My National Adoption Week 2017

It’s National Adoption Week in England and this year the theme is adopting siblings; two, three or maybe even four. I have only two. Here’s my National Adoption Week so far. Please be warned that on our scale, this counts as pretty uneventful. 

I have my first ever session of Reiki. I chose Reiki because it’s 50 minutes of lying still and you get to keep your clothes on. If I had a full body massage I think my skin might come off. The Reiki woman says afterwards, ‘I sense you’ve had enough of explaining and talking’ and I spontaneously cry.

I meet one of my children in town. It’s something I try and make happen every week. We buy food in one of the only shops that hasn’t issued a banning notice. Then we go to the benefits office. The woman we see is kind and there is no judgement. Later I drive my child and two bags of food back to the hostel.

I see something of the lives of young people who have no one to shop for them, check in with them, catch them when they fall, grieve with them, fight for them, keep them in mind and it’s a reminder, despite its many imperfections, of what is valuable about adoption. Later I catch up with Woman’s Hour. June Sarpong says ‘you cannot be what you cannot see’ and I think ‘yeah, that’s more or less it in a nutshell’.

A letter arrives requesting that my youngest child take part in some research. The research has nothing and yet everything to do with adoption. Only a handful of kids in that particular school year were selected. What were the chances?!  I send a ‘no thank you’ email. Child is anxious until I send the ‘no thank you email’.

I respond to a document – the output of a committee I’ve taken part in. I ask if we could please nail down the rights and respect that should be afforded to ‘primary carers’. I also ask that ‘OBE’ be added after my name. I feel like a dick for asking. At the same time I’m so over being the sub-service user/sub-client/sub-whatever.

A friend contacts me in despair. Her child is out of control. Dangerous. Threatening. Disappearing. A passing professional takes the child’s word over her’s, not understanding that trauma has its bloody hands on the wheel. I’m reminded why I’m hoarse with asking for primary carers to be listened to and respected.

I’m asked if I would do it again. Adopt. My answer is more measured than it used to be. It’s gone from a bountiful and glowing ‘YES!’, to a ‘yes but’. It’s  ‘yes’ so long as there was a locked-in promise of life-long support and a much bigger dose of honesty during the preparation stage and beyond. As I’ve said before, I thought I was setting off on pleasant country ramble. What I got was an ultra-marathon I wasn’t equipped for.

We go to the palace; me, my husband and our youngest child. My child says ‘I’m so proud of you mum’ and I explain I can’t imagine myself without the love, the experience and the knowledge that both of them have given me. Then, ‘I’m so glad you’re my mum.’ We have a day that despite being tinged with loss is beyond amazing.

Adoption support – the tanker is turning

The media coverage this week, sparked by the File on 4/Adoption UK survey into adoption support has been saddening, a bit maddening and in a strange way uplifting. Uplifting because it’s the first time I can recall the knotty reality of parenting traumatised children being extensively explored and aired on mainstream media.

We adopted our children thirteen years ago when the prevailing belief was that love and boundaries would fix whatever was broken. There were few to no services within either local authorities or the health service. There wasn’t even a language with which to describe and make sense of the complex and totally unfamiliar set of behaviours that we and many others like us were faced with, some of which were reported this week. After years of bafflement and mistake-making it slowly became clear to me that what helped to make sense of the great magnificent mess of it all was an understanding of physical and psychological trauma. That realisation was like the illumination of a giant lightbulb and it has lit my thinking, my parenting and my work every since. But until relatively recently, to talk of trauma and even attachment (hardly a new kid on the block) was to risk much professional eyebrow raising and worse, being blamed.

For some years now I’ve been involved, as have many others, in the push to improve services around adoptive families, including improving the understanding of early life trauma and the provision of family-friendly, trauma-informed therapeutic services. In 2013, the then Minister for Children and Families, Edward Timpson, who crucially has personal experience in the context of adoption and fostering, secured an amount of money to trial the delivery of therapeutic services to adoptive families. It was to involve as little bureaucracy as possible, as much choice for families as would allow and would, it was hoped, invigorate a starved and conservative (with a small ‘c’) public, voluntary and private sector offering. It was an ambition of many that if proven to work, the project might widen to transform services around all care-experienced children. I was asked to join a committee to steer the design and implementation of the fund, which I did.

