by John Brooks
I kept my true thoughts to myself.
As we stood to go, Dianne said, “Take good care of yourselves. You can talk to me anytime.” We gave each other hugs that felt somewhat more artificial than they did when we arrived. We walked through her cramped waiting room to the hallway. I turned to Erika. “What did you make of that?”
She rolled her eyes. Her expression said everything.
“Right.” I nodded.
We didn’t even bother to bring up the Social Intelligence book or ask why Dianne had recommended it. At that point, it was just another waste of time.
TWENTY-ONE
A man receives only what he is ready to receive, whether physically or intellectually or morally, as animals conceive at certain seasons their kind only. We hear and apprehend only what we already half know . . . Every man thus tracks himself through life, in all his hearing and reading and observation and travelling. His observations make a chain. The phenomenon or fact that cannot in any wise be linked with the rest of what he has observed, he does not observe. By and by we may be ready to receive what we cannot receive now.
—Henry David Thoreau
I had the first draft of Casey’s story finished by the time I’d met with Dr. Palmer and Dianne. Other than recounting Erika’s and my journey to Poland, there were only glancing references to and speculation about the effects on Casey’s behavior of her abandonment and adoption. They were never pursued or treated seriously, even after Dianne had raised the issue in passing. It just seemed inconceivable to me that Casey’s infancy had anything to do with her later life and death. After all, I reasoned that I had no memory of my own life before the age of seven other than from photographs and home movies. How could she? But some people see clearly what others can’t. They are too close to the subject.
I had been working with a group of memoir writers who convened weekly in the home of our writing coach at her stately yellow-and-white-trimmed Victorian home on the outskirts of Haight-Ashbury in San Francisco. It wasn’t until our coach critiqued my draft that she found the story I had completely missed. It was that glancing reference Dianne made in our last meeting after Casey had quit therapy four years earlier, in the spring of 2007.
Attachment disorder.
I thought about Casey in her room, shutting us out with a battered, splintered door. In the years since her suicide it had been replaced with a new six-panel door painted a glossy white, in a vain attempt to paper over the memories of battles raging on either side. Across the hall there was a dimple on the wall that a splash of paint couldn’t hide, the result of one of our fights. So many times I’d stood outside that door listening to her wailing and sobbing inside, helpless to console her. Once I’d opened the door, ignoring a photograph she’d posted on it of an oak tree, on which she’d written, Entrez-Vous? Non! It was French for “Keep Out!”
As soon as I walked in, she abruptly stopped, as if a needle had been lifted from a record. She fixed me with a hard stare but her mouth quivered.
“Get out.”
I paused for a moment, searching for something to say, some way to connect. “Honey . . .” Once again, I couldn’t find the words quickly enough.
“OUT!”
My face burned with humiliation as I retreated.
The minute I was back in the hallway and shut the door, the awful howling resumed. It was a cry for help. But when help came, she refused it and slammed the door.
Why?
Now, years later, inside her room, taped to the hutch on her desk was a piece of crinkled computer paper with a message in red crayon, all in capital letters, the awkward, uneven creation of a five-year-old Casey.
DEAR MOM AND DAD
I LOVE YOU AND MISS YOU BUT I DON’T HATE YOU
BY CASEY
There was an overstuffed pencil holder emblazoned with the Japanese cartoon character Domo, which sported its trademark angry, toothy snarl that American girls found so impossibly cute. Erika had taken a Father’s Day card that Casey had made when she was thirteen and propped it against Domo. In her distinctive, left-handed curly scrawl, Casey wrote:
You sir (yes, you!) have been *NOMINATED* to receive . . . THE BEST DAD AWARD!
I U!
I hope you enjoy this card written, produced, directed and pretty much made by me.
U are the best dad ever!
Her black IKEA bed was in the corner of the room with the Trainspotting poster overhead. There was an inscription at the bottom in bold letters that was tragically ironic:
CHOOSE YOUR FUTURE.
CHOOSE LIFE.
Her bed was a mountain of pillows. She liked to cocoon herself. But she was never the sentimental type, never into dolls, never into collecting things, other than her Beanie Babies and Pokémon cards (she thought they’d be worth a fortune someday). Though she had plenty of stuffed animals, such as plush pink Piggy, Toucan, and big old Pooh Bear, she didn’t have a favorite to drag around and hug in bed at night as I did.
Her only constant companion was her comfort pillow from Poland. Erika had it restuffed and re-covered many times over the years, and had propped it neatly against the headboard.
I sat in my home office in front of my computer and Googled attachment disorder. The first hit brought me to Wikipedia:
Attachment disorder is a disorder of mood, behavior, and social relationships arising from a failure to form normal attachments to primary caregivers in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, or abrupt separation from caregivers in the first three years of life.
Then I searched a related term, reactive attachment disorder, or RAD:
Children with RAD are presumed to have grossly disturbed internal working models of relationships, which may lead to interpersonal and behavioral difficulties in later life. There are few studies of long-term effects, but the opening of orphanages in Eastern Europe in the early 1990s provided opportunities for research on infants and toddlers brought up in very deprived conditions.
