This question came from a friend who had opened her home to a young woman I’ll call Anna, who was attending a summer program in her community. My friend wanted her guest to be comfortable; she wanted to make sure that some of Anna’s favorite foods were on hand, that she had the information she needed to navigate the public transit system, and that the family’s schedule meshed with Anna’s school schedule.
“When I ask what kinds of snacks she’d like or if there are foods that she really likes or dislikes, she just shrugs and says, ‘Anything is fine.’ When I noticed she didn’t eat any of the cake I had for dinner one night, she apologized that she really doesn’t like nuts all that much. We could easily have had a dessert without nuts. Maybe she’s just trying to be polite but it seems like more than that. It’s confusing not knowing!”
Anna grew up in foster care. She had lived in seven different homes. It seemed that during her tenure in the child welfare system Anna, like so many foster children, had learned either not to ask for what she wanted or had not learned how to tell people what she wanted or needed.
Sometimes foster children don’t actually know what they want or need because no one has taken the time to help them identify their likes and dislikes.
Image courtesy of Sebastian Garnier.
Telling someone what you want is risky business. Letting others know what’s important exposes you. It leaves you vulnerable to disappointment, but it also leaves you open to all of the feelings that come up when your needs or desires are met.
Suppose Anna had risked telling my friend that she really didn’t like nuts. What if her hostess had ignored or forgotten that information? Would Anna have to eat the cake anyway so as not to embarrass her?
If nuts were banished from the family table during Anna’s visit, would others in the family be annoyed with her? Would she feel guilty for imposing on everyone? Maybe it’s better just to avoid the question.
This is a small and seemingly inconsequential example of the choices foster children make all the time. They choose, whether consciously or unconsciously, just to put their needs and desires aside rather than risk the pain of having them ignored or forgotten. Even worse, sometimes, having them met—leaving them feeling guilty, burdensome, obligated, or overcome with longing for even more gratification.
As for the other player in this interaction, my friend’s reaction is not uncommon. From her perspective, she was just asking for a simple bit of information. She didn’t want to have to ask two or three times.
She didn’t want to have to worry that Anna was not comfortable in her home. She found herself increasingly distressed by what felt to her like a lack of cooperation from Anna.
Image courtesy of findingtheobvious.
From our conversation, my friend understood that Anna’s reluctance to offer the requested information might be an act of self-protection. She sensed that she had withdrawn a bit from Anna and that she had dampened her earlier enthusiasm about Anna’s visit. She renewed her efforts to be a gracious hostess and make Anna’s stay as pleasurable as possible.
This was only a brief summer stay. Anna was not in a home with a foster parent whose annoyance might eventually build to the point of her being moved along to a different placement. We don’t know the reasons behind Anna’s reluctance to make her desires known. We do know that this particular self-protective stance makes it difficult for her to engage in the kinds of relationships that would meet her needs and wants.
By Toni Heineman
For children who have to leave parents behind and enter foster care the caseworker is one person who can bring stability to their lives. As Alexus Colbert writes about her time in foster care, caseworkers who are can and do make an important difference for children whose lives are filled and uncertainty and loss.
Alexus also reminds all of us that repeated losses make children wary of forming new attachments as a means of protecting themselves against the pain of being left again. “It is better to have loved and lost than never to have loved at all,” begins to wear thin when the pain of the first loss is compounded by another and yet another.
They, like Alexus, begin to wonder why they should open themselves up to caring about a new person if the chance of that person staying around is small. It is extraordinarily sad that we put foster children into situations where they learn to harden themselves against love by the time they are five or ten or twelve years old.
One of the many unfortunate consequences of shunning relationships with adults is that children become prematurely self-sufficient. They don’t want to risk the vulnerability associated with wanting or asking for something. Sometimes it’s not that they need help—maybe it’s as simple as not asking for or accepting an adult’s offer to read a story or join them on a trip to the park. Relationships are built on small interactions like these.
Photo courtesy of Steve Kay.
