Adoption Competency: How to Distinguish Normal Developmental Challenges from Adoption-Trauma Behaviors

Dr. Esther Hess and Dr. Ann Kirsch together discuss the complex issues of how adoption trauma often manifests itself as maladaptive survival strategies, with guidance for differentiating these maladaptive behaviors from age-appropriate developmental challenges. 

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Composer / Writer / Author: ROSSANO GENTILI - SIAE IPI: 161539866

Transcript

unknown 0:00

Wow.

SPEAKER_00 0:03

Here we go. There we go. Good evening, folks. How are you? This is Dr. S. D. Hess. And hi, I'm Ann Kirsch, Dr. Ann Kirsh. And this is On and Off the Spectrum.

unknown 0:18

Yes.

SPEAKER_00 0:18

Tonight, Ann and I are going to have our own conversation about an incredibly important, and I think not often discussed topic, adoption competency. And what we mean by that, it's based on an article by a wonderful, wonderful clinician. Her name is Jeanette Yaffe. The subtext of this article, How to Distinguish Between Normal Developmental Challenges That Are Different from Adoption Trauma Behaviors. Very interesting. Right, right. So Anne, you initially brought this article to my attention. What drew you to this article?

SPEAKER_01 0:58

Well, what drew me to this article was that I've known a number of adult adoptees, meaning adults who have been adopted at birth, and I have noticed in their behavior, in the way that they live in the world, that talking about being an adoptee is the first thing that they talk about in conversation. It is, I because I was adopted, or when I was adopted, or um I found my adopted mother, my birth mother, but I chose not to have a relationship, or I did choose to have a relationship. But almost to every single person, whether I've known them very well, which in some cases I have, or whether it's just been a conversation upon meeting with someone, that is how they how they introduce themselves as not as a doctor, a lawyer, uh a teacher, um, not about their families, their children, but about the fact that they are an adopted person.

SPEAKER_00 2:18

So that defines who they are, that's their sense of self-actly. Okay. Exactly. So I think that's what we have to talk about this evening because this article highlights, it says, how adoption trauma, and they define it as adoption trauma, often manifests as maladaptive survival strategies that are misinterpreted by the clinical community as defiance or pathology. And what we need to do is pay attention and offer guidance to differentiate these behaviors into actually age-appropriate developmental challenges based on the fact that this is a different population.

SPEAKER_01 3:01

Exactly. You know, in my practice and when I'm talking um with other people, I I never talk about someone's uh their psychology, what's wrong with them, um, the problems they're having. I tal I think in terms of what's normal behavior and what is not normal behavior. And in that line from normal to it's that's a questionable. I wonder why that's happening. That's how I think. I have met a lot of people, and I'm sure you have too, who the first place they they go is to what's wrong with that child? What's wrong with that young person, that teenager, that young adult. And I don't do that. And the reason I don't do that is because between birth and being a young adult, there's so much time. There's so much space. And I would like to know what happened if I can know. I would like to know what happened between birth and between the middle school ages, because that's where you find out a lot of and probably most of the information. When I ask um someone in my office, where I'm given permission by my patient to ask questions, when I ask about their childhood, I always want to know about their infancy, their birth. How how if mom is sitting in the room, if it's a little one and mom is there, I always ask mom, what was your birth like? What was it like to give birth to to this little one? What was it like to um have have that experience for the first, second, third, whatever time it is? And the information that comes from asking that question is often shocking. And it can be shocking in a number of ways. It can be shocking in the normalcy of what the mother says, which makes me often want to question uh, what is that? What what is that normalcy that we're really talking about? Because while I believe that it exists, uh everyone has a birth experience that has caused them some kind of trauma in some kind of ways.