The Adoption Support Fund didn’t get a good rap on the File on 4 programme. I can see why the ‘this ASF is funding a load of hokey’ story stuck as surely it must make sense that therapeutic services should be delivered under the watchful eyes of CAMHS, but it’s a long way from the whole story.

The ASF funds a bunch of therapies that, crudely speaking, adoptive families like and find helpful and mental health academics and others write off as a pile of hokey being delivered by charlatans, the majority who work alone, like rogue traders. Damage could be being done, they say, funded by tax payers money. What kinds of idiots and cowboys must these adoptive parents, social workers and civil servants be to allow such awful practice to carry on, one might ask.

The ASF was born (again crudely speaking) because CAMHS appeared to be mostly absent, because it rolled it’s eyes when ‘trauma’, ‘attachment’ and ‘early adversity’ were mentioned, because it was able to declare ‘these are not mental health issues’ and ‘we do not treat adopted or fostered children’ (yes really) and because of its propensity to ‘medicalise’ and medicate symptoms and send parents on inappropriate parenting courses. It was and is also chronically lacking in funding. All this left an enormous, howling void of distress. Voids get filled, with all sorts of good and bad stuff. What happened with this void was that it got filled with the efforts and dogged  commitment of adoptive families and many of those supporting them to make sense of the behaviours, finding what improved the lives and outcomes of their children. Adopters aren’t stupid hysterics who will fall for any old horse-wash, not in my experience anyway.

What was found were the sorts of therapeutic approaches allowable under the Adoption Support Fund, many originating in the US and not evidenced to the satisfaction of UK bodies. These are approaches such as DDP and Theraplay. Many adopters who could afford to, funded these therapies themselves, some even remortgaged their homes. Word spread, conferences were attended, experiences were shared and many local authorities, recognising the value of these approaches, came on board too. Some professionals working within the NHS, such as clinical psychologists began to come across these approaches and finding them useful absorbed them into their own practice. (I know I’m explaining this mini-revolution crudely and possibly inaccurately, but bear with me.) These are some of the rogue traders that were described in File on 4 – individuals or collectives who left the NHS, for a multitude of reasons.

That’s not to say that all those practitioners being funded by the ASF are good, or that their practice is positively impactful, because lots more research is needed. It is said by some that we also need more research into some of the interventions employed under CAMHS – what’s good for the goose is good for the gander.

The ASF is the start of what promises to be a long, difficult process of assessing and embedding best practice, of encouraging more flexible, family-friendly approaches that respond to the complexity of individual need, of responding to latest findings, of ensuring that services around children are trauma-informed and of measuring long-term outcomes. I say it’s the start, but if the ASF gets written off as funding horse-wash then it risks being binned and we’ll be back where we started shouting into the howling void being pelted with CBT, Ritalin prescriptions and blame.

Changing complex human systems that sweep up the very best and worst of human experience, that involve budgets, politics and power balances is devilishly difficult. It takes bloody ages and for long stretches it can seem as though nothing is happening and all you hear are criticisms. But this kind of long, difficult work is like trying to turn a giant tanker, using a few little tugs, being fired upon by gunships. You have to stick at it.

The tanker is starting to turn. Discussions around the long term impacts of early adversity, childhood trauma and attachment difficulties are coming into the mainstream and tremendous work is being carried out around the country to support and heal adoptive children and their families. Things are unrecognisably better than when we first found ourselves grasping into the dark, being told that trauma wasn’t a thing. There is tonnes more to do for all children who have experienced early adversity for sure, but the foundations are there. Now is the time to build on those foundations, not to tear them up.

Improving mental health services for adopted children: co-production

The story so far ….

In October 2015 feedback from adopters about CAMHS services was presented to a large meeting of professionals and government officials. The feedback was the result of an informal but substantial consultation with adopters and professionals and the suggestions we made to improve services were cohesive and well thought through.

In March 2017, again in consultation those proposals were boiled down to two core principles that most agreed should be part of a good quality service that would meet the needs of adopted children and their families.