Caring exchanges that happen over and over again bind people together. The foster mother who gently braids a child’s hair, the caseworker who brings a favorite snack on visits, the teacher who offers a smile of greeting all tell the child with their actions that they care, that the child is important to them.
The child will come to count on them, to believe in her importance to them. But if one leaves unexpectedly, her belief that she was important may be shaken. It is not only the frequency of the losses experienced by foster children that is disquieting but their unpredictability. For example, elementary school children expect to move on from their teachers at the end of a school year; they can prepare themselves for a parting of the ways. However, it is a very different experience if the teacher leaves with little or no warning in the middle of the school year. That will be a much more unsettling experience for the students.
Unlike the loss of a teacher, which is shared by all of the students in a class, a child’s loss of a foster parent or caseworker is often a solitary experience. Even though the caseworker, like the teacher, may be leaving many children behind, those children may not know or have any contact with each other.
One of the very saddest hallmarks of life in foster care is its solitary nature. Foster children are surrounded by people who have responsibility for bits and pieces of their care. Because there is no single person to keep them in mind, they learn too early keep their minds to themselves. That is a very lonely way to grow up.
We at A Home Within know that we all like the feeling of being in kept in mind. When someone smiles and says, “I’ve been thinking about you,” we know that we have been held in the mind of someone who cares about us and that we don’t actually have to be with that person to continue to exist in his mind. When a child is greeted by a caseworker, or foster parent, or therapist with “You’ve been on my mind,” she can relax a little, knowing that someone cares enough to think about her, even in her absence.
By Toni Heineman
We know that holidays are not always merry and bright. Certainly, we are acutely aware of that this year, with the tragedy of Sandy Hook still fresh in our minds as thoughts of the devastation wrought by Hurricane Sandy had barely been absorbed. For many, the holidays will provide a distraction from the enormity of the losses that these events inflicted on families and communities. For others, the holidays will be painful reminders of what has changed and what is gone forever.
Children and families in communities struck by tragedy will be joined in mourning, rather than celebration, this holiday season. The somber mood of the community will reflect the sadness of its members. We are saddened, not only by their losses but also by the knowledge that this season now will always come with memories of the first holiday without those they loved.
Those children whose losses have been more private may find themselves unsettled by the holidays in a somewhat different way. If everything around them—music, decorations, and bright lights—seems virtually to demand that they share in the holiday cheer, how are they supposed to understand their feelings of loneliness or sadness or longing for better times? Even if the hurt is not of the magnitude caused by the death of a sibling, or parent, or the destruction of one’s home, recent losses can easily disrupt children’s participation in and enjoyment of the holiday season, especially if they feel that there is no one to share their painful feelings.
Photo courtesy of h.koppdelaney.
Parents who have recently separated in preparation for divorce may find that their efforts to maintain holiday traditions do little to calm their children’s anxieties about how they will manage to keep their favorite toys and books in two different homes. Recognizing that their parents are working hard to be cheerful, they may feel as if they have to keep their sadness and anger to themselves or that there is something wrong with them for having those feelings at all.
Children in foster care, especially if they have recently been moved into a new home, may also feel terribly alone and confused during the holiday season. Perhaps they are the only foster child in a family joined by biology, or the newest of several foster children who have been together long enough to understand the rules and workings of the family. If they are still making the psychological transition from their own biological family or a previous foster home they may simply feel too apprehensive and disorganized to join in any festivities, thereby only intensifying their sense of isolation and loneliness.
We wish that all children could share the many joys of the holiday season—the warmth that comes from being with family and friends and the pleasure that comes from giving to others. We are also sensitive to the fact that for many among us, the holidays are a time of feeling set apart from the spirit of the season. Our hearts go out to those whose holiday memories bring more sadness than joy and our earnest wish for them is that they find themselves close to caring adults who will be even more acutely aware of their special fragility during this season.
By Toni Heineman
All too frequently, the Referral Coordinator at A Home Within receives calls like this one from Sam*. He has aged out of our foster care system and is now homeless and struggling with drug and alcohol use.
