I just finished rereading Crying for help by Casey Watson. This was the first Casey book I read and I think the first one on kindle.
The book tells the story of the watson’s second foster child Sophia. She comes as a “short term” (so many of her kids are supposedly short term and then are not) placement. Sophia is 12 years old. She’s been in care for several months or a year. She was living with a first time foster carer who had an emotional breakdown and could no longer take care of her. This was to be only for a few weeks until the carer was recovered enough to have her back.
The watson’s learned that Sophia had lived with her mom until she was nine years old. At that point her mother fell down the stairs (a suicide attempt, or something else?) and has been permanently in a coma ever since. Sophia then went to live with an Uncle but then the Uncle’s wife got pregnant. The grandparents, her mother’s parents blame Sophia for her mom’s death.
As if that weren’t bad enough they then hear Sophia has a serious medical condition called Adison’s disease. A disease in which her body doesn’t make two major hormones and she has to take pills on a strict daily basis, watch her diet and stress levels in order to be medically stable. These things if not monitored can cause physical symptoms like being weak, or “brain fog.” Which never was really explained! She had the disease from a young age and the Watson’s were assured things would be fine with it.
Upon meeting Sophia Casey feels there’s something odd about this placement. Firstly though she’s only fostered one other child previously, she never saw so many people show up with a child. There was her social worker, a supervising social worker, and a man named Jack who sounded like a kind of professional companion that Sophia had had since being in the system.
What was even weirder was how from the very first moment Sophia seemed to dominate the room, like she was a little queen or something. Basically with the adults walking on eggshells around her. Casey and Mike never saw anything like it and couldn’t believe these people so called professionals had let this girl behave this way for so long. Yes she had major issues and a lot of trauma but being totally rude and demanding wouldn’t help her heal.
By the end of the first meeting Casey was basically disgusted with this “team” and felt like they’d be working against her efforts to help Sophia. At the next meeting when Sophia brought all her things she basically ordered everyone again to bring them in. She also made really odd off the wall comments about men like “liking iresh men” in a sexual kind of way and asking in a sarcastic way how old Mike and Casey were. Whtin m minutes however she burst into tears and was genuinely upset to have her social worker leave. It was that huge mood shift that was the first red flag for Casey and Mike.
The very first day that same day they had to drive three hours each way to Sophia’s adison’s specialist. Casey and Mike were anxious about this appointment because they knew almost nothing about the disease except what they learned online and social services was downplaying it so much. Sophia practically exploded down the hallway and manically almost knocked her doctor over with a hug. Which was in itself odd. Then they were told Sophia saw the doctor alone for fifteen minutes or so. This was something that concerned Mike and Casey due to them needing to know everything that went on as they were her guardians at the moment. But it was something that had been done it seemed all the time so they dropped it.
Casey and Mike eventually did
Get a chance to have a long meeting with the doctor where they learned the ins and outs of what the disease meant specifically to her. They learned about the strict schedule of pills and issues around diet for example needing a lot of salt. How she needs food and rest if she is having a physical issue. How Adison’s does have some kind of mental health problems associated but these were never explained. Most worrying was when he said that in the past Sophia has been manipulative about her illness saying there are issues when there aren’t. Which is really scary because there is at it’s most extreme form a term known as an adisoian crisis where her body basically shuts down. In which case more pills or even an injection is required. Casey and mike and even the doctor are lost with the question with such a serious illness how do you know if she’s just pretending or not. They were told to take no chances.
As time goes on the illness becomes just one in a series of issues that bring the family many times to the end of their emotional rope. They discover within the first week or two that far from being just a bit manipulative rude or moody, Sophia is extremely mentally ill. The doctor at the end of the book as well as others call these “psychotic episodes.” I’m not sure they are. What Sophia seemed to experience was more like dissociation where different parts of her personality, albiet perhaps not fully developed alters would come to the front leaving Sophia with little memory of the events.
These events include sudden bouts of uncontrolabe anger, verbal abuse and even getting physical pushing hiting ETC. Very sexualized behavior towards Mike, Keeron and other boys at school. A spaced out kind of state where there was no reaching her at all. A cfhildlike vulnerable state, and a manically happy perky aspect.
After such an incident as was stated before she had little to no memory and was always apologetic. Often she would move on after things settled say the next morning and act as if it didn’t happen. To keep their sanity as these episodes escalated in severity and got closer together they tried to stay in the present to and go day by day rather than dwelling on things.
But it seemed nothing seemed to work. There were several adison’s related scares that were in fact it seems manipulation. When Sophia’s behavior escalated to attacking Kerron’s dog and hitting Casey’s grandson the family was absolutely lost for ideas and ge getting more hopeless by the day.
