Category Archives: Post-Traumatic Stress Disorder

Invitation to Share Information on Adoptees and Suicide

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I reached out to Forefront, a nonprofit suicide prevention organization here in Washington state, about depression, trauma, and suicide in the adoption community. I asked if they might consider highlighting adoptees in some way on their website, to provide information for them and their families.

Today I was invited to be a guest author for their blog, as well as to offer other ideas of how I think they could bring awareness to this issue on their website.

I am honored to do so, and am very appreciative of Forefont’s response and their openness to receiving and providing this information.

I want to open this up to adult adoptees to share in the writing of the blog post and the provision of information. It may or may not have been my status as an adoptive parent that opened this door, but I would like to go through it with the voices and insights of adult adoptees. I know so many who have amazing professional credentials as therapists and researchers, who have hard-earned experience with depression and trauma, and who have had loved ones attempt or die by suicide. Please: send me an email at Maureen (at) LightOfDayStories.com and let me know if you would be willing to help shine more light on the role of suicide, and suicide prevention, in the adoption community.

First/birth parents are welcome also, of course, as are adoptive parents, siblings, spouses/partners, and others. We need many voices. Suicide affects all of us, and we must work together on prevention.

Here’s some information about Forefront. Please check out and support their website.

“Mission: Forefront advances innovative approaches to suicide prevention through policy change, professional training, campus and school-based interventions, media outreach, support for persons affected by suicide and program evaluation.

Vision: We envision Washington State as a community where there is no suicide. To achieve this goal: 1) the public needs education that suicide is preventable including how to help those affected by suicide; 2) individuals in crisis have to have rapid access to effective treatment for behavioral health disorders; 3) strategies need to be implemented that prioritize emotional wellness and suicide prevention readiness within healthcare systems, schools and campuses, and by employers; and 4) progressive state policies that support the aforementioned conditions must be enacted.

Goal: Reduce the suicide rate in Washington State by a minimum of twenty percent by 2020. Once successful, Forefront will broaden its outreach to other states where the rates of suicide in the U.S. are the highest.

At Forefront, we know most suicides are preventable and that the time to act is now.”

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Suicide and Adoption: We Need to Stop Whispering

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Update: For resources about adoption-related suicide awareness and prevention, here is information.

Just this morning, as I was getting ready to post this, I read on my Facebook feed about a 28-year-old Korean adoptee who died by suicide two days ago. I did not know her. She was the same age as my oldest son, and she had a daughter about the age of my granddaughter. May she rest in peace.

I am holding in my heart a 20-something-year-old adoptee, adopted with a biological sibling into a huge adoptive family (more than 25 kids). He is overwhelmed all the time these days, as a result of things he has done and has had done to him. He wants to go home, though he’s not sure any longer where “home” is. He is in great need of mental health services, and is intently resisting help. He is teetering on the edge of suicide.

Yes, I know most adoptees do well. But this one is struggling, and it appears to be the result of events after he was adopted. His adoptive family has abandoned him.

My two most shared blog posts (shared over 1000 times on Facebook) are “Does ‘Adoption’ Really Equal ‘Trauma’?” and “Fisseha Sol Samuel: Irreplaceably Marvelous.” Both deal with a hard side of life: trauma and suicide. The first post says, yes, adoption is trauma, and there is a spectrum of response to it. The second post was written last October following the suicide of an Ethiopian adoptee who had previously exhibited no symptoms of depression, and whose death was likely (we will never know for sure) the result of a sudden, triggering, traumatizing event in which he was overwhelmed and impulsive. Fisseha’s mother, Melissa Faye Green, has written several powerful posts as she sorts through her son’s death.

Here is an excerpt from my post about Fisseha:

“There is sobering research that says that adoptees are four times more likely to attempt suicide. It’s here in Pediatrics, the journal of the American Academy of Pediatrics. Not lightweight stuff, and even more startling in that the mean age of the 1000 participants was about 14. Out of the total group, which included adoptees and biological children, 56 had attempted suicide; 47 of those were adoptees.”

I am holding in my heart a 14-year-old Eastern European adoptee, who is too familiar with drugs and sex, who is loved deeply by her adoptive parents, who is in various therapies, who cuts herself and threatens suicide often. She can be a bubbly, sweet teen, and also a deeply frightened and frightening out-of-control mystery.

Yes, her struggle may not be the result of being adopted, but rather of what happened to her before she was adopted. She is struggling, and those who love her are deeply worried.

