Category Archives: Potato Group News

The Potato Group News

 

 

When our children were placed with us aged 3 (twins) and 18 months, we had a lot of information about their history of severe neglect due to parents drug and alcohol issues. At that time there was a big focus on attachment and little was known about the impact that such trauma can have on brain development. So, we were told that because they had remained with their older sister (not being adopted) in foster care and had made good attachments there shouldn’t be any problems. Furthermore, there was no evidence of any problems – they were just “naughty” but the FC had provided good care and there were now “no problems”.

Indeed – there seemed not to be anything to be concerned about. Apart from silent crying, over compliance and “hyperactivity”, that is. In any case, after placement they settled down and eventually presented as typical children. And our experience was, actually, that they were “typical” children – if sometimes a little more “hyper” than others.
This all changed for us when our twin girls began to present with mental health problems which eventually resulted in both of them being admitted to inpatient units aged 14.
Now, we all know that the NHS is marvellous! If you have a serious, life-threatening problem, you will almost certainly get the treatment you need at the appropriate time and usually fairly close to home. Not so, if you have a mental health condition. CAMHS is “not fit for purpose” in a lot of areas. The shortage of suitable NHS mental health beds has been highlighted by the media for quite a while now. Lots of professionals make the right “noises” about the issues, but I am not sure how many of them realise the impact that the bed shortage has on both the patient and their families.
Eloise, was placed in an adolescent mental health unit over an hour away from home. She couldn’t go to a local, open, unit as her sister was there, so she was sent to a secure unit two counties away. This was a totally inappropriate admission: she was suffering with anxiety and depression and did not need to be on a secure unit.
The impact of the mental health bed crisis!

Restricted visiting hours meant that, because we had to use a major, usually congested, motorway to get there, we couldn’t see her in the week – meaning she only had visitors at the weekend. She has a younger brother who was too young to be left alone all day so he had to come and visit with us. Meaning he missed out on typical weekend activities with his friends. On occasions, we would turn up to visit her and she would be too unwell to see us for more than 15 minutes. Or her visit would have been cancelled and staff not bothered to call us. When she was allowed local leave from the ward, we had to try and find activities to do (usually restaurants) to “entertain” her.
But, a more serious consequence of this placement was the impact on her wellbeing. It is acknowledged by those working in mental health that patients will copy the behaviours of others they are placed with. Unsurprisingly, once in this unit her mental health deteriorated rapidly with an increase in the severity and frequency of her self-harming and she eventually became violent and was diagnosed with emerging personality disorder. Clinicians decided that she had to be kept in seclusion for an extended period. She was nursed in a room without even a bed – just a mattress on the floor. With nothing to do all day. Supervised constantly by two staff. A decision was made that she needed a bed in a forensic unit. BUT there were no beds available. She had to wait 6 weeks.

She was eventually offered a bed on a forensic unit 2 hours away from home. This hospital was a good placement for her. However, our Saturdays were now all about driving around the country doing visits. It is not just the inconvenience (or the cost) to the family that is the issue – being placed at such a distance has an impact on her treatment and recovery. The hospital felt she would benefit from family therapy – very difficult to do when both parents work and we have to travel so far for each session. As they recover, patients begin to have leave home to spend time with their family and friends. Hospitals find it difficult to facilitate these visits when they involve a four hour round trip (first visits are usually with staff If a home visit takes place on a weekday (and these are supposed to build up to weekly visits) then we, her parents, needed to take time off work and her siblings missed her because they were at school. However, weekend home leave is very problematic as there are fewer staff on shift. Discharge to home involves a gradual transition over time and this is very hard to do with great distances.

Another impact was that it was difficult for us to build a relationship with staff working with her as we couldn’t attend the weekly ward rounds. So, it became hard to ensure she was being well cared for. Her “home” clinical team were often unable to attend meetings about her as it meant being out of the office the whole day. So she quickly got forgotten about.
When she was well enough to be “stepped down” to a less secure placement it became apparent that she “fell between services”. She wasn’t ready to come home as she had become institutionalised. A low secure ward was felt to be inappropriate because it was likely to be too “unsettled” and might unduly influence her – leading to a remission. However, open, acute, units wouldn’t take her as it was considered to be too big a step down. She was caught between provisions: there was literally no hospital suitable for her.
So she had to be moved to a community placement which didn’t work out. And she ended up in a serious of adolescent psychiatric Intensive Care Units (PICU) several hours away (the furthest was a distance of 4 hours)! However, she was approaching 18 and Adult services did not support out of
county placements. Yippee! She’ll be moved closer to home, we thought. But it was not to be. Once again she “fell between services”. PICUs said she did not need their services, she wasn’t unwell enough but the acute team said she was too risky to have on their wards! She is currently 1 1⁄2 away on a PICU waiting for a treatment ward to admit her.

