Chapter 1. Test1

Introduction

Written by Elaine Cassel, J. D., M. A.

Lord Fairfax Community College

(c) 2013 Worth Publishers

1.1 Presenting Complaint

David is a twelve-year old boy who was so severely abused by his biological mother, Sandy, and her boyfriends, that the court sued to terminate her parental rights when David was 5 years old. Long before his mother’s rights were terminated (David never knew his biological father), David had been placed in foster care by the local child welfare agency. David lived in a foster home with an older woman, Irene, from the age of three years. By that time he had been repeatedly abused by his mother’s various boyfriends. After he started exhibiting frightening behavioral symptoms, he was moved from that foster home to his current home with Patty and John. Patty and John have been David’s foster parents for six years and are about to adopt him. They were on a list of foster parents who could take care of special needs children. David certainly had special needs.

Twelve-year old David was sitting in the front row of a suburban courtroom. Mostly likely he did not understand importance of what was happening to him, but his foster parents, Patty and John, did. They were here to obtain a final decree of adoption, to make David their son.

David had been in Irene’s home for about three weeks, when Irene’s brother came to visit. David was usually such a sweet child that Irene was shocked when David started beating on her brother’s legs with his fist. “David, what’s wrong with you?” she demanded. “Go to your room.” David went to his room, as told, but soon Irene heard a banging sound. She went in to find David beating his head against the wall, tears streaming down his face, saying “Bad Peter, bad Peter.” “David,” Irene said, alarmed, “What are you doing and who is Peter?” David just kept repeating, pointing to his own chest, “Bad boy, bad Peter.”

David repeated this behavior whenever a male friend or family member visited Irene. When social services made a regularly scheduled visit, Irene brought it up to the social worker. The social worker recommended that David be seen by a child psychologist. What the child psychologist found out was unimaginable to anyone who had ever been involved with social services in that town. The child psychologist examined David several times. He gathered all the information available about David and the etiology of his behaviors and, after interviews with Sandy, Irene, the social workers, and David, diagnosed David with dissociative identity disorder. The psychiatrist explained that David’s fragile ego had created an “alter” personality or identity, Peter, to be the “bad” boy who was threatened and abused by his mother’s boyfriends. The social history revealed that David had been almost beaten to death when he was about two years old, and he likely suffered beatings many times since then at the hands of Sandy’s drug and alcohol-abusing boyfriends.

Irene was a good foster mother, but David and his rages were too much for her to handle. In addition to beating his head against the wall, he would destroy his room whenever an adult male was in the house. It sometimes seemed as if he was setting himself up to be beaten by another man. Seeing an adult male seemed to trigger memories of past abuses, prompting David to act out his fear and anger. Patty and John had the financial means, the love, and patience to take in David and provide him with the professional care he needed.

After six years of intensive individual psychotherapy with a psychiatrist who specialized in dissociative disorders, David was still working to fully integrate “Peter” who had been beaten, into David, the good boy he had always been. Fortunately David only had one “alter,” and this made the therapy easier. The triggers that caused David to “switch” to Peter were pretty consistent as well. He had improved enough to be around men he did not know who were not threatening, and he had developed a good relationship with his soon-to-be adoptive father.

Patty and John placed David in a small private school that was willing to make special accommodations for him. For example, he had only female teachers. They knew there might be a rough patch or two ahead, as David entered puberty and had to deal with the usual hormonal changes associated with this stage. David was not interested in team sports. The therapist suggested that was a good thing, since there would be no risk of angering a coach or another adult male that might precipitate a switch to “Peter.” John had gotten David interested in golf and chess which were calmer pursuits that could teach him self-discipline and patience. Patty and John worked with a parenting coach for special needs children who, along with David’s therapist, helped them learn how to recognize when David was about to experience an outburst that might lead to a switch to “Peter.” David was showing progress integrating Peter with David and, with his parents’ help, was learning how to recognize a “switch” when he felt fear or anxiety. His parents were helping him realize that “Peter” was really just memories of a past that he would never experience again.

As rare as his disorder was, complete and total remission was even rarer still. The social workers said that if they had not witnessed the progression of David’s disorder from the beginning they never would have believed it. Several, like many people, were still skeptical about the diagnosis, thinking it was just the stuff of movies.

1.2 Social/Family History

David was born to Sandy who had herself been raised by loving foster parents. She never knew her biological parents. Sandy had been married to a decent man, John, for several years, and had a daughter by him, named Cindy. But when Sandy began drinking and abusing drugs, John divorced her. Sandy started hanging with a rough crowd and soon was pregnant with David by a heavy drug-user. Sandy drank heavily and used crack cocaine throughout her pregnancy. When David was born, he was immediately placed into the neonatal intensive care. He was underweight, had respiratory problems and, sadly, was showing signs of cocaine withdrawal. When David was stable enough to go home, the hospital, as was customary, contacted the local department of social services for a court order mandating that they not release David to his mother. The court turned down this order when Sandy showed up in court with an attorney. Her lawyer argued that there was no reason to think that Sandy would not be a good mother, despite her alcohol and cocaine use throughout her pregnancy. Friends testified that she was a good mother to 8-year-old Cindy.

When David was two years old, the court received another petition related to David. This time, Sandy and a different boyfriend had been arrested for felony child abuse. At a campground on the weekend before the court got the file on Monday, people had heard a child screaming and crying in pain. Running to the camper, they found Sandy’s boyfriend beating David almost senseless. The police were called, Sandy and her boyfriend were taken into custody, and social services were called to take custody of two-year old David.

David was placed in temporary foster care, but once again, Sandy came to court to contest the taking of David away from her. She presented a picture of a concerned mother. Yes, she had been drinking at the campgrounds, but she had tried to stop her companion from beating David. She was helpless and unable to intervene, she said. The court returned custody of David to her, under the condition that social services keep a close watch on her and David. Still, there was no history of Sandy abusing her daughter, Cindy, so the judge again gave Sandy the benefit of the doubt.

Sandy had found another boyfriend; this one was not much better than the last one, who was still in jail. Sandy had beaten the abuse charges the same way she beat back the challenge to her custody—the blame was pinned on her companion. Sandy lived in a modest house in a small town where she had grown up. People knew her and they felt sorry for her. By the time he was three years old, social services was successful in removing David from Sandy’s home. They placed him in foster care with an unmarried older woman, Irene, as David seemed to be afraid of men. Sandy was allowed to visit him twice a week. When David was diagnosed with dissociative identity disorder, social services petitioned the court to terminate her parental rights. Sandy put up a hard fight, but this time, the court ruled in David’s favor. When David was six years old, a young professional couple who had no children showed an interest in adopting David. It is this couple who eventually adopted David.

1.3 Multiple-Choice Questions