Behind the recurrent behavioural and personality patterns there have emerged emotional and psychodynamic issues specifically linked to adoption.
Toussieng also acknowledges that severe emotional disturbances and personality disorders are over-represented among adopted children and that they may have severe emotional difficulties that may never come to the attention of professionals.
He points out that on reaching adulthood some children become obsessed with finding their real mother because they had revealed a feeling of never having been really attached to their adoptive family and never had the feeling of real belonging.
Toussieng refers to Deutsh (1945) where she discusses the influences of unconscious attitudes and conflicts on the abilities of the adoptive mother to be motherly toward their adopted children. She believes that an adoptive mothers failure to develop motherliness is the major cause of later disturbances in the child. They (the mothers) view the adopted child as narcissistic injury, as evidence that they themselves are damaged. The child in trying to identify with such parents may well acquire shaky and defective introjects.
Toussieng summarises by stating "children who have been adopted at an early age and/or who have not been exposed to psychological traumatization before adoption seem to be more prone to emotional disturbances than non-adopted children.
ADOPTED CHILDREN DISABILITIES.
Michael Humphrey and Christopher Ounsted.
Michael Humphrey, M.A. B.Sc Principal Clinical Psychologist. Warneford and Park Hospitals.
Christopher Ounsted. D.M.,D.C.H., D.P.M., Consultant-in Charge Park Hospital for Children.
In a control group of 41 early age adoptees they distinguished the following symptoms. Emotional reactions (tantrums, negativism, jealousy). Enuresis, anxiety, disturbed social behaviour, aggression, withdrawl, stealing, cruelty, destructiveness, lying and encopresis.
They were impressed with finding out that one in two children adopted late had been stealing as compared to one in four children adopted at an early age. The action appeared in several cases to be expressly directed at the adoptive mother, either from a sense of rejection (in some cases well founded) or as an appeal for more individual attention. Sometimes the money would be spent on presents for friends in the hope of gaining popularity. Some of these children have stolen compulsively over a long period with no sign of remorse.
They found the adopted children suffered from varying degrees of parental deprivation, neglect, parental rejection or at the opposite extreme, over-indulgence, mental or physical illness sufficient to impair the quality of parental love, and jealously of a sibling born before or too soon after the adoption.
FANTASY OF ADOPTED CHILDREN AND ADOPTIVE PARENTS.
Schechter.M. Carlson.P.V. Simmons. J.Q. and Work. H.H.
In a paper submitted to the Childrens Bureau, US Department of Health Aug 1963.
The factor of adoption played a consistently important role in the genesis and perpetuation of the given symptom picture. Two major hypotheses were suggested for the higher incidence of psychological disturbances in the adoptee. Firstly the adoptee may intra-physically continue a split between good and bad in his infantile object relations, since in reality he has two sets of parents. Secondly, the adoptive parent is often confused in his or her role due to unconscious guilts and hostilities and tends to project this disturbance backward into the heredity of the child i.e. the natural parents.
Phipps(1953) mentioned the tendency of parents to speak about the heredity of the child as the major causative factor in behavioural difficulties.
Lemon E.M. (1959) referred to the difficulty that the adopted individual has in dealing with communication concerning his adopted status with a resulting tendency to weave factual material together with much fantasied material in his thoughts as he seeks his natural parents.
They went on to say that these patients perceived their adoptive parents as inadequate especially with the setting of limits and viewed their natural parents as their adequate set of parents.
Livermore J. B (1961) suggests that the adoptees have specific problems in identification, since the adoptive mother constantly reactivates primitive unconscious fears that her own insides have been destroyed.
They summarised by saying. "We feel that we have offered substantial evidence from many sources that the non-relative adopted child may be more prone to emotional difficulties".
A statement from the American Journal of Orthopsychiatry 1967.37 402. Mid-Fairfield Child Guidance Centre Norwalk Connecticut.
The number of adopted adolescent children who are referred to our centre and other centres is larger than their ratio in the general population. "We are impressed with the extent to which these children are pre-occupied with the theme of their adoption".
They go on to talk about the similarity of the traits and attitudes in these children which they refer to as the "Adoption Syndrome".
DISABILITIES OF ADOPTED CHILDREN.
Dr Christopher Ounsted, MA, DM, MRCP, DCH, DPM.
