEED to be oppositional for the sake of being oppositional. This is a kid who ALWAYS (and I do mean ALWAYS) had to find a way to oppose (whether verbally or by actions) whatever he was asked or expected to do. It was his default response and usually resulted in some kind of confrontation no matter how much we worked to avoid it. Even if he was in an especially good mood that behavior would surface although many times as indecision and would immobilize him and then get coupled with his other insecurities. So for example, let's say I offered a cookie or a cupcake for dessert (which we rarely did because sugar really messes with his brain.) He couldn't choose. Then he would ask me which one was better. Then he would get mad if I didn't say one was better. Then he would get mad because I wouldn't choose one for him. No matter which one I chose (or he chose) he would get mad because it wasn't the better one. Then he would fly off the handle and down that usual path. It could be a cookie, a book, a shirt, which chair at the table, or whatever. It just didn't matter. If I gave him permission to play outside with his rollerblades or his skateboard he would go out and come back in and ask to play with a scooter (which was inaccessible or being used by someone else) and that would become the focus of an argument. I got to the point where I prefaced every request by saying "THESE are your only choices so don't ask about anything else" before I made whatever request of him.

In the past 6 months that tendency has still been there but it is diminishing. I find him saying "I was gonna ask you if." and then stop himself and say "never mind" or "it's not one of the choices so you are going to say I can't." All by himself he was stopping that impulse! It was wonderful! One thing that I think really helped is that we slowed down his world and this is something my kid really needed because on top of everything else he does have learning issues, processing issues, and sensory issues. This is something that I have been thinking alot about as a challenge for kids like him in RTCs. I know that Tortuga loved being in the RTC. He loved the structure and predictability (probably the first time in his life he had access to food regularly and he could anticipate each meal and snack.) He loved that many of the expectations were pretty low so he both achieved success but didn't get corrected when he fell short (never showering appropriately.) If he destroyed toys, books, papers, etc. no one cared and out of somewhere new ones appeared. He had one on one adult attention several times each day (daily therapy and group therapy), a peer group he could join or escape at will and when he didn't like something or want to do something he quickly learned how to get out of doing it by engaging in unsafe behaviors that immediately put him on "watch" with one adult and usually earned him an extra therapy appointment plus a meeting with the psychiatrist usually punctuated by someone playing ball with him outside when he was supposed to be doing chores/schoolwork.  Before anyone gets upset with me about this please understand that I am not trying to slam RTCs and their staffs. I have worked in facilities like these, I have been trained as both an educator and clinical therapist, and I understand the protocols that any agency working with challenged children must adhere to. What I am saying is that this is how MY son experienced his RTC (which is a very desirable and reputable one) and he is the one who has been able to articulate all of the things I have noted above. Most importantly there was no expectation that he attach to anyone and it fact the RTC reinforced his view of the world which was that people came and went (roommates, floormates, house staff, and therapists) and you never saw them again so there was no real point in attaching to them because they would be gone and replaced by someone else. This is where family life was that much more scary for him AND impossible for him to participate in.

But I have digressed. I wanted to write about our weekend "intervention." C. had been away for a good part of last week and when she returned we checked in about the kids. So I was forced to go through my weekly routine (pickups, dropoffs, errands, etc.) with all 4 kids because we don't yet have a sitter who can handle the kids and do things as they need them to be done. That meant Tortuga spent a great deal more time interacting with the whole crew than he normally does and there were many more transitions. He did better than he normally was but some of the major issues (not behaviors necessarily but issues) surfaced in a clearer way because they weren't masked by his usual antics. So I was telling C. about his newfound obsession with Pollito's classmate and younger brother (I think I wrote about his playing with them at the park) and a secret club he was forming with 2 five year olds and a 4 year old. I was also telling her his new language to refer to Corazon ("enemy") and his continued need to just be mean to her and to Pollito. I also noted that he continues to blame Corazon for every perceived problem he has and he began accusing her of doing things she doesn't do (taking and hiding his things, going into his toybox, looking at him). He also continues to find ways to try and scare Pollito. In fact, we had a recent incident with Pollito at school where he threated a little girl with something that we know he must have heard from Tortuga. As I updated C. she once again reiterated that we needed to confront the possibility that Tortuga might never be a family kid and reminded me of her stance that if he hurts anyone else beside me (well even me if it were more than in the process of trying to help him or restrain him) she would not allow him to stay in our home.