That brings us to now. This week I submitted four detailed proposals to the expert group I belong to. I’ve tried to stick to things that are achievable and affordable.  These are:

Mandatory training (initial and continuing) for all mental health professionals who work with adoptive families in complex trauma and attachment, co-produced by adopted young people and their families.

Adopted young people and their families to be embedded in commissioning and governance of mental health services and in their design, delivery and evaluation. Again, co-production.

Establishment of regional centres of excellence that specialise in complex trauma and attachment, that act as a focus for creating excellence in services and improving skills, education and research. Involve users in the design, delivery and evaluation of services. Co-production.

Development of an app for adoptive parents that encourages and supports self-monitoring of mental wellbeing. acts as a prompt for self care and records data around what helps and hinders. (Not meant as an alternative to professional support). Not very well thought out, so could be a crap idea.

NB I refer to adoptive parents throughout because these are the people who have taken part in this work. I don’t mean to exclude others who parent care-experienced children and young people, although these proposals could work across the board, I’m just taking care not to speak outside my area of experience.

Services that listen to and learn from their users, work best for those users, and adoptive families are no different. Plus we are engaged, committed and well-trained. What’s not to like?

Improving mental health services for adopted children

Some weeks ago I asked for your help in submitting user-based ‘evidence’ to an expert group tasked with improving mental health and emotional wellbeing support for care-experienced children and young people. I asked you to tell me about the clear and achievable ways in which you thought mental health services could be radically improved for adoptive families.

Your responses were full of experience, good ideas and passion. Almost everything you suggested boiled down to two principles that you told me should underpin improvements to mental health services;

  • empower, respect and ‘tool up’ families in order to improve their ability to support their children, and
  • improve professional expertise particularly in trauma and early adversity.

Many of you continue to report that when you can access child and adolescent mental health services your child’s early life experiences are not explored or seen to be relevant and you feel blamed for your child’s difficulties and disbelieved. The more experience I gain and the more I learn, the stronger my view that adoptive families, as well as others who parent care-experienced children and young people are a valuable, knowledgeable and essential part of healing and growth. It makes no sense in health or economic terms to work against the willing, the able and the emotionally invested.

Thank you to everyone who responded, including members of Adoption UK and POTATO. Thank you also to the professionals who checked out our principles and who gave encouragement and advice. Please feel free to use and share this graphic if you’d like to.

Can you empathise too much?

Can you empathise too much?

For the sake of those who are time and attention poor I’ll jump to the answer to this question.

Yes. Yes you can.

Empathy has become a by-word for feeling someone else’s pain so intensely it automatically means you are a good and righteous person and people are miraculously improved by your very presence. It’s very public, very ‘social media’ and teamed with a ’tilted to one side’ head position and a slightly unhinged sing song voice tone it really is something to crow about. But that’s “empathy” (which makes me come out in acts of imagined violence) and not Empathy.

For some of us Empathy means not only casually knowing a person who is suffering and taking them out for a latte, but living with that person 24/7, through thick and thin and shit and stinky shit. Empathy, the real deal, is a much tougher call altogether. It can run dry and require replenishment with sunlight, happiness, good books and simple carbohydrates. (And when we run dry, we risk appearing ‘cold’ and ‘uncaring’ to the latte-drinking, empathy part-timers.)

Empathy, as Dr Brene Brown explains is about taking the perspective of another and rather like climbing into a dark cave with a person, not merely peering down at them from above and shouting down nonsense.

I like that analogy. Except, there are limits.

If one stays down in that cave perspective-taking for too long it can become more a feat of endurance than a virtuous trip down Cheddar Caves. You start to forget there is any kind of life outside the cave, you develop rickets, poor eye-sight and trench foot. You might even start to own the perspective, like it’s yours. One day you may wake up on that cave floor, after a damp and disturbed night’s sleep and realise you are both trapped down there, weighed down by misery (and the rope ladder is rotting away).

I expect Brene would say this herself (in my head she drops round to my house for wine Friday from time to time and we chat and connect on a really deep level): the cave has to be reserved for short trips only and not gap years or longer stays. There are times when a trip down Empathy Caves is not even possible and not even helpful. Sometimes chucking down a head torch and a Bounty and saying ‘it’s sunny up here, why not come and join me when you’re ready’ (in a non-sing song voice) is the best we can do.

