The Girl Behind the Door (22 page)

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.

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.

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.

I
f 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.

I now see a very different person on the other side of that battered bedroom door. Not an angry, misbehaving teenager bent on tormenting her parents, but a child suffering unfathomable pain for whom comfort was out of reach.

She tried to speak to us but couldn't get through. We couldn't hear her, couldn't understand her, or tuned her out as the decibels rose. Likewise, we tried to speak to her, but our words never reached her. Erika and I were desperate to love her but she had trouble letting us in. We reacted to our communication void with frustration, shutting each other out. That was a fatal mistake whose consequences we couldn't possibly know. We had no idea how far out on a ledge Casey was.

On the surface, everything appeared normal; in fact, better than normal. She'd gotten into her dream school, yet that wasn't enough to dent the iceberg of agony that sat below the surface, that she kept hidden from everyone. Only occasionally did she give a hint of her true feelings. Her cries for help were too faint for people to hear, so she weighed the options—live in pain or choose death.

Erika and I were blind from the outset. I thought about the morning we picked Casey up from the orphanage. We were so intent on changing her into some nice, clean girlie clothes that it never dawned on us to ask if she had something she clutched in her crib—a pillow, a stuffed animal, a blanket? For all I know now, we'd left something behind that was indispensable to her, further compounding her distress. To ease the shock of this transition, we should have asked for an article of clothing, a plaything, something she might have snuggled with to keep her company and have something familiar to hold on to, but we didn't.

In their two books,
Adopting the Hurt Child
and
Parenting the Hurt Child
, Dr. Gregory Keck and Regina Kupecky note that adoptive parents want to believe that a sound attachment had formed with former caregivers, in a sort of turnkey process that was readily transferable to them. The adoption becomes a cure-all for the child's difficulties.

So it was for us, we thought. Overjoyed at her astonishing progress in our first few days together, camped out in a cramped hotel room in Warsaw, Erika and I became convinced that Casey wasn't a special needs child at all. She had just been understimulated in the orphanage; nothing that two loving parents couldn't fix. We were part of a fairy tale—two able-bodied Americans rescuing a Polish orphan from her caring but impoverished birth mother, who wanted a better life for her daughter.

We treated Casey as if she were our new pet. She was in good American hands. Just feed her, burp her, change her diaper, bounce her around, and park her in front of the TV when Mom and Dad need a rest. Then there were the outbursts.

I know now that adoptive parents who view their children's disruptive behavior as just normal growing pains are ignoring a time bomb. They need to distinguish between the physical and emotional age of their child and adapt their parenting expectations to the child's emotional age, that emotional immaturity I'd read about and, of course, had seen in Casey.

We should have had her assessed. Ray Kinney, a director and staff psychologist at Cornerstone Counseling Services in Wisconsin, spoke to me about the importance of assessment for children who have lived in orphanages. Having seen hundreds of deprived children over thirty-five years of clinical practice, he said that this was a crucial prerequisite to determining an appropriate intervention strategy.

That first night in the hotel room in Warsaw, when she was inconsolable, rocking herself to sleep, we just wanted her to quiet down so that we could get some rest. Instead of parking her in her stroller in front of a blaring TV—something she'd probably never seen before—we should have taken her into bed with us, held her and soothed her. If it were possible, we should have held her for our whole first month together without putting her down. Maybe we would have had a different result. What she needed then was lots of human touch.

From the moment we brought Casey into our home, it seemed as though we did everything wrong. We assumed that the past would fade into oblivion; nurture would prevail over nature. We took our parenting cues from the pop culture experts.

As a toddler, we tried to teach Casey manners, patience, and independence. When she acted out inappropriately and threw temper tantrums, we scolded and punished her. But we failed to see what was at the root of her outbursts, and our reactions only made matters worse. Rather than sending her off by herself, we should have stayed with her, helped her calm down and self-soothe. She needed to know that Mom and Dad would always be there for her unconditionally.

When Casey entered school, we were mystified by what appeared to be a split personality—a perfect angel at school and a defiant, immature brat at home. We consulted family, friends, teachers, and guidance counselors, and were told that Casey was strong-willed and a bit high-strung; she'd grow out of it.

Erika and I felt that we were the problem. We spoiled her. We were inconsistent. We needed to be tougher with her. So we read books such as
Raising Your Spirited Child
, tried reward systems and used TV, the computer, and playdates as leverage for good behavior. We blamed each other for our lousy parenting skills and our inability to get our daughter to mind her parents like everyone else's kids did. We didn't realize that the provocation and aggression we saw in her may have been caused by her anxiety about further rejection, something she may not have understood herself.

Nancy Verrier told me that the adopted child can push for rejection even though that's the opposite of what she wants. She constantly tests her parents to see if they'll reject her, just to get the inevitable over with. As she tests her parents' commitment, often playing into their own insecurities about being good enough, the parents become defensive and retaliatory instead of understanding and steadfast. Their reactions can provoke the very outcome she feared in the first place—being sent to a residential treatment center or boarding school, or being kicked out onto the street.