So we set the stage for an "intervention." C. went upstairs and spoke with him (it is usually me but we wanted to change things up for him) about his progress and his ongoing problems. She also gave him some "causes" for his problems and told him the whole family was now joining in on helping him with his problems because we wanted to give him every opportunity to become a family kid. She also spoke with him about his issues related to his birthmom (doesn't want to connect with us because it feels disloyal to her, harbors belief that we are keeping him from her, believes she will come get him, etc.)

In the meantime I spoke with the other kids and had them share with me as honestly as they could what they wanted him to be like, what they wanted him to stop doing, whether they wanted him to stay in the family, etc. It was heart-breaking and amazing to see and hear what they had to say, especially Pollito. Then we met as a family and C. shared their conversation and also shared with the whole family our belief that Tortuga does ALL of this because he is AFRAID. Afraid of everything and everyone. She also shared our theory of why he is afraid and wants everyone else to be afraid. We also talked about how Tortuga has been taught that everything and everyone is disposible--when you get bored you throw it away whether it is a person or a thing. We talked about how it wasn't his fault that he was treated at disposible and that he learned to do that to protect himself from being so afraid. We talked about his hatred of Corazon and why we think this is the case and we reminded everyone that Corazon had some of the same behaviors and actions when she first came. Tortuga cried and cried. He spent most of the meeting sitting on my lap.

Then we had him listen to what the kids said about when he was being a "good brother" and what they wished they could do with him if he was able to play/be with them. They were so caring and articulate in sharing their thoughts with him and he continued to cry. The only difficulty we encountered was that he couldn't look at Corazon's face when she spoke to him or when he spoke to her. Then we enlisted everyone's help in helping him by informing him that the kids would be "tattle-taling" on him every single time he said or did something rude or mean to or about them (or anyone) and he was going to practice "owning" the behavior and apologizing when necessary. Plus he was going to THANK them for trying to help him. In return there would be no negative consequence for the behavior. We practiced what this would look like. We had a group hug and spent the rest of the day doing "fun" things as a family--bowling, dinner, ice cream, game. Tortuga did wonderfully and we got a chance to have him practice being "helped" by everyone.

So this is where we are. He is spending more time with the family (for example, dinner every meal now unless he asks to be alone) and we see it as him "practicing" being a family kid. I don't know yet how it is working but so far we have had only minor bumps. I am also reducing my one on one time to increase his investment in spending time with the whole group and we are increasing the "bonding" activities with me and with everyone else. I don't know yet what other steps we will be taking.

5 comments:

Carmel said...

I think what you are doing with him is amazing! I learn so much from your blog.

Christine said...

Beautiful.

Some of the most healing times in our home have come when all the siblings are involved.

SocialWrkr24/7 said...

You are absolutely amazing for the insight and dedication that you have regarding Tortuga. In case no one has told you this recently - even some of the best and most well intentioned parents just could not open their hearts and minds enough to rearrange their whole lives for the sake of a child. I'm in awe of all you are trying to do for your son! You are all in my prayers!

rimps said...

"reminded me of her stance that if he hurts anyone else beside me (well even me if it were more than in the process of trying to help him or restrain him) she would not allow him to stay in our home."
I am SO relieved to read this. Sorry for Tortuga, but relieved on behalf of you & your other children.

Dia por Dia said...

Thank you all for the support and kind words. I agree that the whole family can be involved in the healing process. For us it has been pretty impossible because there was NO investment in any of the other kids for Tortuga so their help led to retaliation and just plain ugliness. Now he still doesn't like it BUT is accepting it and it gives the other kids an important role in his healing.

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