The trauma for Artyom continues. After having been given up to an orphanage by his alcoholic mother who lost her parental rights, being adopted by a US family, sent back to Russia alone when his adoptive mother allegedly was unable to cope with his psychological problems, he has now become the object of a tug-of war between Russia and the US over his citizenship. His future seems to hold unimaginable uncertainty for a vulnerable seven year old boy.
As this battle plays out over the coming weeks to months, I hope we can learn from this tragic tale. As a behavioral pediatrician I often see families who have adopted children out of situations similar to Artyom’s. Among the most hopeful of these is the story of Rachel and Sam.
I vividly remember Rachel’s “aha” moment. She had brought her six year old son Sam to see me because he was aggressive and defiant. Sam was adopted from an orphanage in another country when he was four. Prior to the orphanage he had lived on the streets with his abusive mentally ill mother.
When Sam first came home, he was a terrified child with little language. He immediately began to thrive. But now at six, he was wearing the whole family down. Sam would argue about everything, and frequently these arguments turned into physical battles. Rachel was exhausted and discouraged. She wanted my advice about what to do to control his behavior.
Over 20 years of longitudinal child development research has demonstrated what can happen to children who have been hurt by the very person who was supposed to protect them. This paradoxical situation leads to confused and confusing behavior in relationships with people close to them. When children fear the same person they look to for safety at a time when their brains are rapidly growing, this experience affects the biochemistry of the brain. It creates what is referred to as a state of “hyper-arousal.” This means that a child has great difficulty regulating emotions and may have an overabundance of stress hormones released in response to what seems like a minor event. They do not know how to feel calm and safe.
The adoption agency gave Sam's new family none of this information. Thus his parents were bewildered by the fact that the discipline techniques that had been so effective with their biological children failed completely. I wanted to help Rachel to understand the magnitude of the challenge she and her husband faced, while at the same time not discouraging her.
My thinking was guided by an important research study termed “The Attachment Representations and Adoption Outcome Study.” Miriam Steele and her colleagues found that an adoptive parent’s ability to understand the meaning of a child’s behavior led to a positive relationship between parent and child.
On that magical day of the “aha” moment, Rachel was feeling resigned, deflated. We were focusing on some strategies to manage difficult mornings when she began to talk about her biological children. She suddenly recalled a term from the home schooling philosophy on which they had been raised. The term was “tomato staking” It referred to the way parents stand firm while their developing children twist and turn as they grow up. A parent is always present to guide them in the right direction, and does not ever abandon them.
The image was a vivid one: these plump juicy red tomatoes, healthy because of the strong and steady stake which did little more than stand there. But, Rachel realized, Sam did not have this experience in his early years of development.
Following this visit, Rachel’s approach to Sam changed. She sought out intensive help for Sam. She realized that the whole family needed support in coming to terms with the enormous challenges they faced. Though the work was very hard, the self blame and guilt from which she had been suffering all but disappeared.
I cannot claim to understand what went so terribly wrong for Artyom and his adoptive family. But if we can learn anything from this tragedy, it is that when adopting a child who has been traumatized, it is essential for a family to have both hearts and eyes wide open. And as a country we must offer access to the help they need.
Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.