Sam: You told me to call you if anything changed in my situation. I’m having a really hard time right now. I am living out of my car, I’m trying to stop using drugs and have lost my best friend. I know I’m not at bottom yet, but I can see myself getting there and I don’t know where to start.
A Home Within (AHW):
I’m really glad you called. I’m afraid that right now we still don’t have an available therapist we can match you with.
Let’s see what we can do to get you some support more immediately. Do you currently have a place to sleep?
Photo courtesy of Don Hankins.
Sam:
Yes, I’m alternating between sleeping in my car and at a friend’s.
AHW:
OK, let’s connect you with some housing resources so you can have more options. Can you describe your current drug and alcohol intake?
Sam: No hard drugs, but I’m drinking a lot and smoking pot. The problem is, every time I do, I feel terrible about it and ashamed that this is how I am getting by. I don’t really have a home to go to, which it makes it harder. I can see myself having some kind of an addiction in the future if I don’t change things. And I’ve been trying. I have. it’s just not working.
AHW:
OK, what I’m going to do is give you the telephone numbers of some places that specialize in substance use. They may not be long-term services, but can be helpful until we can get you matched with one of our long-term therapists. How does that sound?
Sam:
Do you know how long I’ll have to wait to get a therapist?
AHW: I’m sorry, but at this point I really don’t know. We’ll do the best we can.
Photo courtesy of scribbletaylor.
Sam: OK, thanks. I wouldn’t have known where to go.
Someone gave me your number and said I had to call you. I’m so glad that I know this place exists, now. I can’t do this without help.
Sadly, Sam’s predicament is too common. The unmet mental health needs of foster children and youth are extraordinary. By some estimates only 25% receive treatment. This year we have been able to match 50% of those referred to us. That’s better, but we still have work to do.
*Name has been changed to protect client identity and confidentiality.
By Toni Heineman
The hunger of parentless children is palpable, as a visitor to a Haitian orphanage captured so eloquently in her blog. Unfortunately, we do not have to travel to watch children who live without families beg to be held—both physically and emotionally. Children in our foster care system, who have been separated from parents who are unable to care for them may not live in orphanages, but they may live with many different families—none their own, over many years in foster care.
Some fortunate children find “forever families” through adoption, but many never have the certainty of knowing that, at the end of the day, they will return to the same home they left in the morning and that they will do this day after day and year after year. This kind of uncertainty depletes children’s resources, leaving them emotionally impoverished. Even when in the care of loving foster parents, the abiding knowledge that they could be moved at any moment, leaves them longing for unbroken connections.
Photo courtesy of Szadok.
Like the Haitian orphans who declared their visitors to be “my mommy,” “my daddy,” foster children, in an effort to assuage the gnawing hunger for family, often quickly attach themselves to people they barely know. Paradoxically, these premature attachments leave children even more vulnerable to loss. They fall in love quickly and repeatedly, only to be left again and again by people who are confused and overwhelmed by the intensity of feelings they have aroused in children who hardly know them.
Children simply must have stable relationships with adults who love them in order to thrive. Granted, some children will leave orphanages or foster care, having learned to care for themselves well enough to lead successful and satisfying lives, but they will never entirely leave behind an emotionally impoverished childhood, in the same way that children who have grown up without adequate financial resources will understand poverty with their entire beings—not just as an economic, social, or political concept.
Tomorrow many of us will gather to enjoy food and the companionship of friends and family. It is a time to give thanks that we can satisfy, not only our physical hunger, but the deeper hunger for connections to those we love and care for and who love us in return.
*These are the words of a contributor to Mamapedia describing her visit to an orphanage in Haiti.
By Toni Heineman
It’s been several days since a colleague alerted me to a lawsuit that has been filed in South Carolina by the parents of a child who was adopted from the foster care system. I have been unable to understand how the foster care system could have failed a child so utterly and completely.
According to this report a child who is now eight years old entered foster care at approximately three months of age and remained there until adoption about a year and a half later. Initially, that would seem to be a story with a sad beginning and a happy ending.
