On a good day, parenting will test the integrity of your character. On a bad day, parenting will test your will to live. Parenting children with trauma histories will cause you to test the integrity of everything and everyone you thought you knew, for the rest of your life.
~J. Skrobisz

Thursday, July 29, 2010

RADs mimics everything

I know this inherently, that RADs mimics everything. That some RADishes are diagnosed out the wazoo with mental health and developmental delay concerns. Sissy is one of them. I know that some times, when RADs is tackled head on, those other diagnoses just disappear because it was all the RADs in the first place.

But sometimes, it's not just the RADs you're dealing with and thus begins the game - do I treat the RADs or do I treat the other diagnoses? Just how do I respond to my child, anyway?

If your ultimate goal is healing by first making your child safe in the home, treat the other diagnoses medically and therapeutically, letting the RADs issue become just a component to your child's issues that you learn to therapeutically parent.

I understand that this is not everyone's accepted approach and that I may have just stuck my neck out for a lynching by making that statement. I readily accept that the tried and true RAD techniques fully embrace the fact that if you tackle RADs head on, it'll turn out that your child's DSM list of issues are nonexistent. But this momma is sitting on the other side of the fence and the grass is pretty green over here.

Every child and scenario is different and ultimately, you know your child best but let me tell you how things have gone for us. We tried EVERY, and I do mean E.V.E.R.Y. psychologically recommended approach to address Sissy's issues. 8.5 years of it. We also burned through a whole lot of meds trying to find some that would help. We just kept spinning our wheels, getting more and more frustrated with our lack of progress and Sissy's escalating rage and violence. Finally, last summer, the pdoc said, "Well, the only other thing you have left to try is RAD therapy. If that doesn't work, you may have to give her up."

That's harsh! HARSH COLD TRUTH! So we dove headlong into RAD therapy and discovered it was WAY more than we were prepared for. Just attempting the approaches casually and carefully made Sissy suicidal with homicidal rage and she won a ticket to RTC where they fully endorsed the resperidal medication regime.

RTC never got her on a stable med cocktail but with so many other dramatically severe children in comparison to her issues, I don't think the staff noticed she was still very wobbly in her moods and psychoses. After 100 days, she won a ticket home and continued to escalate. We were no closer to attachment than we were before her placement and it's safe to say, it was a few steps backward.

Then some time mid April, when I'd had enough of the crisis, I embraced a nugget of wisdom, largely due to the incredible wisdom of some of the amazing RAD moms I've met in the blogosphere. This nugget of wisdom was to address the medication issue and to not rest until Sissy was stable. THEN we would be able to see what Sissy's real issues were and tackle them therapeutically. Well, I'd tried everything else with no success so I embraced this new notion and begged for more meds.

It's been one month since Sissy has raged. One month since I've observed her 15-day cycle. One month since we've had to call the crisis team for intervention. It has been the best month of Sissy's life and that's not an exaggeration.

I'm not saying her issues are gone. They're not. But true to the wisdom I garnered, I have a much clearer picture of her needs. I used to cry myself to sleep at night not knowing if Sissy's issues were deliberate defiance or if she was legitimately impaired. I no longer wonder. Nearly all of Sissy's issues are legitimate impairment.

Some days Sissy acts like she's mentally retarded. Some days she acts like she's autistic. Some days she acts like she's five and other days we'll get the rare cognitive and lucid comments that can't be anything other than "normal 10 year old". So yes, RADs mimics everything. None of her diagnoses support any of those behaviors and yet she does them. But here's the kicker, it doesn't bother me anymore because I know it's not deliberate defiance. And on the occasions when her issue is strictly a RAD issue, I can spot it a mile away and address it therapeutically in a productive manner. The result? Sissy is attaching. She's been my daughter for 9.5 years and she's finally attaching. Ya'll, 9.5 years is a VERY LONG TIME to wait for success - do not give up!!!!

I'm not going to tell you that she is no longer narcissistic, self-indulging, hoarding, resistant to hygiene or blatantly defiant while feigning ignorance. But I can tell you that she seeks affection in appropriate ways about 90% of the time now. If I took her RADQ today, I'd probably only score half of them. A year ago, we scored her for all but two (fire starting and killing animals, but since she's killed her fish recently ... lol)

Today was a classic example of RADs mimicking a diagnoses in which she and I engaged in physical touch that did not repulse her.

My friend's son is a late teen who is severely autistic. We spend a lot of time with them and most of that time is in a pool. This young man likes to be "in the deep" where he stays under water most of the time. But when he's submerged, he'll swim toward us and reach out and touch us, a physical thing he doesn't do nearly as often when he's out of the water. Bob, dip, touch, laugh, bob. This is his routine. Sissy has watched him and picked up on his behavior. Now when I'm in the pool with her, she does exactly the same thing. She swims in the deep with me and underwater, touches my feet, my shoulders, my arm. She caresses me, hugs me, and asks to be held or touched back. We don't talk, she just touches. Today she gave me a two minute back massage, all while she was underwater using her snorkel to breathe. Wow. WOW! That was amazing.

Clearly Sissy isn't autistic, neither is she non verbal or cognitively impaired. But by letting her mimic those behaviors, we've been able to do some pretty significant RAD therapy unobtrusively. Read - no paybacks.

I'm not a psychologist, therapist, psychiatrist or RAD guru but I can testify that medicating the psychologically diagnosable mental health and developmental delay issues makes it possible to begin useful RAD therapy that has far reaching results with very few negative affects. Yes, some of the other diagnoses on Sissy's list are legitimate health issues and many of them are just the RADs but I'm no longer concerned about it. My ultimate goal for Sissy no matter how we get there, is healing in whatever capacity that is for her. I hope you can find your path too. I hope our experience lends a helping hand.


Bren said...

Truly wonderful post. You have a great understanding.
Thankful that Sissy is not raging. Whatever you are doing, keep it up....though we all know what works for a while may not work forever. It sounds, though, like you may have gotten just the right med to help her control herself.

J. said...

I am big fan of the school of " whatever works" is the best therapy there is.