SPEAKER_00 5:39

Well, I I wanted to speak to that specifically because when I imagine the trauma associated with separating a child from its parent, you know, you think of parents who are unfit, you think of uh violence, uh, you think of uh of abuse, you think of sudden death, something that that's like you know, a a jerking away from the normal attachment of a child to a parent. But what they said actually, which was very interesting, imagine what we are talking about, people who are very good, kind people, and for whatever reason, they just cannot uh afford, or perhaps they could just they're not capable at this point in their lives of raising a child, and they give up a child, and the child is adopted at birth. That too is trauma. Because they said when separation occurs, the developing brain interprets it as danger, triggering a survival response. This unresolved grief is pre-verbal and often manifests later as maladaptive behaviors that caregivers and clinicians, again, that we have to be aware of, can potentially misinterpret. But it never dawned on me that what we consider a positive uh um uh uh wanted adoption uh that's been arranged between a a uh biological parent who you know gives up a child for uh uh you know whatever the reason at a positive, let's say it's for the best of the child, still that's traumatic.

SPEAKER_01 7:20

Absolutely, because attachment disorders, as we refer to them, don't always occur for the reasons that we talk about. An attachment disorder can occur at birth. Because when you think about what happens with a baby and a mother, this baby is growing inside of her, and the baby not only feels what it's like to be inside of its mother, but it hears the sounds, it hears the voices. We know absolutely by the sixth month for sure, and and we have some some uh some benefit of science knowing that maybe five months might be. Um these babies hear the sounds around them, they hear what's going on, they hear arguments, they hear sibling fights, they hear, they feel patting on the belly, whoever is doing that. They hear it all. And if what they're hearing, they they interpret as any infant would, any normal, healthy infant would, as home. This is my home inside of me. Now, they don't have the language, we know that, but they have the feeling of it.

SPEAKER_00 8:59

So, so this in adoptive terms is trauma, but it is a very specific term. Relinquished trauma. Yes. And oh excuse me, relinquishment trauma. And in the article, there quotes a uh one of the founders of trauma therapy, uh Vanderkoek, who reminded us that trauma is not the story of something that happened in the past. It is an imprint, just as you're suggesting, and that from the very uh very moments of conception, an imprint is left on the body and the mind for the adoptee. That imprint is now defined as separation. Yes. All right. So one of the things that we have to work on then as clinicians is healing that requires recognition of the loss, validation, and then integration of this loss into the child's own narrative. That's exactly right.

SPEAKER_01 10:00

I'm I'm so happy you said it the way you did, because what happens with families, with children and parents is that parents don't typically want to talk about things that are really difficult. They don't talk about adoption. They don't want to talk about, it's like I told my kid they were adopted, that's enough. I don't want to talk about it. Children will bring it up, and especially as they get older, what was my other mommy like? What, why didn't she want me? These are the classic typical things that children will say. Parents who don't have the training, they haven't gone out and found out how to speak about it because they're afraid, because they're afraid that their children won't love them, and they desperately want the children to love them the way they love them because they chose them. You know, um adoption is a choice. It is choosing to love a baby that someone else, for a myriad of reasons, can't love in that moment and keep forever.

SPEAKER_00 11:14

But there are still consequences, and I think what I'd like to focus on now is for us to understand the maladaptive ways of coping that can show up as trauma responses, but can be misinterpreted by the clinical community. Yes, right, exactly. So one of the most common um reactions is a constant state of hyper-arousal or hyper-vigilance. And I like to imagine, you know, the Buckingham Palace Guards always on alert, right? Because, well, there's ups and downsides. The upsides is you have these kiddos who oftentimes can become like uh you know like superheroes, right? I'm gonna do everything right, I'm gonna get always, I'm gonna be the best at everything. So uh two of the most common uh well-known adoptees uh are uh, for example, Steve Jobs, yes, and Simone Biles, who excelled in their areas of expertise, whether it was you know computers or uh gymnastics, um uh because they went that hyper-arousal, that hyper-awareness uh propelled them into a certain level of greatness. To be the best. To be the best.