“Orphanages in Eastern Europe in the early 1990s.” This couldn’t have been just Romania. It was the Czech Republic, Slovakia, Hungary, Bulgaria, and Poland. I searched and sifted through mounds of data and studies from sources ranging from attachment experts and clinicians to blog posts by adoptive parents. A behavioral profile of the adopted child began to emerge.
Emotional Regulation: Because of the absence of the modulating influence of a dedicated caregiver in infancy, the adopted child frequently has a low tolerance for frustration, ineffective coping skills and impulse control, and trouble self-soothing. She can be clingy, hyperreactive, quick to anger or bursting into tears over what others might consider insignificant or nonexistent slights. It can be difficult to calm her with logic or discipline. She may have out-of-control, prolonged tantrums long past toddlerhood that are disproportionate to circumstances, giving the appearance of emotional immaturity.
Control: Abandoned in infancy, the adopted child has learned early not to trust. Controlling her environment and distancing others around her—especially caregivers—become paramount as a way to protect herself from further abandonment. This can affect her social realm, where she must navigate relationships and read social cues. She may feel threatened by others, have trouble tolerating relationships or participating in competitive games other than on her own terms. She can be a sore loser when things don’t go her way. She may have trouble sharing toys, food, or friends, long past what is age-appropriate. She may lack cause-and-effect thinking and blame others for her mistakes. Convinced perhaps that caregivers are unavailable and untrustworthy, she might avoid asking for help. She might be seen as bossy, but not to everyone. She can be manipulative—extremely charming, in fact, even indiscriminately affectionate, toward strangers—but cool and remote at home.
Transitions: Because of her need for control, the adopted child can have difficulties with transitions, especially when they come unexpectedly. She can’t easily “go with the flow.” Rather, she does
best in environments of structure, predictability, and regularity. Changes in routine—such as transitions from the school year to summer, vacations, and holidays—are times of great stress and acting out.
Discipline: Trust, control, and discipline go hand in hand for the adopted child. She may display a pattern of disobedient, defiant, and hostile behavior toward authority figures that goes beyond the norm, giving the appearance of being unduly stubborn and strong-willed. Epic battles can erupt over the most trivial things.
Self-Image: The adopted child whose needs are not met in infancy builds up a pessimistic and hopeless view of herself, her family, and society. She may be uncomfortable with physical closeness or intimacy. She can hear compliments from parents yet feel no association. She’s not worthy of love or respect, and may have enclosed her heart in a vault and fought to deny access to anyone who truly loves her. “I love you” can strike terror in her heart. She can’t feel love, believes that it hurts, and wants nothing of it. She may manifest destructive behaviors such as self-mutilation, eating disorders, and suicidal tendencies.
A simple Google search explained everything about Casey. The uncontrollable tantrums and crying jags. Her lack of patience, whether waiting an extra minute in her high chair for some ice cream or, years later, learning to skate or snowboard. Her tendency to be thin-skinned at home with no tolerance for the most benign joke or jab aimed at her. And my reaction to this? Out of sheer frustration, I told her to stop crying, grow up, and act her age.
Great job, Dad.
She didn’t handle threesomes well and would stomp home in tears from a friend’s house feeling left out or slighted, losing it when something didn’t go her way. I remembered our earliest meeting with Dr. Klein, when we probed him for an opinion about her bossiness and combativeness, but he described an entirely different child at school—a delight in the classroom who rarely had to be reprimanded.
Power struggles erupted over the most ridiculous things—Casey, please put your dirty dish in the sink; Casey, please don’t leave your wet towel on the bathroom floor; Casey, please take Igor for a walk. We were stuck in a never-ending cycle of time-outs, withheld privileges, abandoned reward programs, groundings, and empty threats to spend her college fund on a year in purgatory. We resorted to spanking her, even threatening to hit her, violating every tenet of good parenting and giving her more reason to despise us.
And transitions? Maybe Bennington was the last straw. I thought about Julian’s theory at the memorial that Casey had no intention of going; she just wanted to prove a point. For all of her bluster about Bennington, I could see how she could have been terrified. She was a creature of habit, had never been away by herself (except for the Alaska trip), never shared a bedroom or bathroom. At home, she had some measure of safety and privacy where she could unleash her rages and tantrums without fear of repercussions. At school, there would be no place to hide and unload in private. She’d be vulnerable, exposed.
Her issues with self-image went far beyond teenage angst. She seemed to loathe herself. But in retrospect, it was almost impossible to distinguish among the typical insecurities of a teenager, attachment issues from infancy, and dangerous suicidal tendencies when the symptoms looked so much alike. It would be impossible to treat every raging, sullen teen moping around the house as a potential suicide risk.
I had stumbled onto something big almost by accident, something that had been staring us in the face for years, and everyone had been blind to it. Casey was alone, in pain and unable to trust, and we couldn’t see it. In her fragile state, there wasn’t enough to live for, not enough for her to stay in the game, to see through the rough patches. Her perception of the future was bleak, hopeless.
Casey must have had some kind of an attachment disorder.
