Imagine if, one day, you woke up and you couldn't get out of your bed. Nevermind why. Maybe your legs didn't work. Maybe there were bars so high you couldn't climb them. Just imagine it.
Imagine that you're hungry, so you cry out, but no one comes to feed you. Imagine that when they finally do, hours and hours later, you're hastily fed a watery mush that doesn't even take the edge off the gnawing pain in your stomach.
Imagine that in your room, there are dozens of other people stuck in their beds. They're crying out. They're hungry too. They want to be able to help themselves, just like you, but they can't. Imagine hearing their moans, cries, all night long... not sleeping.
Imagine that the only person who ever cares for you (and I use that expression loosely) gets tired of you and the others grunting and rocking and crying out at night, and shoves medication down your throat. It makes you feel strange, heavy, and you fall into more of a coma than a sleep. You don't feel like yourself even when you wake up.
Imagine that you have to go to the bathroom. There is no call button for a nurse to take you out of the bed to the bathroom. That does not happen. You have a diaper - that's what it is for. Only it hasn't been changed all day. You're soaking in your own waste and you can do nothing about it.
Imagine the hours passing by. There's no TV, no music, no computers or video games, no toys or people to talk to... nothing but you, your fellow sufferers, and the sterile, hospital green wall across from you. Imagine one hour like this. Nothing to do but lie there. Unable to sleep anymore. Imagine two hours like this. Trying to find something to occupy your mind. Imagine the whole day like this. It passes by agonizingly slowly.
Now imagine living that day over and over for years.
How long until you lose your mind?
Psychology theorizes that there is a hierarchy of needs - at the bottom are basic physical needs. Food. Shelter. Air. Sleep. At the next level are safety needs - the need to know that you and all that you care about are safe. At the next level are psychological needs. Love. Friends. A family. Above that, you can see that the hierarchy gets more complex.
Maslow's theory states that if the needs at any level are not met, a person cannot achieve the contents of the next level. So, for example, if you are starving, you will not be able to achieve any sense of safety or security - because you can't even be secure in your most basic needs.
Think back to what you just imagined. You aren't getting enough food. You aren't getting enough sleep. You're getting no intellectual stimulation or human contact. Your environment is not clean or sanitary. You are at the mercy of whomever happens to be tasked with keeping you alive (for now).
Would you know how to love another person? Be in a family? Be a friend? Would you know how to trust that when you lay down at night, you'll wake up safe? Would you believe, when you ate, that there would be more food before that gnawing pain in your stomach could take back over? Could you be certain of the motives of the people around you?
I don't think I need to answer that for you.
Like anything, it is a process. A person must become secure in those first needs before learning to achieve the next level. When a person past infancy displays an inability to be secure in even their most basic needs because they have been in an environment of deprivation, we call this 'institutionalization'.
It's not just a word. It's lives. It's people. It's something I've seen with my own eyes. And it doesn't go away overnight. You don't wake up one morning, never having had your needs met in your life, and then wake up the next morning confident that everything is going to be just A-OK, no matter what happened in those 24 hours. When a person who has been institutionalized is removed from that environment... well - think of it like refeeding syndrome - many of us know what that is.
After the concentration camps were discovered by liberating troops at the end of WWII, well-meaning people rushed food to the starving, skeletally thin prisoners. Most of them hadn't seen anything resembling a meal in months, maybe years. They did what anyone would do, what is human nature to do - they ate until they could eat no more. But their bodies had fallen into survival mode over those months and forgotten how to process proper nutrition. The sudden rush of nutrients overloaded their frail bodies, and in that moment it was discovered that
food can kill a starving man. Beginning to feed someone who has been in a state of starvation properly again must be done very carefully and slowly to avoid overloading the system. Refeeding Syndrome, as it's come to be known, is still a very real concern with orphans and people in developing nations all over the world.
But whereas actual physical starvation is linked to refeeding syndrome, institutionalization (essentially psychological starvation) can be linked to a sort of 'emotional refeeding syndrome'. Too much, too soon, overloads the senses and causes a person to do whatever they can think of to sooth themselves. For people who have been institutionalized, this can be a whole host of behaviors. Rocking. Self injury. Lashing out at others. Yelling. Hand flapping. Kicking and screaming. You name it. These are what we call 'post-institutional issues'. They're the behaviors a person exhibits when learning how to go from an institutionalized environment to a different one - perhaps a family. They're a period of transition that sometimes subsides quickly and sometimes has lingering effects for a long time. They're not insurmountable.
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| Imagine emotional starvation as visible as physical starvation |
Consistancy is key here. Look back at Maslow's Hierarchy. Start at the bottom. Anything above that first level is going to overload the person and cause the behaviors I mentioned previously (commonly called 'stimming', short for self stimulating) because they just don't know how to handle it. That doesn't mean they shouldn't be offered those things - love, security... it just means that when they're given, expect a different response than what you would from a person who has not been institutionalized. Most likely, the person will stim at first. Maybe for a while. Keep working. Re-feed them that affection slowly, over time. A starving man was never returned to perfect health in a week.
Why am I posting this? Aside from the fact that it's been on my mind, I feel that it's key to understanding international adoption, particularly of children with special needs, who have often been the most deprived. And understanding the issues related to adoption is absolutely vital to ensuring a positive outcome for everyone involved. There are families, people out there, who, like myself a year ago, have just discovered the orphan crisis - maybe because of all the press involved with the Russian adoption ban right now. They can only think one thing - 'we want to help'. And that's wonderful - we need people who want to help! But from my own experience, I know that first 'want to help' instinct is often less realistic than it should be. It is this that creates a false image of what adoption is like in people's minds and leads to disappointing experiences. You can't say "I want to adopt a child with down syndrome" and expect to
just get a child with down syndrome. You can't say "I'd love to adopt that little girl with hydrocephalus" and only expect to deal with hydrocephalus. You have to realize that institutionalization is a part of these kids now, you have to have realistic expectations based on what they've been through, or you're doomed to be disappointed. You have to be prepared to deal with the whole gamut of institutional behaviors, to commit to 're-feeding' as long as it takes.
I'm not saying to second guess a desire to adopt - never. I'm just saying, do your research. Read some blogs. Talk to some families. Meet some friends. I bet there are internationally adopted children near you - for over a year I had no idea a Reece's Rainbow family was living right down the street from me! Build a support system, so that as issues arise, you'll have someone to go to for advice. Find out what resources are available in your area and how to get them. You'll learn a lot, you won't regret that you did it, and you'll be that much more prepared when you do decide to take the leap... and it will make your experience all the more positive. Everyone wants a happy ending, but in real life, prince charming (or adoptive mom and dad) don't just come along and magic everything better in an instant. Happily ever after doesn't just happen. We have to make our own happily ever after, and it starts with a solid understanding of what you're going to deal with on the other side of your adoption.
And for those of us who haven't adopted yet, like myself (and listen to me preaching on institutionalization. Rest assured that I'm not completely ignorant, even though I haven't crossed the ocean myself yet), we need to be prepared to
support those families as they come home and 'de-institutionalize' their children. A sympathetic ear when a friend's day has involved WAY too much poop. A shoulder to cry on when a diagnosis the parent wasn't expecting is handed down. A meal dropped off so the adjusting family doesn't have to cook. Help around the house so the parent's focus can be on the child. A simple card, note, message, to say, "I'm thinking of you, I'm here for you."
They say it takes a village to raise a child. Find your village. Get to know the ins and the outs of living there. When it feels like home... move in... and your village will be there to help you through the thick and thin.
Happily Ever After is out there... you just have to work... and work
hard for it.