Even after an amazing birthday party put on “casey style” ((as in the best party you can imagine) there was a rage filled scene where Sophia came down dressed like someone in the mood for sex and Mike ended up carrying her up to her room!
Throughout John was sympathetic and tried to support as best he could. It seemed he too never expected this severity with the case. It turned out that the previous worker resigned from fostering altogether. Casey was pushing to get Sophia in with the CHMHS team, child and adolescent mental health services which have strict requirements and huge waiting lists. She enlists the help of her own GP and it turns out a acouple paramedics who are brought on the scene several times become allies for the family.
When it seems things can’t get worse, though the family is hanging on to a supposedly soon psychiatrist appointment Sophia cuts her wrists severely as a suicide attempt. It was learned soon before when Sophia first started talking like that that she had had several suicide attempts either by not taking her important hormone meds or taking too much. Why this vital information wasn’t given to the family I have no clue. They were stunned to know that someone had this background yet it was not known. I myself don’t understand why Sophia was not brought to the hospital or crisis team when she first was talking about suicide. But I know things are different outside the US. The maze of resources in the UK/ Ireland is very confusing to me and it seems like if you don’t have money for private care it’s basically like having Medicaid, getting whatever is offered through public means.
The suicide attempt obviously pushes things to a head. Sophia is assessed. The diagnosis which again perhaps reflect the country they’re in are” clinically depressed, had been having acute psychotic episodes, and it had all been symptomatic of what originally had been flaged up as mild sociopathy which they now felt indicative of an extreme stress reaction.” Again not how I would phraise it. Really do think she has some sort of dissociative disorder and definitely PTSD as well as problems attaching and forming healthy relationships.
In any case it was clear foster care the mainstream or specialized types weren’t right for Sophia. She was transferred after some time in the hospital to a teen residential unit. The whole family was there to show support including surprisingly her Uncle who thanked the family for what they did for Sophia. This seemed a bit unsettling given Sophia reported her Uncle sexually abusing her, as well as her mom’s boyfriends.
The family feel they’ll never know the truth of that because her moods and just how she presents moment to moment make it almost impossible to get clarity on what’s really going on. They did strongly believe she suffered extreme abuse and this would fit with the development of a dissociative disorder.
The book ends with the knowledge that Sophia succeded at the treatment unit. They did cognitive therapy again something I was surprised at I thought deeper psychodynamic therapy would be best or trauma informed though I’m not sure the status of available therapies and popularity in England. However it’s wonderful to know she’s doing as well as she is and that come full circle The Uncle and his wife agreed to have Sophia live with them. A weird twist that raises questions.
An even weirder lose end is whether Sophia actually did “murder her mother” or if it was an accident. At any rate devastating doesn’t even begin to describe that whole situation. I think her ability to dissociate was a way of keeping herself emotionally together enough to function somewhat with all the trauma and the chronic illness with it’s own emotional components as well.
This case really tested the emotional and professional capacity of Casey and Mike. They were originally trained as behavioral management foster carers using a points program with the kids based on privileges. Though the first child, Justin, had his major ups and downs the program was the framework they stuck to and it propelled him to do well and he was truly a success.
To not have that concrete framework, because for the longest time the family didn’t even know Sophia would be staying with them long, plus the huge emotional rollercoaster and unknows of adison’s the family had nowhere to really ground themselves to be objective in steering this girl in a healthy direction. Upon first reading this book, I didn’t know this. I : thought that though surely Casey was a good foster carer I found her floundering saying she didn’t know what to do unsettling. I now know she was being honest about just how difficult and unprepared she was for such an emotionally disturbed child. Now I realize the social services were the ones that dropped the ball, and did not give her adequate information or any kind of support. The only support she got was from her link worker who too didn’t have answers.
In one scene Casey needs to restrain Sophia to keep her from attacking her and while mentioning professional training on violence she is so overtaken by Sophia’s anger the one thing that came to mind was self defance training from her father. I thought that was so weird that she didn’t instinctively know how to restrain but this was obviously her first time doing it in her own home making her much more vulnerable. After a second careful read I have so much compassion for the family and how emotionally stretched they were by this case. And that Sophia disturbed as she was couldn’t have found a better family to see her true colors b be taken seriously and who stick with her to this day.
This book has many twists and turns and the outbursts Sophia has are truly terrifying to read about. I highly recommend it however as I’m sure in the world of fostering there are many Sophia’s out there and hopefully as many Casey’s.
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