Note: This series of posts illustrates the early childhood experiences contributing to attachment issues in adopted or biological children. While this story is fictional, the majority of children suffering from attachment issues will have experienced much of the trauma written about here. The childhood trauma, as well as behaviors depicted, are common in lessor or greater degrees to the majority of children treated at Zion Hills Academy.
Mariana remained in the hospital in the psych ward for 10 days following her failed suicide attempt. The doctors were trying to get a handle on her medication, which consisted of two drugs to ease her anxiety and another for depression. Differing from many other patients, Mariana did not appear to be as bothered by the effects of her meds. Instead, Mariana had such little connection to her emotions, that not feeling wasn’t particularly noticeable.
Mariana paced like a caged animal in circles past the day room, the nurses’ station, the bedrooms, and the solarium. She was surrounded with people completely unlike her - old and fragile, hollering from wheelchairs; as well as many others who were clearly not right in the head. Mariana longed for a cigarette. The social worker was due to meet with her later that afternoon. Mariana hoped that her mother would forget to visit that day.
Aside from monitoring her change in medications, there wasn’t real therapy happening at the hospital. Every day brought new therapists, doctors, and nurses. Mariana sincerely felt that she really didn’t need these nutcases around her. In the hospital, she felt like nothing offered would forward a greater level of functionality emotionally and spiritually.
The skills that Mariana had to learn would be a process that could take years; the first step of which was to find a residential facility that was a good fit for everyone.
Carrie had been talking to Dr. Hornbeck, Kyle, and the staff from Troubled Teen Assistance. Everyone involved in this conversation agreed that a residential treatment facility with longer term and more extensive care was the next step for Mariana. Carrie hated to think of sending her little girl off for a longer stretch of time, but the prospect of returning Mariana to their home was equally as frightening. Carrie knew that in order for Mariana to feel and understand real love, the commitment for years of intensive residential therapy was essential. Together, the team helped Carrie to find a facility that was about six hours away, in Utah.
Carrie left Dr. Hornbeck’s office with the brochure tucked under her arm. As she got into the car, she finally let out the breath she had been holding since leaving the office. Sobs wracked her body, and a few tears fell onto the brochure, causing the ink to run a little.
After a few minutes Carrie was able to steady herself emotionally and pulled out the brochure to learn more about the treatment center. It showed happy-looking girls with big smiles posing on a trail during a hike through one of Utah’s canyons. Reading through the remaining information, she saw that in addition to the extensive individual and group therapy, the facility offered Equine Therapy, Cognitive Behavioral Therapy, EMDR, various types of experiential therapy, a fully functional school program, and more, in the gorgeous setting of Southern Utah.
Carrie spoke to the financial aid advisor at the academy to learn more about the different types of funding sources available to her. After considering IEP funding through the school district, and Carrie’s insurance, they found that Mariana was eligible for funding through the state of California. Kyle was able to get county approval for the Adoption Assistance Program funding which would cover all of Mariana’s treatment costs. The program was available to parents who had adopted a child through the state of California.
From the hospital, Carrie would have to take Mariana directly to the treatment center. She had lovingly packed Mariana’s favorite clothes, toiletries and a stuffed bear. The six-hour drive was spent mostly in silence as both Mariana and Carrie worried about this next chapter. Mariana resented yet another move. She hated being forced to interact with a whole group of new people she didn’t know or trust in the slightest. Mariana believed, deep inside, that her time with Carrie was over and would never see her again. So many times in her short life, Mariana had found herself whisked away by social workers to the next group of strangers. Today was just another blow to her already fragile psyche.
Carrie felt anxious and afraid, wondering if yet another solution would end in more pain, anguish and, ultimately, a complete failure. Carrie ached looking at the “tough girl” face of her baby. Mariana seemed almost cold. The conversation was sparse, each woman lost in a different hell.
Late in the afternoon, Carrie pulled up in front of a large house - from the outside it looked like a normal multi-family residence. The treatment center made every effort to create an environment that would be as close as possible to the kind of life the girls experienced in their homes, so that the transition back was close to seamless.