Dr Ounsted states that in the late fifties it had become apparent to him and his colleagues at the Park Street Hospital for Children that they were seeing an unexpectedly large number of adopted children. Many of the children owed their disabilities either to some inate handicap or to defects in the structure of their families, such as having parents who were psychotic, inadequate, psychopathic, defective, or in some other way not able to fulfil their parental roles adequately.
Ounsted noted that of the symptoms of adopted patients, compulsive theft was more significant.
Henry Kemp. Archives of Diseases in Childhood (1971) states that some children may be more vulnerable to abuse than others. Among them are the hyperactive, the precocious, the premature, the stepchild and the adopted.
1974 Dr Triseliotis in his research paper on Identity and Adoption, gives examples of adoptees views on identity.
- 1st adoptee,
- "I look in the mirror and cannot recognise myself".
- 2nd adoptee,
- "I feel there is something about adoption that gives you a feeling of insecurity as regards just exactly who you are".
- 3rd adoptee,
- "I feel that I am only a half a person, the other half obscured by my adoption".
- 4th adoptee,
- "I never really felt I belonged. I feel empty and I find it difficult to make friends or be close to people. I have been hovering on the edge of a break down".
One of the main anxieties of adoptees is the fear of being different and somewhat set apart from the rest.The adopted child has to gradually accept the loss of his natural parents and the "rejection" this implies. Yet he has to also accomodate a preferably positive image of the original set of parents and their genealogy in his developing self.
Children who are adopted into a different culture will still need to identify with aspects of their original heritage.
Bennett Olshaker, MD. In his paper "What shall We Tell the Kids", he notes that the adopted person has to contend with the feeling that he was abandoned, but we can try to help him in a positive manner by portraying his natural parents in a positive manner. He goes on to say that some adoptive parents may feel that their childs' parents were immoral for having a child out of wedlock. These sentiments create difficulties for the parents when the child has questions regarding sexual matters.
ADOPTED CHILDREN ADMITTED INTO RESIDENTIAL PSYCHIATRIC CARE.
Harper.J.; Williams. S. 1976.
This was an investigation over a period of five years from 1969-1974 into 22 adopted children admitted into the childrens unit at North Ryde Psychiatric Centre. Six were referred at age eleven and over, three were referred before their fifth birthday and the remaining thirteen fell between five and ten years and eleven months.
Symptoms in the children ranged from depression, aggressive acting out behaviour to stealing. In some instances stealing was a desperate attempt to buy friendship since the stolen money was to buy sweets and toys for peers. In other instances it seemed to compensate for the loss of the real mother by acquisition of material goods. In all cases it could be seen as a cry for help.
In some instances admission to the unit signals the relinquishing of parental responsibility as evidenced by eight cases where the child was made a ward of the state and placed in a child welfare home. A summary of the various outcomes indicated that they on the whole were unsatisfactory with one third settling back into their adoptive families with a positive prognosis and two thirds demonstrating a breakdown or possible breakdown in the adoptions.
Family trauma and parental pathology was investigated since it was felt that the stress of adoption could not alone account for the severity of symptoms and outcomes in the children. In terms of family trauma one mother and one father suicided after a history of depressive illness, one set of adoptive parents were murdered, two fathers were killed in car accidents with the adoptive child present and three fathers were unusually violent and aggressive men.
In seven cases, the mothers had a history of psychiatric illness prior to the adoption, including one with a schizophrenic illness. In the case of the seven mothers and three fathers for whom a psychiatric diagnosis was made after the adoption, one can only speculate on the degree to which extra-familial stresses and internal pressures contributed toward this decompensation.
Rickarby. G.A. Eagan. P. 1980.
Rickarby and Eagan say that in their and others studies, there has been consistent evidence of morbidity of various types in adopted adolescents. He states that adoptive families are four times more as likely as biological to seek help for their distress. Acting out, degrees of depression, identity crisis and special roles, (the bad one, the mad one, or the sick one) may constitute an adolescent's expression of a families dysfunction.
With the added issues of adoption, adolescent development crises become more difficult and the concomitant distress and behaviour exaggerated. These situations include the adolescent who is unable to communicate to others his frightening or idealized fantasies about his biological parents and who cannot readily accept the identity expected of him in his adoptive family and the adopted adolescent who is struggling to cope in a family beset by marital conflict or mental illness.
Cultural fables may have a destructive aspect on the adopted adolescents development. One such fable is "the chosen child". This is often a source of great anger to the child whose experience of his family has not been "good enough". His anger is directed at the adoptive parents because these people "chose him".