No one enjoys thinking of adoption as a trauma. No one likes to talk about suicide. And, I know: most adoptees–most people generally–don’t consider or die by suicide.

That said, let’s start thinking and talking about the link among adoption, trauma, and suicide. Let’s insist that suicide awareness be a part of pre-adoptive parent training classes. Let’s demand that anyone who claims “adoption competency” in their therapeutic practice is extremely knowledgeable about suicide. Let’s actively and shamelessly share resources to prevent suicide. Let’s request workshops like “The Presence of Suicide in Adoption” as a topic at adoption-related conferences. We need to stop whispering about suicide and adoption, and to speak about it with clarity and without fear.

I am holding in my heart a 16-year-old adoptee from India, beloved by her adoptive family, mentored by an adult Indian adoptee, raised in Minnesotan suburbs, who killed herself about a month ago.

Yes, she struggled, and also was offered and received help. She may be at peace now, though all those left behind are filled with sorrow and questions.

These 3 adoptees are among the reasons that we must talk about the role of trauma and suicide in adoption.

A few weeks ago, I was at the national conference of the American Adoption Congress. The main legislative advocacy effort of the AAC has historically been access to original birth certificates, a means of allowing adopted persons to know who they are, a basic human and civil right.

What is the connection between suicide and the AAC’s legislative efforts? Well, there may be a genetic component to the likelihood of suicide. Access to one’s medical and mental health history–too often denied to adopted persons–could be a matter of life and death. Knowing about a history of depression or other mental illnesses in one’s family could mean proactive treatment and interventions. It is yet another reason that closed records are unfair, untenable, and wrong.

Here are links to two medical journal articles:

Genetic and Familial Environmental Effects on Suicide – An Adoption Study of Siblings

Genetics of Suicide: An Overview

Many adoptees are adopted into families where the adoptive parents are well off financially, have attended college, and are in highly regarded professions.The adopted children go to excellent schools and often have wonderful opportunities. Still. Take a look at “Best, Brightest–And Saddest?”, in which Frank Bruni reflects on the “suicide contagion” among teens in Palo Alto and elsewhere who are under pressure to succeed academically in highly competitive situations. The article cites a CDC report that says 17 percent of American high school students considered suicide in 2012. Eight percent said they’d attempted it.

Suicide, of course, feeds on trauma and depression, and does not discriminate based on economics and education. While the “suicide cluster” among high schoolers in “epicenters of overachievement” is discussed in the New York Times’ article above, there has also been a similar tragedy–which has not made national press–among young people in Seattle. Three young men, ages 18, 18, and 20, who were students at the Seattle Interagency Academy (SIA), died by suicide, within a 4 month period in the last year. SIA works with at-risk youth, who have struggling families and who are often homeless or on probation. Listen to an excellent podcast with the SIA principal here.

Coincidentally, there was a string of 7 suicides by adolescents on the Pine Ridge Indian Reservation in South Dakota around the same time. No one is quite sure why this is happening, though bullying and grim prospects for the future seem to be significant.

I don’t know if any of these young people had spent time in foster care or were adopted. Certainly, though, their life paths echoed those of many young people whose families are struggling mightily, and those struggles are often the reasons that children land in foster care and/or adoption. Racism and micro-aggressions can significantly affect the mental health of transracial adoptees; I wrote about that reality here. Even adoptees placed as infants in same-race families can struggle with loss, grief, identity, and feelings of not belonging. It’s clear that many of these challenges manifest in adolescence.

This is all daunting tough stuff. I am seeking a balance: to acknowledge suicide prevention as a goal about which we can all speak in the adoption community, not over-reacting, being pro-active, and supporting each other. My next post on this subject will give some resources.

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Light Through Trees, Forest near Lake Langano, Ethiopia © Maureen McCauley Evans

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.

 

 

 

 

Yoga, Trauma, Healing (And the Seahawks)

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I recently attended a weekend workshop called “Healing From Trauma with Yoga, Writing, and Nutrition,” held at Seattle Yoga Arts. I’ve been fortunate not to have had a lot of trauma myself, though many people whom I love deeply have experienced trauma. I’ve dabbled in yoga. I love that this workshop combined yoga with writing, since I do lots of that, and with nutrition, because the way we nourish ourselves, and our feelings about food, can have a great impact on the way we heal and thrive, emotionally and physically.

I attended the workshop to see how all this might merge together: yoga, writing, nutrition, trauma, and healing.

