Category Archives: adoption competency

Resources Around Trauma and Suicide in Adoption

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It’s a balancing act to discuss adoption as trauma. The idea of adoption as trauma is relatively new, and I understand that it’s disconcerting for many people. Separation from one’s mother as baby or child is traumatizing; we are hardwired to connect with our mothers. Adoptees often undergo additional separation from caregivers in a foster home or orphanage. Those losses can be traumatic as well, and the trauma can manifest over time or later in life. Depression is also disconcerting, to the 19 million Americans who struggle with it and to those who love the people who are struggling. Many adoptees struggle as children, as teens, and as adults with anxiety and depression. Talking about these medical conditions can be hard. Still, as anyone involved in adoption or in life knows, not talking about difficult, uncomfortable things rarely ends well.

It’s also a balancing act to encourage discussion about suicide without encouraging suicide. Same with remembering those who have died by suicide without inadvertently glamorizing suicide. High schools, for example, face this dilemma when a student has died by suicide, not wanting to trigger any sort of imitation, or “suicide cluster.”

Suicide is the third top cause of death among 10 to 14 year olds, and the second top cause among 15 to 24 year olds.

My post Suicide and Adoption: We Need to Stop Whispering has been shared on Facebook about 800 times since I published it last Monday. There have been several thousand views and visitors, and I have heard personally from many people. Clearly, it struck a chord, and we need to keep this conversation going, even if it is complicated and difficult to balance.

For anyone in crisis, call this number: 1-800-273-8255. You can call the number if you are considering suicide or if someone you know is. Available anytime, day or night. 24/7/365.

Two significant resources are the Suicide Prevention Lifeline and the American Foundation for Suicide Prevention. Both have huge amounts of information, research, and more. I’ve reached out to both organizations above, asking if they would consider providing adoptee-specific information on their websites.  I’ve offered to draft material and network with them about this, and I hope I hear back soon. Please reach out to them as well.

Here are suggestions for talking with someone who may be suicidal. I share this because there are many resources available for this tough stuff.

Most suicide attempts are rooted in some sort of trauma and/or depression. Many people who have considered or died by suicide have also been diagnosed with depression and/or Post-Traumatic Stress Disorder. President Obama in February signed a suicide prevention law to make it easier for U.S. military veterans to access mental health resources. The law also provides funding to recruit and retain professionals to help veterans struggling with PTSD and other challenges.

Here’s an eye-opener: Former foster care children are almost twice as likely as US war veterans to suffer from PTSD. You can read more in this Casey Foundation report.

I’ve cited, several times, the American Academy of Pediatric’s report that adoptees are 4 times as likely to attempt suicide as non-adopted people but it bears sharing again. Read the report here.

We can recognize that trauma is a part of adoption, without claiming that all adopted people are affected the same way. Many do just fine, handling challenges with resilience and strength. Many struggle, and those are the ones I want to recognize, acknowledge, and assist, if possible.

Here are some strategies and resources:

  • Learn about trauma in adoption. “Assume that all children who have been adopted or fostered have experienced trauma.” That is a central quote from the American Academy of Pediatrics guide for pediatricians, “Helping Foster and Adoptive Families Cope With Trauma.” Share this resource with your pediatrician.
  • Make suicide awareness a component of pre-adoptive parent training classes. Suicide awareness should be part of information provided to prospective parents about trauma, depression, and anxiety disorders, and their frequent appearance in adoptees.
  • Insist on speakers in pre- and post-adoption workshops who have struggled with depression and trauma. Agencies: Improve networking with adult adoptees and adoptees who are therapists, so that adoption agencies have several speakers to provide for families.
  • Understand why access to medical histories for adoptees is essential. Denial of that information (which could be lifesaving), in regard to mental illness and other medical conditions, is unconscionable. The American Adoption Congress has focused its legislative advocacy efforts on opening access to original birth certificates. Information is available here.
  • Advocate for adoption competency among therapists. Suggest that families also look for therapists trained in childhood trauma, as well as in adoption-related issues.
  • Advocate for strong post-adoption mental health services for everyone: the adoptee, the adoptive parents, and the first/birth parents.
  • Suggest, promote, and provide workshops with titles like “Depression Among Teenage Adoptees: What It Looks Like, What Can Help,” or “The Presence of Suicide in Adoption,” or “PTSD and Adoptees: The Realities and the Treatments,” and “Adult Adoptees Speak Out About Depression, Anxiety, and Suicide Prevention.”
  • Learn about the impact of bullying and cyberbullying on children and teens. According to the site stopbullying.gov, “Although kids who are bullied are at risk of suicide, bullying alone is not the cause. Many issues contribute to suicide risk, including depression, problems at home, and trauma history. Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth. This risk can be increased further when these kids are not supported by parents, peers, and schools. Bullying can make an unsupportive situation worse.”
  • Adoption agencies and adoption-related organizations: Provide current, substantial lists of resources to families about therapists, therapies, articles, podcasts, videos, and more related to adoption, depression, and suicide prevention.
  • Learn about psychotherapies that can benefit people struggling with depression and trauma. The National Institute of Mental Health has clear information: Psychotherapies. One therapy, Dialectical Behavior Therapy (DBT) is for chronically suicidal people diagnosed with borderline personality disorder, and is also used for substance dependence, PTSD, and depression.
  • Learn about the role of addiction in adoption, and how addiction and substance abuse intersect with trauma and depression. One resource is a YouTube video by Paul Sunderland, titled Adoption and Addiction.

Fill yourself and your loved ones with accurate information, with hope, and with attention to deep listening. Let go of shame and fear about mental illness, and encourage others to do so as well. All of us in the adoption community can work together in a powerful way to increase awareness of suicide, and to promote suicide prevention.

 

Racism, Trauma, and Adoption: Wake Up

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Racism, trauma, and adoption are far more entwined than many people want to admit.

As a white person, I will start by saying this: Racism is real, pervasive, mostly implicit, better than it once was, and currently is damaging our culture, children, and future, in a genuine and tragic way.

As an adoptive parent of children of color, let me say that if you adopt transracially, you must make every effort possible to raise your child in a home where he sees you have friends who look like him, where she sees other children and adult role models who look like her, where you understand racial microaggressions and are comfortable talking about them, and where your approach to the child’s culture of origin isn’t an ethnic restaurant on special occasions or just artwork, dolls, and music.

Enough.

Here are two Wake Up Calls, for adoptive parents of children of color, though truly for anyone who wonders about racism and its impact.

The First Wake Up Alarm:

A 69-year-old black man, walking in Seattle in July 2014, using a golf club as a cane, was arrested, because the police officer says he threatened her with the golf club. Problem: The police department’s own video shows no such thing.

While the incident took place last summer, the video only came to light yesterday. It was obtained through a public records request by the Seattle-based paper The Stranger. Read the article with the videotape here.

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I’ve long known about DWB (Driving While Black),  but OMWWB (Old Man Walking While Black) is a new one.

Racism in the Seattle Police Department has been well-known for years, and the department is under federal investigation. Read more here.

This could be your grampa. William Wingate is a US Air Force veteran. He drove a King County Metro bus for 20 years. He was walking in daylight using a golf club as a cane. He is not mentally unstable, nor was he threatening anyone. He never swung at the police officer. He needed help getting into the police wagon, since he was handcuffed, and almost 70 years old.

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William Wingate on the way to jail. Image taken from police videotape.

He was arrested and spent a night in jail, something that had never happened to him before in his life.

If the videotape were not requested by The Stranger, we never would have known what happened to this man.

The Seattle Police have apologized, as of yesterday.

For me, this is a tipping point. As if Ferguson and Michael Brown and Tamir Rice and Trayvon Martin weren’t enough. For me, it’s seeing, on videotape, an old man, who’s clearly hard of hearing, being accosted and jailed for nothing. It’s all on the videotape. The officer said in her report she was fearful of being assaulted by him. The officer, Cynthia Whitlach, has been reported as posting racist comments on Facebook along the way as well, per this The Stranger article.

I have written recently about “Being Black in Seattle: Rewards and Challenges” and “Being Black in Adoption: Seattle and Elsewhere.” It’s a sad coincidence that this case of William Wingate–the man with the golf club–should reach headlines today.