SPEAKER_01 12:28

And and you can read a lot into that. One of the things that I that I read into it is is often I wasn't kept, I wasn't chosen, so I'm going to choose to be the very best at whatever I'm good at, and I will be the very best, and people will want me, they will love me, they will, they will literally clap for me.

SPEAKER_00 12:58

And not have any second thoughts that that, oh gosh, I chose that one. That's not the winner that I had that I imagined. Right.

SPEAKER_01 13:07

I'm making my mom happy, I'm making my dad happy, because look what I can do.

SPEAKER_00 13:12

But there are consequences, negative consequences to this hyper state, hyper-aroused state. They include anxiety, certainly, exhaustion, burnout, sleep issues, emotional disconnection, numbness, difficulty relaxing, letting go, and a tendency to both overthink and be self-critical.

SPEAKER_01 13:33

And not all of these things are true for everyone. I want to make clear that that the majority of people who adopt a baby, and that's what we're talking about mainly here now, uh, the majority who adopt a baby don't run into all the problems that we're gonna be talking about and have been talking about. But I'll tell you, I had a woman bring her newborn into my office some years ago, and what was her presenting problem? This was a young mom, she was probably in her late 20s with a beautiful little baby, brand new little baby, and her her presenting problem was, Dr. Kirsch, I don't know how to be a mom. Now that's an interesting thing to hear from a from a new parent because most new parents don't ask that question. They just assume that they'll know how to be a mom. It's put me on the alert to a number of things. And I first thing I said to her, as I talked about a minute ago, was I said to her was, so tell me first about what it was like. What was your birth experience? What was it like being pregnant? What was the birth experience? How was all of that for you? And the first thing she did was she looked down, not at the baby, but down in her lap. We were all sitting on the floor, down in her lap, and she looked up at me with tears. Just tears, no, not crying outwardly, and said, I adopted my baby. I don't know what it's like to be pregnant. And then she really broke into tears. That was a tremendous loss. The loss of not as as the story went on, she wasn't able to get pregnant. And the guilt she felt over not being able to get pregnant. I asked her, Well, where's your husband? Did he is Kitty join us today? And she said, no, um, he didn't want to come. And he didn't want to come because he didn't want to talk about something that was so painful for him. I told her how brave I thought she was because it takes an enormous amount of bravery to go into therapy in the first place. But to talk about a subject that where you feel like you've made the biggest mistake in the world, women are we're told from young, young ages we're supposed to have children. So when this woman found out that she could not carry a child, she couldn't, she couldn't have a child, she was in such pain. Where do you think that pain goes when she sees this brand new baby that's just beautiful, that is everything she wanted, but she doesn't feel bonded, she doesn't feel connected, she doesn't feel attached. And so her presenting question of, I don't know how to be a mom was perfect. It was the perfect question, the perfect problem.

SPEAKER_00 17:07

And and while you're coming from the perspective right now of the adoptive parent who may not is grappling with the whole process of being a parent through this process, what goes on for the child who has a mom who has ambivalence at best to take this child on, and how does that impact attachment overall?

SPEAKER_01 17:30

So what uh that's a huge question, and I'm so glad you brought that up.

SPEAKER_00 17:35

Absolutely, because there are actually the article goes into further seven domains of adoption-related behavior. And the most primary one is attachment, attachment and relationships. How does the child with this kind of distortion or break in the typical child conception, child birthing experience, child receiving experience, especially if there's ambivalence on the part of either the child or the parent, how does that impact the attachment? And what is shown often is that children with disruptive caregiving histories show attachment-related behaviors that deviate sharply from the norms. What you see sometimes is two different potentials: excessive clinginess, enormous anxiety at the potential for separation, or conversely, children who have great difficulty attaching, children who may display indiscriminate um friendliness or seek closeness with unfamiliar adults, or have really nothing to do with uh the parent who did adopt them, and those become snowballed into potential future attachment issues, both with the adoptive parent, parents, as well as the capacity to attach in a healthy way to their future partners. Right. That's right.