Things I learned in 2016

Most Decembers I write a light and reflective round up of the year. As I’ve been as yet unable to digest the events of 2016 and am still bouncing from despair to mild optimism and back again, sometimes within a matter of moments, I’m going to stick to something far simpler. Here’s a list of shit I’ve learned about this year.

  1. Turns out cutting down carbs does in fact help you lose weight and feel better.
  2. Carbs are lovely.
  3. Feeding the birds is really satisfying. I like woodpeckers.
  4. I need to get better at arguing with racists (there are way more around than I’d thought).
  5. There’s zero point arguing with those who have rigid belief systems and racists as it just leaves you feeling terrible and post-factual.
  6. Most people are generous and thoughtful and kind.
  7. Things are better than they were, and we must hang on to that.
  8. Things are way worse and getting scary.
  9. No one is an expert, so we must engage with a wide variety of people and listen and learn.
  10. Of course we need experts, idiot. Who’s going to fix you when you get a tumour or something? An amateur? A newspaper columnist?
  11. Democracy is imperfect but the best we have.
  12. Democracy is rubbish because people read and believe any old shit.
  13. People have valid concerns and no one is listening to them.
  14. It’s ok to vote for a maniac if you feel ignored and ‘little’.
  15. We’re all fckd.
  16. Mental health services are properly bust.
  17. Mental health professionals should trust people more and enable them to help themselves and each other: it’s the democratisation of health.
  18. People read and believe any old shit.
  19. Walk or self-combust.
  20. A nice pair of shoes makes the journey more bearable.
  21. Books are much nicer in paper form. Sorry I ever doubted you, books.
  22. Getting angry makes things worse. Everyone’s so angry with each other.
  23. Watching Question Time makes me want to hurt people.
  24. It’s best to avoid Question Time, most news, Andrew Marr being annoying on a Sunday, most twitter scraps, for reasons of mental wellbeing.
  25. It’s important not to hide from current affairs and challenging debate. Don’t you know anything about the rise of Nazism?
  26. I really like owls.

Comedy and the Art of Therapeutic Parenting

Parenting children traumatised by their early experiences has taken me to some of the most bleak, incredible, lonely and wonderful places: places I had never imagined existed before I became a parent. At the same time the experience has been one of the most comic: not in a flippant way, but in the way that comedy and tragedy collide and for a moment the tragedy it forgotten and perhaps longer term becomes more bearable.

And thank goodness for that, because without the moments of comedy accompanying us through the times of drudgery and drama, where would we be?

Comedy is about making sense of things, its pain relief, an unsticking, its sharing something silly and profound with someone. Laughter, even in the bleakest of times humanises, ourselves and each other. It magics us away from rage and despondency and tips us off our high horses and out of our despair. Laughing along with someone, a child, a partner is pure connection.

And it is one way of trying to marry up the mainstream lives we may have imagined for ourselves, with the bizarre lives we end up with (and perhaps not just because of the kind of parenting we do). It’s a bridging material. Comedy is found in dissonance and there’s never been a greater need for that.

trumpfarageIf you were at the Adoption UK conference last weekend then you may have noticed the sound of laughter everywhere; around the coffee tables, the stands, the dining room, the toilet queue. It’s what happens when isolated people come together and find things in common. It’s the sheer relief of realising you are not alone in say happening upon a poo in a strange place or a digestive biscuit in your wash bag. These events experienced alone can be a long way from funny, but sharing them takes some of the the sting away. And the next time something similar happens, we may be able to experience it with a comic disbelief, rather than the hopeless kind.

That’s not to say I’ve laughed my way through parenthood. I haven’t. I’m not insane. The moment itself, in that moment can be too painful for words but what plays out after that moment, given a bit of context, can be comic, in the full Shakespearean sense of the word. And like they say, if you don’t laugh, you cry, or you get angry, or withdrawn.

The ability and the opportunity to see the comedy gives us back some power and it reminds us we are all doing the best we can. And the best kind of comedy, my favourite kind isn’t mean, it’s full of heart. And you need tonnes of that to be a therapeutic parent.