The Second Wake Up Alarm:

Racism, both violent incidents and the accumulation of micro aggressions, is a form of trauma. Don’t believe me? How about the medical profession’s bible, the DSM?

Medical Daily reported in 2013 that proposed changes in the criteria for post-traumatic stress disorder (PTSD) in the fifth edition of the Diagnostic Manual of Mental Disorders (DSM-5) could increase the potential for better recognition of race-based trauma in racial and ethnic minorities. In Psychology Today, Dr. Monnica Williams, a clinical psychologist and the associate director of the University of Louisville’s Center for Mental Health Disparities, said that in “earlier versions of the DSM, racism was recognized as a trauma that could potentially cause PTSD, but only in relation to a specific event. There had to be an incident of intense fear, helplessness, or horror for such consideration. For instance, if someone was assaulted in a racially-motivated event, then racism qualified as a sufficient trauma to be categorized as a cause of PTSD.

But now, under the new DSM-5 definition, the requirements for fear, helplessness, and horror have been removed, making room for the more lasting effects of subtle racism to be considered in the discussion of race-based traumas.”

That is an important and groundbreaking bit of news. Subtle racism can include microaggressions, which over time can erode people of esteem, energy, and hope. Microaggressions have been written about in many places, including American Psychologist and the Journal of Counseling and Development. The abstract for that latter article says that “This study examined the relationship between racial microaggressions (subtle and unintentional forms of racial discrimination) and mental health. Results from a large sample (N = 506) indicated that higher frequencies of racial microaggressions negatively predicted participants’ mental health and that racial microaggressions were significantly correlated with depressive symptoms and negative affect. Differences in the types of microaggressions experienced by various racial groups (Asian, Latina/o, Black, White, and multiracial) and counseling implications are discussed.”

Another perspective on racial microaggressions can be found in Buzzfeed. It’s received close to 3,000,000 views.

Add to that a discussion of whether adoption is a form of trauma. I wrote a post Does Adoption Really Equal Trauma? which has been shared on Facebook close to 950 times.

What happens to transracially adopted children, who may well have experienced trauma, and who are subject to racial microaggressions (if not explicit racism) as well?

The issue of trauma is a spectrum, and is influenced by individual experience and resilience. Not all adopted people, not all Asian (or other race) adoptees, and not all black people experience trauma or PTSD.

Some do, though.

For adopted children, especially but not only those of color, we need to have big, courageous conversations around racism. We need to be aware of trauma.

And we need progress in mental health and in adoption-related services.

We need more therapists of color, who have life experience with racism and with racial microaggressions, who can help their patients of color feel comfortable and safe in seeking help, and who can help educate their white colleagues as well. Can white therapists treat people of color successfully? Yes. But let’s get more therapists of color so that our children of color see themselves reflected in mental health professionals.

For adopted children, we need to value the life experience and perspectives of adult adoptees who are clinical therapists. There are increasing numbers of white, Korean, Colombian, and African-American adult adoptees who are doing excellent, important work in adoption.

We need more counselors and therapists across the board who are well-trained in adoption competency. One such approach is Training in Adoption Competency, affiliated with the Center for Adoption Support and Education.

A quote from TAC:

“What are the core knowledge areas for an adoption competent mental health professional?

An adoption competent mental health professional understands the nature of adoption as a form of family formation and the different types of adoption; the clinical issues that are associated with separation and loss and attachment; the common developmental challenges in the experience of adoption; and the characteristics and skills that make adoptive families successful. An adoption competent mental health professional is culturally competent with respect to the racial and cultural heritage of children and families and the culture of birth families.”

Another strong training resource for professionals is Dr. Joyce Maguire Pavao’s Certificate Program in Adoption Competency. My point: If you are an adoptive parent interested in therapy for yourself or your child, insist on adoption-competent therapists.

I don’t know if William Wingate, the elderly black man I wrote about at the beginning, experienced trauma. I’ve no doubt he has experienced racism. I wish him well, and I think he deserves much more than an apology.

For transracially adopted babies, children, and teens, who grow up to be adults, let’s talk openly and honestly about racism in the United States, and the intense damage it is doing to all of us. Let’s do that for all of us.