A fifty-ish woman greeted Mariana and Carrie at the front door. She introduced herself as Melissa Smith, and would be Mariana’s therapist during her stay. Everyone shook hands, Mariana rolling her eyes slightly. Carrie felt emotion welling up but forced herself to be strong and not let it show.
Melissa gave them a tour - showing Mariana and Carrie the layout of the home. Melissa explained that when it came time for school to start in a couple weeks, the girls would ride to and from the location in a van. This would also be the case for trail hiking as well as the Equine Therapy that was held weekly.
Carrie was quite impressed at all they had to offer; it felt like the perfect place for healing and becoming whole. Mariana of course remained aloof and standoffish; she didn’t trust anything or anyone in this new place. After bringing a couple small loads to Mariana’s room, Carrie left, per Melissa’s suggestion. It was time for Mariana to settle in and get accustomed to her new surroundings.
Walking back to the car, Carrie refused to turn back and look at Mariana, lest she change her mind about the placement. Carrie knew enough to know that Mariana needed to be at the treatment center in order to heal. Carrie also knew that she had to bring Mariana there so that Carrie could begin her own healing. Discuss the setup of residential treatment center.
Mariana at first had one roommate, Stacy, who had been at the treatment center for almost a year, was 15 as well and would be in the same class as Mariana. Stacy was friendly yet guarded, typical for many of the girls in this setting. Even after years of work, the early defensive instincts remained, never completely going away in some cases. As a ‘veteran’ of sorts, Stacy would be able to guide and mentor Mariana through her first days and weeks.
Night was not a good time of day for Mariana - certainly she was tired enough and needed to sleep, but it didn’t come easily. As soon as she closed her eyes it was as if her very existence became less real. She could not sense herself in her body, which made her very uncomfortable. These feelings of anxiety caused her to lay awake for hours every single night. It was absolutely exhausting.
In front of staff, Mariana acted ambivalent toward her more-than-adequate surroundings. For her, this was just one in a series of terrible places where she didn’t want to be and had ultimately no choice in remaining here for now. Mariana’s mind never stopped looking for a way out, however, during that first 24 hours.
It seemed that there were a million rules. Mariana walked the halls of the house like she owned the place and didn’t let on any of the isolation or fear she felt. One thing was for sure - her attitude established her to the other girls as not one who should be messed with. Mariana wore a mask that no one would see underneath if she could help it.
The first several days were a flurry of activity - pretty much not a single waking moment was left without a very specific plan, even where it concerned quiet time. After breakfast, the girls boarded the Academy’s van to spend the morning in Equine Therapy or some type of exercise - hiking a nearby trail through the canyon, running or walking at a local track, or going to a the gym. Back at the house, they took turns helping in various functions - cooking, setting the table, clearing and washing dishes and general cleaning duties. Afternoons found the girls engaged in school, and evenings were spent in group and individual therapy and free reading time. Every day was some variation of this and went on in similar fashion for the first two weeks.
After daily private sessions with Melissa, the first order of business was to be seen by the facility’s nurse. Mariana was still coming off the meds she had been given in the hospital. The nurse and psychiatrist would reexamine medication over the coming few weeks. The general philosophy, however, was that psychotropics were only to be used in extreme circumstances. Instead, the clinical team felt that other methods were just as effective without the negative side-effects.
During the first 45 days, Carrie was not allowed contact with Mariana. She could write and receive letters, however both were read by her therapist before being sent out or incoming ones given to Mariana. As a 15-year old girl, some of the things Melissa asked her to do felt completely ridiculous. Why in the world would any self-respecting teenager have any desire to play peek-a-boo, do the hokey-pokey or put together a Mr. Potato Head?
The games were designed to take Mariana back to early developmental stages, such as permanency and constancy, that she had missed during her unpredictable childhood.
Mariana defiantly refused all of it at first, but Melissa consistently and subtly included these activities during therapy sessions. Eventually, although she never would admit it to anyone, Mariana came to enjoy this play time. Even with her head bowed, Melissa was able to see the tiniest smile creep across her face.