SPEAKER_01 19:11

The idea that a child could attach not to just or if to their parent, but that they could attach to anyone is a very common but not very much spoken about um idea in childhood. I was at the park once with um with a school group that I was with, and I uh watched this little girl, she was about six or seven at the time, darling, very outgoing, very friendly, and I thought, well, this is a kid who, you know, she's probably got a nice home and she's probably well taken care of. That wasn't the truth, but I didn't know that at the time. What I found out, what I watched, was this little girl went up to absolute strangers in this park and asked if she could sit on their lap, wanted to know if they wanted some of her food, because they we went to the park. I joined them when they were having lunch in the park. She asked if they wanted food. Now, these the people that were in the park were just normal people in the park. They were taking their lunch in the park, they were there with their own children, but there were people there who were uh unsavory. They were not the kind of people that you would want your kids to be sitting on their lap. We would just talk about them today as not having homes. This was about 20 years ago, and the word unsavory was used all the time, and it always kind of struck me as not a great word. But this girl, little girl, didn't see the difference between a person who might be safe and a person who might not be. She had no way of recognizing these differences. So it's this indiscriminate attachment.

SPEAKER_00 21:20

Indiscriminate attachment. There's also concerns of trust and safety. That's right. Oftentimes, children who have been actively neglected when there has been abuse or even when the intention has been only good, go ahead and have great difficulty imagining that their needs, emotional or physical for that matter, will ever fully be met. And so sometimes what happens is they'll say, I don't have needs.

SPEAKER_01 21:52

Yes, exactly.

SPEAKER_00 21:53

Because I don't want to expose myself anymore to needs that couldn't possibly be met. Or This is huge. This is this happens all the time. Or they imagine that maybe their needs were too big. And that's why they were rejected. That's why the parent gave them up because they were too much to handle. I cried too much.

SPEAKER_01 22:16

I needed too much food. I wasn't good at sucking on my bottle. I oftentimes kids will give up their bottle way too early or stop nursing way too early because they bit their mom. Or they they heard their mom say something that they interpreted as not a good thing for a child, like, oh, this kid is always eating. They don't necessarily know what that means, but they do know the tone that they're receiving those words in.

unknown 22:50

Right, right.

SPEAKER_00 22:51

One of the things that it is imperative for clinicians to do is to instruct the parents. And they have to learn, teach the parents to learn the difference between a child's mistrust for all the understandable reasons we're talking about now, and oppositional behavior. Because a child who looks like they're rejecting you, your food, your ability to love them, whatever it is, you know, you're we're human, we become, we know we we bleed, we wound, and we become reactive when truly what has to happen is just the opposite. We have to work differently, harder, but differently, to work and gaining that child's trust, that we're not going anywhere. That this isn't about what you have imagined. That this life experience is safe and we'll be actually repairing that breach of trust that happens at such a young age.