However, tragically, those in charge of “M.C.’s” care decided that this child should be raised as a girl, not merely treated as a girl, but made to look like a girl. M. C. had been born with ambiguous genitalia—with both male and female reproductive organs—but at the age of sixteen months, sex-assignment surgery irreversibly altered that and M. C. officially became female. The problem is that M. C. feels like a boy to both himself and his parents, but his body has been permanently disfigured.
Setting aside, for the moment, the prevailing expert opinion that genital surgery should only be undertaken when the child has clearly and consistently identified as male or female, one is still left to wonder what compelled those in charge to inflict needless physical and lasting emotional pain on a child too young to understand what was being done to his body or why. How did this happen? One can only wonder how the decision was made? Who participated? Surely there were multiple people involved. Who had the final authority? Was this a result of “team decision making,” that relies on all of the important people in a foster child’s life to make important decisions?
What makes this all the more baffling is the rush to permanently alter this child’s body when adoption was on the horizon. Would it not have made sense to allow the adoptive parents to determine whether to raise their child as a boy or a girl? And if the parents noticed only a few months after the surgery that M.C.’s behavior and preferences tended more to the masculine, was this not at all evident when he was in foster care?
Those in the foster care system are repeatedly called upon to make very difficult, often life-changing decisions about children in their care. For example, it can take years for a parent to recover from the drug addiction that caused her permanently to lose custody of her child.
Yet, freeing the child for adoption may have seemed like the best or only realistic course of action at the time—and may ultimately have been. In another instance, a decision is made to return a child to his parent’s care only to have him turn up in an emergency room with broken bones following a severe beating. Only in storybooks can we turn back to the decision point and try out a different ending.
Sadly, those in charge took it upon themselves to write a premature ending for M.C. He was not given time to say “no,” or to put words to his feelings about being a boy or a girl or both. The story might have had a happier ending if M. C. had been allowed to be the author of his own life.
By Toni Heineman
Suppose that you are a foster parent with four children in your care. One of the children is excited about going trick-or-treating. One child knows nothing about the holiday. One comes from a family that does not celebrate the holiday for religious reasons. The fourth is a new arrival who is easily frightened and who erupts into panicked screams when her foster sister disappears behind the mask that transforms her into a witch.
You want to create happy memories for all of the children but crafting an event that includes everyone does not seem as simple as one might wish. Is a trip to the Pumpkin Patch a Halloween celebration? Is the scarecrow the family makes for the front yard more frightening than fun? Given all of the difficulties facing foster parents who are trying to bring order and stability into the lives of children who have been removed from their families because of abuse or neglect, these could certainly be seen as a trivial issues. However, for foster parents who understand the importance of ritual in creating a sense of family, matters such as these can loom large.
Photo by: Urbansoup.
Foster parenting is not easy, particularly for those parents who open their homes to several children. Chances are good that they will come from different backgrounds, and bring with them not just different expectations about holidays and whether or how they might be celebrated, but from varying communities. The suburban parent who takes in a child who has lived in a city tenement may discover that the quiet of the new neighborhood is unnerving rather than comforting and interferes with the child’s sleep. The family who bows heads in prayer and spends most of Sunday in church may find themselves with a confused and ill-behaved foster child if this is her first exposure to formal religion.
For foster parents who want children to feel part of the family, it is natural to include them in the family’s traditional holiday celebrations. Yet, paradoxically, rituals that are unfamiliar to the child may make her feel like an outsider, rather than one who belongs. As a result, she may deliberately exclude herself from the festivities or disrupt them by acting out—thereby ensuring that everyone shares in her misery.
Halloween ushers in the fall and winter holidays with parents anticipating a rising tide of activities—some welcome and some not. For foster parents this season often means a rising sense of anxiety, as well, as they attempt to help the children they care for feel at home with them and yet still connected to their families of origin. Foster parents always need community help and support, but particularly at this time of year.
By Toni Heineman
This is the complaint of a foster mother who last month had three-year-old Jesse delivered into her care. Not only will he not sit still, he fidgets while she is trying to read him a story and gets up from the dinner table without asking. He frequently bumps into things when he wanders around the house because he doesn’t watch where he’s going. He has trouble falling asleep and often wakes, crying, during the night.