Traumas can be physical, emotional, psychological, or a combination. Doctors talk about trauma as significant, sudden damage done to the body. Trauma also can mean an emotional response to a terrible, unexpected event, something that shatters our sense of security, of feeling safe. These events can occur in childhood, when we are unprepared and powerless to prevent them. Traumas can be a terrible accident or a natural disaster. They can happen to toddlers, to highly trained soldiers, to athletes, to anyone. Sometimes right after the event, we deny or minimize what happened. Sometimes, we recover quickly. When we don’t, later on we can have emotional symptoms (feelings of sadness, hopelessness, guilt, shame, self-blame, anxiety, and fear; mood swings with anger and irritability; withdrawing and feeling disconnected) and physical symptoms (being easily startled, having difficulty concentrating or sleeping, feeling tired or tense).

Symptoms can fade, and people can recover. Sometimes, symptoms can be triggered (well after the event) by reminders of what happened, reminders that can be based on the calendar (anniversary dates of a death or disaster), or on an unexpected reminder (a sound or smell, a picture of something that traumatized us).

Adoption is a trauma. We adoptive parents may not like to think about it that way–I certainly don’t. Still, it’s true.

Here is information from Emotional and Psychological Trauma: Symptoms, Treatment, and Recovery:

Childhood trauma results from anything that disrupts a child’s sense of safety and security, including

  • An unstable or unsafe environment
  • Separation from a parent, especially a mother
  • Serious illness, surgery (especially before age 3), intrusive medical procedures
  • Sexual, physical, or verbal abuse
  • Neglect

Though it’s not labeled as such, that list describes reasons children are placed for adoption–and why it is trauma. Significant separation from a child is also trauma, and thus adoption can be traumatic for birth/first mothers, fathers, and siblings as well.

Some adoptees recover from the trauma well, as do first parents. Some struggle throughout their lives. It’s a spectrum. Why is one person resilient, and another not at all?

Maybe that question, though, is just a distraction. The key is to accept the reality of trauma, to be aware of the impact of trauma, and to be open to helping oneself and others to heal.

Yoga is one good resource, perhaps especially because it connects the mind and the body, providing means to soothe the brain, and thus allow the body to better bear the physiological responses to stress and the triggering recurrences of trauma.

Slow, steady, purposeful breathing really is a big deal. Counting to 10 is only half the point: breathing slowly in and out, letting the body and mind get steady, is even more helpful.

Let go of any stereotypes about yoga. I admit I was heartened this weekend when our yoga group was not entirely high-toned reeds, because I always feel a bit daunted in those classes. Our group had a few um violins. A cello or two. It worked well.

We were encouraged to take care of ourselves, to talk about our expectations for class time, and to say what we hoped to take away from it. Safety was central: emotions, abilities, and efforts would all be safe, and accepted. Giving our beloveds (family members, friends, colleagues) space in which they are safe is a meaningful gift.

I want to emphasize this. Making a safe space–doing so with clear intention–may be one of the best gifts we can give to anyone who has experienced trauma. What does this mean? To me, it means that assuring (and backing it up) loved ones that when they are with us, they will be safe. We will listen to their needs deeply, we will accept the needs as they are expressed, and will partner with them, where they are. This could mean figuring out ways not to startle them, or best ways to express concern or affection, or what words are least/most helpful.

This weekend, we practiced different, gentle yoga positions, always encouraged to pay attention to our bodies, to notice what the muscles and joints were saying–and to breathe. This was “restorative yoga” we were learning: ways to restore energy and promote healing. Our wonderful instructor, Bianca Raffety, told us to pay attention to pain or discomfort, and to pay attention to what felt good. That was powerful. When we focus on what causes pleasure, in a healthy way, we can focus on maintaining or re-creating it. That’s true in yoga, and in other parts of daily life.

Meditation is often also powerful. Children can learn to meditate. The brain clears, the mind calms, the body regenerates. We are so over-tired and over-electronified, and over-loaded with information. What if, when we woke in the morning, we didn’t immediately reach for our cell phones? As a result of this weekend, at night I’m putting my phone in another room to charge, rather than on my nightstand. I’m going to use my waking up time to pause, breathe, and maybe meditate a bit, before bounding into the day.

I mentioned letting go of stereotypes about yoga earlier in this post. Here’s another dimension: the Seattle Seahawks–why, yes, they are the Super Bowl Champions–use meditation and yoga in their training. This article (the title made me groan, so try to move beyond that) has some fascinating points: “Seattle Seahawks Will Have ‘Ohm’ Team Advantage.”