SPEAKER_01 23:56

It's the idea that you're saying and showing I love you. I know you're mad, but that's okay, and I and I love you. And it's okay to be mad. Now that's maybe a little older child, but to go back to the child that I mentioned in the beginning, where the mom said, I don't know how to be a mother, what I knew, what I know how to do is do, I learned this very early on in my career when I was learning pre- and perinatal psychology, which means that I worked with uh parents before they had their their children, when they were pregnant or thinking about becoming pregnant, to through the babies, through the process of pregnancy, and then afterwards. And one of the things that I learned then in that training that stuck with me and had through all of the years that I've been a therapist is that when you are when you have a baby, and that baby is crying just all the time, or acting out and in the way that babies can do, stomping their feet, having temper tantrums, but they're infants. Um they're showing that their anger, they're showing their feelings, and and rightfully so, a new mother doesn't know what to do with that. What's what we think is what's wrong with my mom, my baby, what's wrong with me, what did I do wrong. What I knew through my training was to watch this baby and see what how she was behaving. And what I noticed, you watch from the top of the head all the way down the body. And what I noticed when I started watching this baby's nap, I noticed that she had a lot of tension in her nap, meaning that she would look one way and another way. When she was screaming, crying, she was looking up, she was looking down. She never looked at her mother. She looked at me, whom she did not know, but I was safer than her mother because she didn't have anything to lose with me. I said, What I said to the mother was, have you ever heard of infant massage? She hadn't. Most people hadn't at that time. I said, I'm gonna show you how to do something. I want I'm gonna demonstrate how to gently whisper like whisper like a hummingbird. Whisper, touch, just gently touch the neck, or wherever you see this tension in this baby with in the neck. Slowly, gently rub your hands as gently as you can, understanding that the baby will let you know when she or he wants you to stop, and they will. They'll pull their head away or they'll shake their head. It's like a cat, little kitten, when you're when you're petting them and they don't want to be petted anymore. They put their paw on your hand and they move it. Babies will do that. She will move your hand away. And when she when she went like that, I pointed out, I narrated everything I was doing, and I said, see, what she did just then was she told me that's enough. Doesn't matter if I'm mommy, daddy, the neighbor, but that's enough. And so when she got she got calmer, she stopped screaming, and then about ten minutes later, she got worked up again. And I said to the mom, I said, I want you to do what I showed you, and I want you to know that I'm here, you're safe, I'm gonna watch what you're doing, I'm not gonna let anything go wrong here. Do what I tell, and I'm narrating it.

SPEAKER_00 28:21

I think, and what's so beautiful about that is your parenting both the parent and the child. Yes. Because when you have these kind of patients coming into you, count how many patients are there. You have yourself as the clinician, you have, of course, the child, you have the parent, but you also have the child part of the parent coming in. And so, really and truly you're treating this configuration of injury. Absolutely. All right, absolutely. But you spoke about something so important. You spoke about this hyper-aroused state, emotional dysregulation. Right. And with children who've been adopted, you often have a disproportionate amount of uh dysregulation. So, for example, when they cry, they may cry for hour-long bouts. Uh they are uh they might minor issues might trigger uh major, major responses. Changing a diet might turn into a what sounds like chaos. Absolutely. And and if the parent has a sensory processing concern where the sound of that baby's intense cry is dysregulating to themselves, and they it it prevents that kind of bonding.

SPEAKER_01 29:47

Sure, we have to take into consideration everybody's issues. Right. It's not easy doing this work, but I'll tell you, when you see a baby like the one I'm talking about, and we did, and it took months. Probably at the four-month mark, she brought the she brought her in with a and the mom had a big smile on her face, and she said, she said, I'm not afraid of my baby anymore. It brought tears to my eyes. Sure. And I said, Well, tell me, tell me why, what it, why aren't you? And she said, because you taught me that I am a mom. And one of the phrases that I use a lot with moms, that isn't is not my phrase, but the idea of being a good enough mom. And I would say to her, you're a good enough mom. Your baby doesn't know it yet. We need to teach you that you're a good enough mom.

SPEAKER_00 30:52

What you were addressing was the emotional center of this parent and child and the physiological center. Because what happens is you have this implicit traumatic memory that is being injured. Could be for both parent and child. Yes. And both parent and child on a neurophysiological level have overactive amygdalas that you, with both your physical touch and your emotional verbal touch, contained and soothed and bonded and moved forward.

SPEAKER_01 31:30

And we did it twice a week for four months, the same thing. And the mom would say to me often, do you think she knows I'm here? Do you think she knows I love her? Do you think, and whatever the question would be? And I would say yes, because we're teaching her. Absolutely. Absolutely. Your hands are on your baby. She's being soothed by you because she can't soothe herself yet. When she's ready to soothe herself, you're still there to do it. You're not leaving her.