Thank you to everyone who came to the Adoption UK conference in Birmingham. I hope you came away feeling encouraged and connected. I certainly did. It was a joy to meet so many people, so thank you! And for those who couldn’t make it, here’s something I shared from my own catalogue of self care strategies, filed under ‘funny youtube videos”.

Arvon Experimental Fiction Week Learnings

As a break from Experimental Living, I spent last week Experimental Writing at the Arvon centre in Devon, with tutors Adam Foulds and Toby Litt and a fabulous and kindly group of writers and experimenters. The Trump Triumph and his Farage Menage were a world away. It couldn’t have been better timed. 

Don’t pack a spare towel, you won’t need it. Likewise teabags. Bring more clothes.

Download more podcasts for palate cleansing at the end of a day of rich brain food.

Expect to feel odd and dislocated for a day or two. You will come back to yourself. You will make friends.

Physical isolation, plus no wifi is a GOOD THING. You will experience panicky feelings over an inability to instantly fact check. Get over yourself. Leave a gap and go back later. Be less of a dopamine reward junky.

It doesn’t matter if you haven’t read all of the things, but you should read better. TLS. LRB. That sine wave storyline thing though, that came straight out of Ramsay Street.

Remember a plot doesn’t need to be bland to be believeable (POTUS afterall) however if it feels wrong, it probably is. Wrong. Trust your instincts.

Work in the wifi-free, well-heated town library more often. Drink the coffee. Pity the old men.

Continue to get up early and work before the crazy grabs the day. Two hours early is worth four later.

Say ‘no’ to a lot more stuff, especially if that stuff involves complicated travel arrangements.

Create space to ….

write, write, write.

Write the scene, not the summary.

Nurture brainy friendships; Malteser Rachel and University Kirstie.

Go to the pub, but this time order a pint. Otter. Stop crapping on about Poldark.

Do it again next year.

Big Thank Yous to the Arvon Experimental Writing class of 2016; Adam, Toby, Mary, Louise, Luke, Natasha, G, H, S, M, S, J, L, L, E, C, P. 

Things that were broken

The outbreak of peace in our house continues. It’s brilliant. That’s the thing, when life has been so relentlessly crap for so long, it just needs to be less crap for a few weeks and everything is a complete joy.

I went to the Yorkshire and Humber Adoption Consortium annual conference this week – had a ball (I so enjoyed meeting everyone). I caught up with old friends in the pouring rain – brilliant. I spent two hours selling raffle rickets in a field yesterday, and even that was a blast.

Living in a state of near hysterical joy (for one never knows when it will end) means that things get done as there is at last time and head space to tackle Mount Must Do. On the Must Do list for this week was:

RING PLUMBER: heating has been malfunctioning for … two years, radiator has been leaking for …. five years.

RING OIL TANK SUPPLIER: oil tank is old and has cracks in it, which means it cannot be refiled. Current oil level = empty.

RING TREE SURGEON: massive tree has needed cutting down for … at least three years, but at last I have a certificate saying it is allowed to go.

FIX LAWNMOWER: broken for six months, state of lawn = dire.

On a separate Must Do list has been, lose some weight. Living in Trauma Central is bloody terrible for the BMI. That’s been done too.

In other news, Mr D has been building a summer house in our garden. He took some unpaid ‘I take it or I go insane’ leave from work last year and spent weeks in a happy bubble of woodmanship drowning out the crap with power tools. It’s almost finished, and it looks fabulous. I bought some cane furniture for fifteen quid in a charity shop  and have sprayed it green (apple green, if you will). I won’t mention how much I’ve spent on the paint.

IMG_0384

There has been a theme around our family for a long time about Rock Bottom. Mr R (trusty therapist) had been saying to me for ages ‘we often only see a turnaround when our children and young people take things to rock bottom and you need to think about how far down you are willing to follow’. It took me ages to see it but he was on the money. Both he and our family therapist C were also on the money as they helped Mr D and I to work out when we needed to shout ‘enough’ and how to do that as therapeutically as we were able. This process has played a large part in our survival of Rock Bottom and current state of flourishing.

I sit here typing and I can hear our family outside, doing their things, having fun in the sunshine. I’m going out now to join them. Things that were broken are being mended and it’s a complete joy.