What has become clear to us as we struggle to get the right care for our daughter is that the shortage of suitable mental health beds is very real. There needs to be more emphasis placed on getting patients close to home – to reduce cost/impact on the family, to aid the patient’s recovery and to reduce costs for the Trusts treating them. We have had to fight to get her moved from wards where she was badly treated or inappropriately placed. We have been able to do this because we are not in awe of professionals (having dealt with them for so long as a result of adoption) and because we are articulate and informed. It makes us wonder how many people with mental health problems who do not have a voice are left in unsuitable placements.

The Potato Group News

 

TRANSFERENCE

She comes home apparently calm, but soon I am a nervous wreck inside. I feel anxious in the pit of my stomach and don’t know why. I ask her if anything is wrong – from experience I know that often these feelings I get from nowhere have nothing to do with me. They are hers but she somehow manages to transfer them onto me.

I don’t know how she does this. She doesn’t seem to do it to my husband (though I suspect she does it to her boyfriend). And I don’t pick up on other people’s feelings in this way. We adopted her and her elder sister at the same time. I don’t have that sort of experience with her elder sister.
She continues to tell me that there is nothing wrong. But by now I am in a frenzy of anxiety. The problem is that I know that pushing her for answers will simply infuriate her. She has an autistic spectrum diagnosis and she is not always very good at communicating how she feels to me. And I guess that she thinks that there is no reason for me to question her – she has told me there’s nothing wrong, so why shouldn’t I believe her?
So I have no option but to let her be. But then later that evening we get a message from her boyfriend – they have had a huge row and he has finished with her, but he’s worried about her, so could we keep an eye on her?

She bursts into tears when we confront her. I am now feeling enormously sad instead of the anxiety. And I continue to feel a mixture of sadness/anxiety over the next few weeks, to the point that I am wondering if I am heading for depression (which I have never suffered from).
Sometimes I get angry feelings instead – all directed at an 18 year old boy who I hardly know.
Some days are worse than others. It is useful information as it lets me know how she is doing. Her ex said that he was worried she would harm herself, that she had told him she had suicidal thoughts in the past. So it is useful for me to know when she is particularly down as I can feel it.

I feel like I am experiencing the break-up of the relationship myself. It is hard to explain – I am not mourning the loss of the ex as such, but I am definitely experiencing the feelings.
I now understand why I was so happy last summer. That would have been when they got closer after having seen each other intermittently for a while. She wasn’t sure if she wanted a relationship and then they got really close. At the time I put it down to the weather, my therapy, our new puppy……. Now I can see that I was just picking up a different set of emotions from her.
I have discussed this with my therapist, who knows me and the family well. She thinks it’s a sort of transference, where my daughter is dumping her too-big feelings onto me to deal with as she doesn’t know what to do with them.

Babies can’t manage their emotions and they need a tuned-in caregiver to help them do this.
Our daughter was badly neglected as a baby. Her birth mother had several older children (including our other daughter) and didn’t have much to do with her – she was passed around friends and family and looked after by her older, but primary aged, siblings. It is unlikely that anyone was enabling her to manage her too-big emotions and so she had to try to do it all herself.
We have always known that she tries to self soothe and manage all her problems by herself. She is very reluctant to seek help. She masks amazingly well in public and then falls apart later on. Other people are forever telling me there is nothing wrong with her – she is pretty and fun and, ,at the age of 17 has no anti-social behaviours or habits.
But it seems like things are leaking out – and in my direction.

I have tried to explain what this is like to friends. Most people seem to think that I am being too empathetic, too involved with her, that I need to set an intention not to get drawn in to her business, that I should have better boundaries. But I am not actively doing anything here. I do sympathise with her like any parent would do and try to talk to her about boyfriends and young love and I do try to remember that she is the one with the relationship (or not) here and she can handle it by herself.
But it doesn’t change the fact that I feel her emotions. It seems to me that this is being done to me completely without my permission or any active involvement by me.

My therapist thinks that I am a prime candidate for her feelings because, while she is perfectly primed to be the sort of person who needs to dump emotions on other people, I had the experience of managing my own mother’s emotions as a child, and so I am used to doing this.
It is a ‘perfect storm’ for the two of us. Her sister, my elder daughter, had a very different experience in the birth family, where she was looked after by the birth father (not brilliantly, but he did actively parent her). And my husband didn’t have to manage anyone’s emotions.

So it is something I am experiencing but I don’t know how to fix it. I have explained to my daughter how I feel what she is feeling and she is bewildered, as she doesn’t mean to do it. She is fed up with my preoccupation with this relationship – I keep checking in with her and she doesn’t want to talk about it.
The good news is that the boyfriend is suddenly back and she is euphoric – and so am I…..

The Potato group supports and informs parents of adopted teens.
www.thepotatogroup.org.uk