SPEAKER_00 32:12

So imagine, imagine this disruptive kind of attachment and the repair, thank God in your case.

SPEAKER_01 32:21

Yep.

SPEAKER_00 32:22

And the development of a sense of self, a sense of identity. Oh, that's good. All right. If you think about it developmentally, the the premier developmental psychologist, Eric Erickson, identified identity exploration as central to an adolescent's core. But what happens in adoptive, dysregulatory, attachment, trauma-fused kinds of identity. So adoptive children face additional layers of identity questions. There's a sense of not knowing, of never belonging, that drives the life roadmap. Who am I is an extremely, extremely profound, profound uh question that resonates for often for adoptees.

SPEAKER_01 33:22

There was a woman that I met at a um at just a conference, um, and we were seated just at the same table at lunchtime, and we started talking, and there's a lot of people around, and and in the conversation, the first thing she said to me, she asked my name, I asked her name, then she said, You know, I was adopted. And I said something to the effect of, oh, oh, really, that's very interesting. And she said, Yes, it's who I am. And I said, Well, you're here uh in this conference, you're a therapist. Now, I, you know, therapists have to be careful not to be therapists to the world, so I try to be very careful. But I said to her, but you're a therapist also. Are you married? Yes. So do you have any children? Yes, I have two kids, two boys. And I said, So you're all these things. Now, this is not why she sat down next to me. It's not why I sat down next to her. But I could not believe that the only that the first thing she led with was, I'm adopted.

SPEAKER_00 34:53

But look at this question of self. Who am I? Right. Why was I given away? Do I have an intrinsic value to the world? And what will you think if you know that I'm adopted? We as clinicians, exactly what you were doing, you we have to create a validation for that grief, for that loss. And that's it's not like, oh, you're fine. Well, no, right. Yes, you're fine, but yes, you were injured.

SPEAKER_01 35:28

That's exactly and to acknowledge that injured. Right. And she, this woman and I, by the way, we became friends for years, uh, probably five years or so, until she and her family moved out of town. Um, but there was never a time that went by when we were together with other people at conferences or whatever it was. Um, I once saw her do this with, we were out to lunch, and uh the waiter came over and asked what and asked what we wanted, and then we went through all of that. And the waiter was very chatty and very friendly. And she said to the waiter, Well, you know, I'm adopted, and I think the reason I like to eat, she named what she liked to eat, is because my my birth mother must have liked, we'll say, asparagus. So I like a lot of asparagus, I like asparagus. I eat that a lot, and I've often wondered whether the woman who gave birth to me liked asparagus. Well, the waiter was kind of gobsmacked, he didn't know what to say. I reached into the conversation and I kind of headed it off in a different direction. And when he left, I said to her, You know, you don't. I'd known her about a year at this point. And I said, you know, you don't have to tell everyone you meet that you're adopted. And she looked at me shocked, and she said, I don't do that. And I said, You just did it.

SPEAKER_00 37:10

You know, as you're saying this, Anne, what I what makes me almost bring tears to my eyes is that I think she's saying, I feel like I'm damaged. Do you think I'm damaged? Yes. And at the same time, this idea like I like foods that my birth mother liked, is that something like maybe I could still hold on to a piece of her.

SPEAKER_01 37:34

Exactly what I thought. That was exactly right. Or do you and do you think that that this do you like asparagus? She just said this, but do you like asparagus? Is it is it a good thing to like? Right. And she did it all the time, but she didn't know, it was such a part of her that she was shocked when I said it.

SPEAKER_00 37:53

You said something though, so wise. You said you don't always have to talk about your adoption in a public you know forum. Boundaries in the context of behavior and and over control are often characteristics of adoptive trauma. Yes. Where there are for trauma-affective children, control becomes a survival mechanism.

SPEAKER_02 38:16

Absolutely.