TWENTY-TWO
I scoured the Marin County library and the Internet for every book and article I could find on attachment. I contacted experts on adoption and attachment issues. Several of them agreed to talk to me about the disorder and what was being done to help the children and their parents. Nearly all of the experts were either adoptive parents who struck out on their own as I did, or were adoptees trying to understand themselves.
I learned that attachment begins with the trusting bond formed between a child and mother or other primary caregiver during infancy. This bond becomes the blueprint for all future relationships. The British psychiatrist John Bowlby, widely considered to be the founding father of attachment theory, says that at birth a baby cannot automatically self-regulate. Her emotional state is as simple as stressed or not stressed. When she is stressed—from hunger, a wet diaper, insufficient sleep, or fear—she cries. She is brought back into balance when the caregiver responds with soothing sounds, gentle touch, and loving looks.
Nancy Newton Verrier, an adoption specialist in Lafayette, California, provided me with her own analogy of mother-child separation. “It’s very unnatural to separate babies and mothers,” she said. “You can’t adopt a kitten or puppy for about eight weeks, in order to give the babies time to wean off their mothers, but we give away human babies to strangers as early as birth.” I never thought of it that way, and yet it seemed so obvious. Why would we treat animals with more deference than humans?
An infant left alone, with no instinctive soothing mechanism, lives in a state of prolonged fear and hyperarousal. Unable to summon help or physically escape, the infant’s only protection from this unendurable state is to emotionally withdraw.
Amy Klatzkin is a marriage and family therapist intern I met with at the Child Trauma Research Center at UCSF/San Francisco General Hospital. She is also an adoptive mother.
“There’s only one thing worse than an abusive relationship, even if it’s harmful,” she said. “And that’s no relationship at all, just nothingness.”
I saw Casey alone in her crib in the orphanage as Amy continued. “Casey was probably getting sustenance but no connection, not even a tiny attachment. People come and go, and you never know if they’ll be back. They’re all equally distant and interchangeable to her.”
She went on to talk about another kind of separation—the moment the child left the orphanage system with her adoptive parents. There was an element of predictability left behind—familiar sensations, sounds, and smells—for something unknown with two complete strangers. To ease that separation, Ms. Klatzkin offered a good piece of advice: leave the child in her clothes from the orphanage, even if they’re dirty or smelly. “Let them have some continuity,” she said. “It’s our instinct to cling.”
In High Risk: Children Without a Conscience, the clinical psychologists Ken Magid and Carole McKelvey wrote: “If a child does not form a loving bond with the mother, she does not develop an attachment to the rest of mankind, and literally does not have a stake in humanity. Incomprehensible pain is forever locked in her soul because of the abandonment she suffered as an infant.”
Incomprehensible pain. My daughter. The awful wailing behind her door.
So profound is the effect of institutionalization that Dr. Jerri Ann Jenista, a pediatrician and writer in the field of adoption medical health, suggests that all institutionalized orphans be considered at risk for attachment issues.
The longer they stay in the institution, the greater the damage. “We now know that if the child is adopted within the first year, the adverse effects of institutionalization are not too difficult to treat,” explained Dr. Robert Marvin, the director of the Mary D. Ainsworth Child-Parent Attachment Clinic at the University of Virginia Medical Center. “But for a child like Casey, adopted at fourteen months, there’s already been a fair amount of psychological and brain developmental damage that leads to very unusual behavior.” In fact, studies have shown that institutionalized children have measurably different brain structures from those raised in a family. Researchers have found striking abnormalities in tissues that transmit electrical messages across the brain, perhaps explaining some of the dysfunctions seen in neglected and orphaned children.
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The effects of institutionalization rarely go away. Parents of these kids find that depression, moodiness, self-mutilation, screaming fits, defiance, and academic struggles can be “normal” parts of life. Some children leave home and break contact with their adoptive families. Job instability, unplanned pregnancies, suicide attempts, and stints in disciplinary, rehab, and psychiatric programs are not uncommon.
Patricia, the adoptive mother of a boy from southern Poland, wrote to me that her son—then an eight-year-old—was at the emotional level of a five-year-old. Though he had recovered from early developmental delays, he was still prone to meltdowns, anxiety attacks, and struggles with self-esteem.
An adoptive mother of a girl from northwestern Russia wrote that her daughter was born to alcoholic parents and was unschooled and neglected until she was placed for adoption at age seven. Her adoptive mother received her at age eleven with a range of challenges, from growth deficiencies to language delays and learning disabilities. At the age of eighteen, she had the emotional maturity of a nine-year-old. The slightest provocation could send her into a rage or sobbing fit. Her parents feared that she couldn’t be trusted on her own.
Of course, this is, for many parents, only part of the story. As one mother wrote about her troubled daughter from Russia, “She has brought more love into my life than I ever thought possible.”
My reaction to these difficult stories was envy. Their children were still alive. My daughter was dead. I had failed in my first duty as a father, to keep her safe. The information I needed to keep her alive was out there, but it was just beyond my reach. It was in the library and on the Internet.
I had never thought to look.
TWENTY-THREE
If we could turn back the clock, there is so much that we would have done differently. Casey’s life didn’t have to end so abruptly and tragically.
