Tag Archives: PTSD

Small Town Football, Schizophrenia, and Transracial Adoption: A Devastating Perfect Storm

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In the U.S., we have lots of small towns where high school sports are entrenched. There are many traditions, and much enthusiasm, for the games, the players, and the coaches. Playing high school football is tough work: memorizing dozens of plays, completing and repeating complex drills, working through pain, following instructions that are yelled, living up to history and traditions of the team. Sometimes there is also character building, camaraderie, and excellence in sportsmanship.

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Dietrich High School football team practice

I can understand why young men in high school, especially in a small town, would want to be on the football team. I can understand why those who didn’t play sports would feel like excluded outsiders. Take tiny Dietrich, Idaho, for example. Why not try out for the Blue Devils team? The whole town (all 330 people) would know and maybe love you.

 

If you were part of an unusually big (25 kids) family, your family was the main reason the town had a black population at all, and you were a black 17-year-old who wanted to be part of the team and the town, maybe you’d try out for football. Maybe your only role models for black men were pro football players that you’d seen on tv. Maybe you’d hope to fit in, be part of a community where, as a transracial adoptee, you felt like an outsider, an “other.”

I get that.

What I don’t get is why a teen with disorganized schizophrenia would be considered by his parents or his coaches as a good candidate for lineman on a small high school football team.

The adoptee’s mother has said in news reports that her son, adopted at age four, was exposed to drugs and alcohol (Fetal Alcohol Effect or Syndrome?) before he was born, and was diagnosed with disorganized schizophrenia. “He struggles to carry out tasks that involve a sequence. When writing the first sentence of an essay, for instance, he may forget the point of the project. He carries this huge backpack” full of all his books so he can be sure to have the one he needs, the teen’s adoptive mother told news media.

People with disorganized schizophrenia have disorganized speech and thinking, and grossly disorganized behavior, They often have a flat affect, and inappropriate emotions and facial responses. Treatment for disorganized schizophrenia is more difficult than most of the subtypes of schizophrenia. They can be successful in life, of course–with support.

A teen with disorganized schizophrenia would not likely be safe or successful on a high school football team, unless appropriate safeguards and resources were in place, where people (coaches and teammates) were willing to work with him closely and intensely.

For this teen, playing football had to have been a nightmare. “As a lineman with the football team, the teen could seldom avoid jumping offsides; the quarterback’s play calls confounded him,” say news reports. Imagine–under the best circumstances–how that affected the teen himself, and imagine the responses of his coaches and teammates.

Add to that baseline the horrific racist taunting that (apparently) the coaches and the high school staff knew about and condoned. Add to that physical bullying in the locker room. Add to that being humiliated by teammates taking naked pictures of him on the team bus.

Add to that sexual assault by 3 teammates–a coat hanger in the rectum.

I hope that the alleged criminals–his teammates–are prosecuted to the full extent of the law, for “forcible penetration by use of force or a foreign object,” and for every possible charge. The federal criminal lawsuit will take time to wend its way through the system, as information is gathered and witnesses deposed. I wonder if one of the witnesses will be Hubert Shaw, who owns Dietrich’s feed lot, and is related to the main defendant, John Howard. Shaw is quoted saying about Howard and the other two defendants: “They’re 15-, 16-, 17-year-old boys who are doing what boys do.”

The adoptive family has filed a $10 million civil lawsuit, and that will no doubt take a long time to settle as well. The Dietrich school system has a $2 million annual budget. Maybe they have a lot of liability insurance. I don’t know how that works. I am heartened that the Dietrich School coaches, principals, and other staff members are explicitly named in the suit. They must be held accountable. Everyone who let this teen down in such a cruel, traumatizing way must be held accountable.

The mentality of small town sports can be overwhelming and consuming. Football is a tough, unforgiving, complex sport.

Adoption is complex, and can be traumatic. Children adopted at older ages (and 4 is older in adoption) have likely gone through some difficult experiences, or otherwise would not be placed for adoption. Adoptees often need and can benefit from clinical and other support services, especially in the teen years.

Transracial adoption has its own challenges. A good adoption agency and any adoption-competent licensed therapist would recommend that families have access to resources, role models, racial mirrors, same race mentors, and a deep understanding of racism (both on an individual and systemic level).

Treatment of mental illness often involves medications, therapies, counseling, and other services. Schizophrenia is particularly serious. I agree that stigma needs to be removed from mental illness. But mental illness is real, and should be treated with appropriate care.