SPEAKER_00 38:17

There will be constant testing, constant sort of inappropriate motions into realms that don't need to, for example, tell everybody that they're adopted. Like the little girl in the park. Right, right. But it is a um a paradigm of how they experience the powerlessness of their early life, and that they need then to sort of get constant affirmation, if not constant sense of control. Yes.

SPEAKER_01 38:47

Yes. Absolutely. You know, I um it come to I learned a lot about this woman who was my friend, um, about her childhood and about, you know, her life. I often wished I had learned, been able to learn a lot about the little girl in the park because I wasn't her teacher. I didn't know her family. It made me nervous when I watched her. It just made my heart go a little bit faster because I wanted to say to the teachers, keep an eye on that one. She's the one in your class, you have to pay attention to it. Pay attention to. Absolutely.

SPEAKER_00 39:36

Well, it isn't just during the awake hours that the trauma of children who have been adapted, adapted adopted reacts. Oftentimes this trauma manifests somatically. What does that mean? Nightmares, uh, aneuresis, stomach aches, hypervigilance, those are all very, very common. Body remembers the trauma and is acting it out. And and it can lead to uh a sense that this child is always sick, uh, more medication than is necessary, excessive visits to doctors, excessive treatment, excessive resentment by parent or partners. Right.

unknown 40:23

Right.

SPEAKER_00 40:23

So that's really because this is this this is the this is an individual who constantly presents as something is wrong, something is ill. All right.

SPEAKER_01 40:32

And doctors can often think that there may be some kind of abuse going on in the home because parents who bring children in uh at least once, if not twice, three times a month, because something is wrong, will often look at the parents and wonder what's going on here.

SPEAKER_00 40:52

Trevor Burrus, Jr. But this is a manifestation, not of malingering. No. It is an expression of fear. That's right. Okay. And so what they this wonderful article advises is clinicians can go ahead and integrate body-mind uh uh exercises. For example, uh mindfulness, yoga, occupational therapy, somatic uh experiences to start reintegrating healthy whole body experiences. Yeah.

SPEAKER_01 41:24

Yeah. I always in my office will do yoga with little kiddos. I'll do yoga. They love to do it. It's exercise, but it's fun, so they love to do it. Yeah. And they get value from it. Yes. I also have always had I had um a rain stick, and that is a long or short stick made out of bamboo that has little tiny um seeds, huh? Yes, it has little seeds in it. And I would give it to child, depending on the age and the size of the stick, and they would go like this, back and forth with it. And they would say the most amazing things. In the beginning, it would be like, Well, what's making that noise? And can I see inside? And then it became, can we make one? And then I had to figure out how to make it, and and yes, we made them. But it also started to become, and I didn't know it would do this when I when I bought it, a sway to soothe. It became a self-soothing mechanism. So as children were doing this and they're sitting on the floor, they're not laying down. It's their choice. They're sitting on the floor, and what they're doing is they start to tell stories. And they often start off with once upon a time, because kids at a certain age think every story starts with once upon a time. I was going to the market with my mommy, it could be anybody, and we saw this and we saw that, and it becomes a full-blown story that sometimes is is a wonderful, great story for the child, and sometimes it's a story that makes me think I have to intervene with this family. And I never know where a story will go. No therapist does. But when children start telling you stories because they are calm and they are open, they'll do it in the bathtub. They'll do it when you're driving.

SPEAKER_00 43:49

And I'm going to interrupt us because I will tell you this is such a fruitful conversation. We could keep talking about this topic forever. But we do need to stop because we have. Have to go ahead and remind folks that we are going to be launching our podcast in in the next uh month. And at that point, we're also going to give you folks an opportunity to write to us through our website to let us know the topics that you would like to hear. Until that time, this is Dr. Ann this is Dr. S. D. Hess. And I'm Dr. Ann Kirsch. And this is on and off the spectrum. We're wishing you peace and safety. Have a very wonderful good night. Thank you for again joining us at this very, very thoughtful conversation. Thank you so much. Take care. Take care. Bye-bye.