During the day, Mariana mostly kept herself in some control. She was quick to anger, however, and her rage spilled over the fear and anxiety and bordered on self injurious. Group sessions happened in the morning, and could become emotionally charged. To keep order, and give everyone a chance to speak the group members got in que by raising their fingers to indicate position in line. The first person raised one finger, second person raised two, and so on. As the first person in the que finished, two became one, three became two, etc. Thus, each girl was able to have a fair chance to express herself.
Melissa often facilitated the group sessions and taught group members how to use the appropriate vocabulary from the Positive Peer Culture method. Behavioral issues were broken down into twelve distinct categories which allowed peers to use the defined vocabulary in a non-violent method.
It was during these group sessions that true healing and learning happened - the girls were called upon to identify and describe their feelings, and then in response, the rest of the group would make comments and ask questions. This approach could be an extremely awkward and difficult one at first, as almost all of these girls had difficulty connecting to and expressing their emotions - although in the case of many, rage, anger and defiance were well-established.
Mariana, instead of keeping her nose clean and head down, was determined to get out of this terrible place at her first opportunity. One night, she thought it would be a piece of cake to simply run out the front door and keep on running. Certainly Mariana had been advised multiple times that there really was no escape, as every door to the outside at the facility was hooked up to a siren. Despite this fact, she was determined and made a break for it. The alarm went off, just as it was supposed to, and Mariana was caught on the front lawn, only making it about 100 feet from the door. The staff led her back to her room, surprising Stacy, who hadn’t even realized Mariana was missing until the alarm woke her.
The following day found Mariana with a ‘staff buddy’ - Ariel - who she had to stay with at all times during waking hours. Naturally, Mariana was majorly annoyed at more limits being put on her in an already over-structured environment. However it was clear that this, as well as any of the other rules in place at the treatment center were completely non-negotiable.
Mariana was not a person to surrender to authority, always finding ways to buck the system. On the way to eat lunch one day she noticed a paperclip on the floor. Looking around her to make sure no one was watching, Mariana grabbed it, slipping the paperclip in her pocket. Later that evening, it was back to one of her favorite bad habits - cutting. She ripped into her inner thighs until she saw blood flowing and was immediately transported by the rush of the pain. Mariana was finally able to forget about all her cares and worries for that few minutes, but it was only temporary. The hurt dissipated and the damage of this sick cycle of behavior simply kept her captive in sickness.
The girls were spending a lot of time together doing household chores, cooking meals and in group therapy sessions interacting and talking about very personal experiences. Naturally, this process brought about a certain amount of bonding, recognition of themselves in others and personal connections. One of the girls in her group sessions, Chelsea, had many similarities to Mariana’s story. They shared intimate details with each other about cutting - how, where, what the best tools were and to hide their dark secret from everyone. Chelsea too had come from a home in which early abuse had occurred with her biological parents and told some stories that astonished Mariana.
The two girls shared another thing in common - a general distaste for their surroundings. Both of them felt the rules to be far too restrictive and longed to go back to their preferred behavior of doing what they liked and lying about nearly everything. It had been weeks since either girl had enjoyed a cigarette, something that frustrated them to no end. They were also pretty fed up with having to go into an elaborate description every time they had a feeling, wanting instead to take solace in the practices that helped them to squash and obliterate any such things.
Melissa and Mariana had been working a lot together so that Mariana could start to understand and interact with the complex nature of her emotions and to more specifically describe them. The method used was called “Parts Language”. For example, ‘the angry part of me is a part of my scared part, which is a part of my sad part’ The process could be tedious, confusing and at times frustrating. There were moments that seemed like Mariana was developing a true understanding for her emotions, but these moments were fleeting at best. As soon as anyone ‘got inside her head,’ it was shortly afterward Mariana became defensive, angry and lashed out. Melissa had seen this before, many times, so it was all in a day’s work for her.
The next few months saw major changes in Mariana, though her overall progress was sporadic at best. After the 45-day waiting period, Carrie was able to visit during a parent weekend. She attended a family session with Melissa and Mariana and learned about the ways they were working together. Mariana seemed different to her, but not better exactly. Her precious little girl had a long way to go.
Stay Tuned For Part 7!