There’s so much misunderstanding of special needs and of mental illness, of the realities of racism for people of color, and of the complexity of adoption. What a devastating perfect storm for this teen in Idaho.

 

 

 

 

 

October, Traumaversaries, and Hope

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T.S. Eliot may have called April the “cruelest month,” but I am thinking October–6 months after April–gives that notion a run for its money. October holds Halloween, and the Day of the Dead. It’s when school kids (right up to college) often move out of the honeymoon start of school, and problems start surfacing. Trees in many parts of the world change their colors, and leaves drop off. Harvest season has ended, fields lie fallow, days get darker.

An Ethiopian adoptee, the British poet Lemn Sissay, wrote this on his Facebook page a year ago today, October 9: “When October arrives, part of me leaves. I want what leaves to come back.”

A year ago today, Fisseha Sol Samuel died by suicide at 20 years of age, near the soccer fields of his college campus. I send my heartfelt condolences to his family, left behind, grieving mightily, healing slowly.

In The Wasteland, Eliot wrote that “April is the cruellest month, breeding
Lilacs out of the dead land, mixing Memory and desire…”

Memory and desire. Loss and love. The powerful combination that can firmly glue and sometimes rip apart a family, a child, a beloved soul.

We celebrate or observe anniversaries of important events. Sometimes, less official but quite real, we experience traumaversaries:  a feeling of sadness, anxiety, and/or grief around the anniversary of a trauma (experiencing a deeply disturbing frightening event). I hear this term “traumaversary” fairly often in the adoption community. Adoptive parents note that their children fall apart (crying, overreacting, withdrawing) at a particular point of year because the children had experienced a traumatic event during that time, a year before, 10 years before. Often the body remembers, even as the mind seeks to forget, and an edginess or anxious vigilance can manifest on the anniversary. I know of a young adoptee who had a psychotic episode in October many years ago; every October the fear that it will happen again, the unsettling knowledge that it happened at all, permeates the month.

It’s hard stuff. And it is real. I offer these thoughts to assure people they are not alone in and on their traumaversaries, whether in October or any cruel month. There are resources, and there is hope. Hope is being able to see that there is light despite all of the darkness, said Desmond Tutu. Sometimes we need to be the light for others; sometimes we ourselves need to look for it. The astronomer Pamela L.Gay, writing about Childhood’s Shadows, notes that “you can only be there for someone when they let you be there. You can only listen to someone who is willing to speak. You can not force yourself into any other person’s life no matter how much you may want to be there for them.

So I watch, and I wait for the moment when my extended hand will be taken. When you are ready for help, understand that I will still be here.

And on this October night, on traumaversaries, and in this cruel, crazy, beautiful world, may we watch, and listen, and extend our hands.

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Flower in Ethiopia, 2014. © Maureen McCauley Evans

 

A tip of the hat to Dr. Jason Evan Mihalko, who today tweeted the link to the “Childhood’s Shadows” post.

Another Adoptee Suicide: Unspeakable Pain

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This week I heard about the death by suicide of a young Ethiopian adoptee, reported by his US family to be about 12 years old, living in America since 2013.

My heart aches for everyone–for the boy, for his family in Ethiopia and here in the US, for all of us.

Adoption can be full of great joy, many gains, and lots of love. It can also have deep layers of grief, loss, and trauma. I do not know the circumstances of this most recent death. I do know that adoptees attempt suicide at higher rates than non-adoptees, and do so at alarmingly young ages. One source of information is Pediatrics: “Risks of Suicide Attempt in Adopted and Non-Adopted Offspring.”

My post “Suicide and Adoption: We Need To Stop Whispering” has had thousands of views in the last few days. Please take a look also at my post “Resources Around Trauma and Suicide in Adoption.” There is lots of information there about suicide prevention, depression and PTSD resources, strategies to talk about suicide awareness, and more.

Save this number somewhere: 1-800-273-8255, available 24/7, 365 days a year. Their website is here: Suicide Prevention Lifeline.

I am saddened by how many people I know in the adoption community who have considered suicide and who have attempted it. Almost everyone in the adoption community knows personally of adoptees who have died by suicide.

Let’s keep talking about the realities of depression and trauma, and encouraging others to talk about their loss and fears, especially around adoption, without judgement or dismissal. It’s tough stuff. We have to do it.

There is a GoFundMe account for the family of the young man who died by suicide. Since I’ve been asked about it several times, here is the link.

May everyone find compassion and healing.

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Candles at a Vancouver BC Church. © Maureen McCauley Evans

 

 

 

 

 

 

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.

 

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

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.”