When Love is Not Enough 

Some traumatized orphans have brain damage that affection alone can't heal. So therapists are seeking new ways to simulate the nurturing they didn't get.

Claire raised her arms above her head and did a cartwheel on the balance beam. Her ten-year-old body was taut and strong, her limbs flowed like water from pose to pose in her gymnastics routine. Watching this magnificent girl, you wouldn't suspect that she had recently used those powerful legs to kick her mom across the room because she'd told Claire to get up and go to school.

Getting to school has been a problem for Claire; she was late 54 times last year. And just the night before, she had broken the bow of her violin in a tantrum sparked by a careless remark by her dad. In fact, she's destroyed many things, like a portable DVD player she couldn't get to work. She's taken scissors to her hair and clothing — and once brandished them during a play date.

Claire is a challenging child. But that shouldn't be too surprising. She was abandoned in a market in South China when she was three weeks old, and spent the next twelve months in the municipal orphanage. "They showed us the room she lived in, maybe ten or twelve babies in little cribs," recalled Barbara, her adoptive mother. "There were rows of small cribs with rails maybe a foot high. They didn't let them crawl or walk, so they didn't need to have high rails. When they put them in high chairs, they'd just sit there."

After struggling for years to get pregnant and spending $16,000 on in-vitro fertilization, Barbara and Steven Pirelli had traveled from Oakland to China to adopt. They were drawn by nothing more than a single color snapshot. The baby they met was dirty and painfully thin: just fifteen pounds. From the waist down, she was atrophied. She couldn't crawl, roll over, or sit up, and didn't make eye contact. But Barbara and Steven didn't care. "You've waited so long, you're not going to say no," Barbara said.

While the couple had been warned about what physical condition to expect, they hadn't been prepared for Claire's strangely detached personality. She was friendly to everyone — inappropriately so when she got older — but not especially bonded to her new parents. When she started preschool, all the other toddlers cried and clung to their parents when they were dropped off, but Claire happily ran off to the swings without a backward look.

But as she got older, she developed a mean streak. She'd make one girl in her group her best friend and reject the rest. In 2005, on a fourth-grade class trip, away from adult supervision, she pushed another girl down and kicked her. Notes from teachers got more pointed; the word "vicious" was used.

When Claire was only two, a psychologist friend of Barbara's who also had adopted a baby from China had warned her that Claire needed help. Now, years later, it finally sank in.

"Oh My God, I Found It"

On a recent sunny afternoon, Elena emerged from the gaggle of fourth graders at her school on a hilltop in Pleasanton. She has soft brown hair, fair skin, and a lanky frame that's helped her become a starter on her school's soccer and basketball teams. She couldn't wait to tell her mom everything: how she did on her math test, what she wrote, what her friends said and did. Walking back to the SUV for the short trip home, she said, "Mom, I'm getting my hopes up about Chrissie coming on Friday. I'm getting my hopes up — but I'm trying not to keep my hopes up too much, so if Chrissie doesn't come over, I won't be too disappointed."

"It sounds like you're doing good in school and being fun to be around, so it just might happen," said Betty, her mom.

While some nine-year-olds live in a whirl of sleepovers and play dates, having a friend come over is a hard-won privilege for Elena. The four years she spent bouncing from a Romanian orphanage to a series of foster homes took their toll, cognitively, emotionally, and physically.

"She was so tiny, only 28 pounds," Betty recalled. "She didn't have much hair. She had ringworm, and couldn't speak." Betty thinks Elena was kept swaddled for the first year of her life; when they met her in the foster home, she was three years and nine months old and still sleeping in a bassinet.

Betty and Howard Sundahl had an American-dream life: Their biological sons, now ages eighteen and sixteen, were growing up strong and healthy. Their house, in a development of million-dollar homes, had all the right stuff, from the granite in the kitchen, to the swimming pool and terrace out back, to the two dogs lounging on their special cushions in the comfortable family room. "We wanted to give thanks for everything we have here and we wanted to do something to make a difference," Betty said. "I wanted a little bigger family, and I thought taking care of a little girl that's already on the earth would be better than bringing a new one. We chose Romania because the children there were in more need."

In her first year with her new family, Elena had some speech problems; they chalked that up to her getting used to a new language. But by her second year, it was clear that something wasn't right. Elena's silence gave way to incessant chatter. In kindergarten, she had trouble staying in her seat, seemed to have no sense of personal space, and constantly interrupted in class. "We wanted her to bloom here, and it just didn't really happen until we got into some therapy," Betty said

Betty took her to specialist after specialist, and each gave her a different diagnosis and treatment recommendation — autism, sensory integration disorder, auditory processing difficulties, attention deficit hyperactive disorder. Finally, a pediatrician suggested in passing that she might want to see an attachment therapist.

"I came home and Googled attachment therapy, and up comes this list of symptoms," Betty recalls. "I said, 'Oh my god, I found it. This is it."

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