He squirms when she is trying to dress him. He quickly loses interest in activities. She is beside herself because he just doesn’t seem to pay attention to her. She tells the caseworker that she thinks he should have medication for
ADHD to help him calm down.
Jesse was placed into foster care when he was found roaming the halls of a residential hotel. His mother had left him with a couple that had recently moved into the hotel, saying that she would pick him up later that day. Two days later, she still had not returned.
This is Jesse’s third foster home in the last year. He has been removed from the two previous homes because the foster parents were unable to manage his behavior. If, as is likely, his caseworker is beginning to panic that she will have to remove him and find yet another placement, it is quite possible that Jesse will be taken for an evaluation of ADHD and receive medication to help him “calm down.”
Photo courtesy of electrictuesday.
Jesse certainly does need help in calming himself. He is, after all, only three years old and needs the reassurance of adults to manage his understandable anxiety. From what little we know of his history, we can reasonably assume that Jesse has had little experience of being comforted by a reliable adult. Not having been soothed by another, Jesse is unable to soothe himself. Not only is Jesse’s three-year-old neurological system developmentally immature, the lack of care and instability he has endured in his young life has likely resulted in his cognitive, social, and emotional development lagging considerably behind what we would expect of a well-cared for child of his chronological age.
Of course Jesse can’t focus. Why would we expect that he could? He’s a kid—a child who has had a traumatic introduction to life. He is a child who has every reason to be anxious—to be constantly on the lookout and on the move. And yet, there is a significant chance that he will be given medication when what he needs is a stable caregiver who can lend him her calm mind and soothing presence. Jesse needs to be held and rocked. He needs to hear lullabies and comforting words. He needs to see smiles and bright eyes when he looks into a loving face. This is how Jesse will develop a mind of his own.
It is likely that Jesse is no more able to control his mind than he is to control his behavior. However, when we rush to medicate children’s brains, we fail to attend to their minds. And when we turn to substances to control behavior we would do well to remember that “a mind is a terrible thing to waste.”
By Toni Heineman
Over the last twenty years we have been amassing evidence that negative experiences in early childhood have life long deleterious effects on physical and emotional health. Early maltreatment results in years of emotional pain, chronic illness, and, too often, premature death.
As David Brooks reminds us the multiple lenses through which we have been able to view the initial findings of the survey of over 17,000 patients at Kaiser Permanente have contributed to an increasingly sophisticated and nuanced understanding of the wide and long range effects of early adverse experiences. In some ways, the knowledge that the more children are exposed to adverse experiences—such as divorce, a substance abusing parent, abuse, domestic violence, or significant contact with an adult with serious mental illness—the more they will suffer has been woven into the fabric of our understanding of child development.
However, this knowledge has not been well integrated into programs designed to prevent or treat maltreatment. The reasons for this are multiple and complex and must draw on an appreciation of individual psychology, systems theory, the interface of political and economic forces and historical shifts in the ways in which we view children, maltreatment, and individual responsibility.
Photo courtesy of Natesh Ramasamy.
Although we know that adverse events in children’s lives rarely occur in isolation, we too often create programs designed to address a single issue or, recognizing that there are multiple problems, we introduce “wrap around” programs that bring together a team of experts to address the identified symptoms. Unfortunately, these professionals rarely have the time or funding to address the underlying issue, which often could best be described as chronic and unrelenting family and community chaos.
Consider, for example, children in the foster care system. The overwhelming majority of foster children have been removed from the care of their parents because of physical neglect (one of ten adverse childhood experiences). However, neglect typically results from parental substance abuse and/or mental illness, each adding an adverse experience and, most likely emotional abuse, adding yet another. Taken together, it is not difficult to imagine a child living in an environment that is wildly unpredictable with no certainty about the parent’s mood from day to day or hour to hour, no reason to assume that dinner will be on the table or that the night will not be interrupted by angry shouting.