Seahawks.com

Seahawks.com

A few highlights about the benefits of yoga and meditation:

“While football is obviously an intensely physical sport, mental muscles also flex pretty hard during a game. Learning to slow down and calm down is so important…because it teaches players to fine-tune their focus, attention and attitude. This leads to…a more mindful approach to the game.”

“There’s an entire body of science backing the idea that increased mindfulness can equate to better performance. Studies find that daily meditation helps raise awareness of self-defeating thoughts. Mindfulness practice also helps reduce production of the “flight or fight” hormone adrenaline that contributes directly to anxiety and distracting mental chatter.”

“Meditating regularly probably influences the size and topography of the player’s brains as well. Not that all that extra brain matter is useful for blocking or tackling opponents, but work sponsored by the National Health Institute for Complementary and Alternative Medicine found an increased thickness in areas of the brain associated with self-awareness, introspection and learning after several weeks of short meditation sessions.”

“By halting negative thinking and replacing it with sunnier thoughts while in training, players learn to carry a more positive attitude onto the gridiron…This can also translate into direct physical advantages as well. For example…the time players devote to sitting on a meditation cushion with their eyes closed has taught many of them how to slow their heart rates during the intensity of play.”

Who knew? I love unexpected, positive connections.

May we be open to healing and strength, and to new possibilities.

Adoption, Art Therapy, and PTSD

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There’s a school of thought that adoption is equivalent to violence, that the separation from one’s mother is inherently traumatic, and that the loss of a family (language, culture, history, birthright, traditions) is for some people so severe as to be debilitating.

As an adoptive parent, I find that school of thought to be sobering and daunting. I’d like it to be wrong. Yet I know that, for some adoptees, the impact of their being adopted–even if it’s the “right thing,” even if the adoptive parents are good and loving people–has a challenging, lifelong impact that interferes with their ability to trust others and to build healthy relationships.

Add to the trauma of being adopted any incidents of abuse and/or neglect, either before or after adoption, and you have the potential for a diagnosis of Post-Traumatic Stress Disorder.

We think of that diagnosis perhaps most frequently for soldiers who have witnessed or participated in horrific acts during wartime, and who then seek help after that trauma. But PTSD can appear in other circumstances, including adoption.

The National Institute of Mental Health explains it this way:

“When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.

PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers.”

Immanuel Williams was diagnosed with PTSD after being removed from his adoptive home. During the trial of his adoptive parents, Larry and Carri Williams, Immanuel’s therapist testified about Immanuel’s diagnosis and prognosis. I wrote about the therapist’s testimony here.

I doubt that most adoptees struggle with PTSD, but I am certain that some do. In any case, many children, teens, and adults deal with the “fight or flee” response quite often. I’ve read about a “freeze” response as well, that response of an inability to react, of staring, of feeling panic or anxiety. I would not minimize the trauma of adoption. Most adoptees ultimately do just fine, but some have mighty struggles. We do them and their families a disservice to minimize or deny the impact of grief, loss, and trauma.

In addition to understanding attachment and trauma, in addition to working with skilled clinicians in determining a diagnosis, art therapy can often be a significant healing tool, for wounded warriors, for adoptees, for anyone working through a profoundly painful experience.

Here’s a recent New York news story about the successful use of art therapy with soldiers.    There’s a good, brief video about the program. Here’s an example of the art:

From wwnytv.com: "Art Therapy Helps PTSD Sufferers"

From wwnytv.com: “Art Therapy Helps PTSD Sufferers”

We tend as a society to discount or minimize the mental suffering that we ourselves or others go through. We also tend to minimize the value of art in healing some of that suffering. I am increasingly convinced that art can do great things in helping create new stories, or in expressing pain in safe ways, and in then leaving the pain behind.

It doesn’t have to with artistic talent. It has to do with letting go, with letting sadness and trauma take a different form, and with easing suffering.

Source: Healing Through Art (Facebook site)

Source: Healing Through Art (Facebook site)

Here are a few related Facebook sites; click on them to see more.

Healing With Art (I got the link to the New York story from this site.)

Art Therapy Without Borders 

Art Therapy

According to the news story about the soldiers: “A permanent display of hand prints and pins will soon be on the wall of the building for all who enter to see and will include the following quote chosen by the soldiers themselves: ‘The healing of your invisible wounds begins here.’ ”

Let me say that again: “The healing of your invisible wounds begins here.”