For these children, whose lives are rife with adverse experiences, the whole is greater than the sum of the parents, particularly when the events stretch over weeks and months and even years. When they enter the foster care system, they need not only physical and emotional safety, but the security and sense of well-being that comes from a consistent, stable, caring relationship. Instead, they are often introduced to multiple people—each of whom has an important role to play—but none of whom is fully responsible for the child. This is not to discount the importance of what caseworkers, foster parents, attorneys, educational specialists, therapists, and community volunteers have to offer foster children.
What is missing for these children is the parental mind that mediates all of the child’s experiences—positive and negative. Without that single mind, the child lives in a fragmented world with no means of creating a coherent narrative. This is echoed in the systems that are supposed to be addressing the problems; they work in silos—sometimes at cross purposes, whether strategically or inadvertently.
Brooks suggests that we might begin to address these issues by bringing people together. That might be a first step or it may be just one more conference that sounds important and accomplishes little. We must not just talk about the importance of early experiences and children’s need for healthy relationships in order to thrive. We must integrate this knowledge into the fabric of every institution and program. Until we shift our culture to one that supports children and families we will continue to pay the price of psychological and systemic dysfunction.
By Toni Heineman
Many years ago I was asked to make a recommendation to the court about the fate of a toddler whose mother had been raised in foster care. Mother and daughter arrived at my office and immediately headed for a basket of toys. Sadly, the mother was more interested in playing with the toys herself than in helping or enjoying her daughter’s play. Over several sessions over a number of weeks, it became painfully clear that this young woman was totally unprepared for parenting and, sadly, seemed unable to use any help that others or I offered. If her parental rights were terminated, chances were very good that she would have another baby and end up repeating an evaluation in a matter of a couple of years. If they were not, her daughter would most likely grow up in foster care with intermittent returns to her mother during protracted attempts at reunification and family preservation.
Imagine yourself in a similar situation—a sixteen-year-old girl—with a six-month-old baby. As an adolescent you are developmentally on track if you are working to define yourself as a person in relationship to your family, friends, and community. It takes years of experimentation with different ways of being in the world until the uncertainties of adolescence gradually coalesce into the more comfortable sense-of-self that begins to unfold in early adulthood. That’s all fine for the sixteen-year-old, but what about the baby?
The six-month-old is also trying to figure out how she fits into the world. She is learning to recognize different physical and emotional states and to signal her needs to her caregivers with increasing accuracy. Although she is busy exploring the world, developmentally, she sees herself at the center of the world and, as such, expects that her needs and desires should be first and foremost.
Of course, as a teenager, her mother is also preoccupied with her own needs and desires; this is part of the developmental process of self-discovery. Adolescence is hard; parenthood is hard; adolescent parenthood is even harder. Teen parents who have grown up in foster care and face both adolescence and parenting without parents to guide them are facing a formidable task, indeed. It is hardly surprising that the children of these young parents are five times more likely than other children to enter the foster care system.
Photo courtesy of storyvillegirl
Over the last few years important legislation has recognized the need for late teens and young adults to have the safety net of foster care beyond the age of eighteen. However, that system now finds itself responsible for the young parents who are among that group and there are many; fifty percent of young women in foster care will be parents by the age of twenty-one.
California’s State Senator Leland Yee and the John Burton Foundation are to be congratulated for their work on legislation to help address the unmet needs of this population, including providing subsidized childcare so that parents can complete their education and improve their chances of moving themselves and their children out of poverty. Of equal importance is the provision of education about sexual and reproductive health, which has been shown to decrease the chances of subsequent pregnancies.
As the child welfare system works to educate caseworkers, transitional housing staff, and others working with youth in extended foster care, they must now meet the additional challenge of offering training and support to the adults working to help young parents and their children. It is crucial that the adults charged with supporting young parents have education about the changing developmental needs of infants, toddlers, and preschoolers as well as the needs of their parents, who are entitled to attention to their growth and development along with parenting support.
These are beginnings. But we must remember that the neither the young parents in foster care nor their children can afford for us to take baby steps. We must make courageous strides if we are to break this cycle of loss.
By Toni Heineman