Another fable is that of "the poor child whose parents did not want him" and who was adopted by the bountiful parents to whom the child should be ever more grateful.
ADOPTIVE ANXIETY, RAGE AND GUILT.
Silverman. M.A. 1985. Discusses in his paper that when adoptive status is foisted upon a child, the child is encumbered with so many problems that he or she is at risk of developing a host of psychological problems. This is particularly so if the child learns of his adoption at an early age.
These can be unhappiness, separation problems, difficulty knowing and learning, aggressive fantasies and acts, preoccupation with knives and other weapons, and his feelings of being deprived and robbed.
Adoptive status tends to affect multiple aspects of the developing personality. It interferes with the childs sense of security, the modulation of and channelling of the childs aggression, the development and resolution of the Oedipus complex, super-ego formation, and identity formation.
To lose a parent early in life, especially when there is a felt element of cruel rejection and desertion, as there tends to be when a child is told of adoption while still in the throes of "sadistic-anal" ambivalence and the hostile-dependent struggles of the reproachment crisis of separation-individuation, mobilizes in tense fear and rage. The rage at the abandoning parents is in part directed toward the adoptive parents.
In part the rage is turned back on the self, contributing to the fantasy that the child was abandoned by the original parents because he or she was bad, troublesome, greedy, and destructive.
Silverman goes on to say "nearly every adopted child or adult I have treated sooner or later has revealed the fantasy that the reason for the adoption was the biological mother died in childbirth, which tends to be depicted as a tearing, ripping, bloody, murderous affair in which the baby gains life by taking the life of the mother".
The adopted child not only needs to learn about pregnancy and childbirth to solve the mysteries of his or her origins, but also needs to find out if he or she is really a murderer! Adopted children often entertain the fantasy that the original father too has died.
BORDERLINE PERSONALITY DISORDER IN ADOPTEES.
Wilson. : Green. : Soth. : 1986. Report that many adopted adolescent patients in their hospital (10 out of 21) have received a diagnosis of Borderline Personality Disorder. This diagnosis, made official in the American Diagnostic and Statistical Manual of Mental Disorders (3rd edition 1980), includes the following symptoms: impulsivity or unpredictability in areas that are potentially self damaging, a pattern of unstable and intense interpersonal relationships with idealization, devaluation and manipulation, inappropriate intense anger.
Identity disturbance was manifested by uncertainty about several issues relating to identity, intolerence of being alone, affective instability, physically self damaging acts, and chronic feelings of boredom and emptyness. It is theorised that this disorder arose because of deficits in early parenting experiences which did not enable the child to develop a core identity, so they didnt feel part of a fused dyad, which explains their fear of abandonment and intolerence of being alone.
ANTISOCIAL BEHAVIOUR IN ADOPTEES. ADOPTED CHILD SYNDROME.
Kirshner.D. Nagel.L. 1988.
Is there a distinct pattern of presenting behaviours and symptoms among adopted children and adolescents referred for psychotherapy? Some clinicians and clinical researchers whose day to day observations strongly suggest that such a pattern does, in fact exist. The senior author has observed extreme provocative, aggressive, antisocial, and delinquent conduct much more consistently among adoptees than their non-adopted counterparts.
Behind the recurrent behavioural and personality patterns there have emerged emotional and psychodynamic issues specifically linked to adoption.
Schecter, Carlson, Simmons, & Work (1964) looked at adopted and non-adopted children in a psychiatric setting and found a much greater occurrence of overt destructive acts and sexual acting-out among adoptees. Menlove (1965) used a similar sample and found significantly more aggressive symptomatology among adoptees. Although several predicted differences were significant, adoptees had significantly more hyperactivity, hostility, and negativism, and significantly more of them had passive-aggressive personalities.
What then is the adopted child syndrome? On the behaviourial level, it it is an antisocial pattern that usually includes pathological lying, stealing, and manipulativeness. Fire setting is sometimes seen and promiscuous behaviour is common.
Typically, the child seeks out delinquent, antisocial children or adults often of a lower economic class than the adoptive family. Provocative, disruptive behaviour is directed toward authority figures, notably teachers and parents. The child often threatens to run away, and in many cases repeatedly does so.
Truancy is common, as well as academic under-achievement and, in many cases there are significant learning problems. There is a typically shallow quality to the attachment formed by the child, and a general lack of meaningful relationships. The child reports feeling "different" and "empty".
Yet the parents of most children with the Adopted Child Syndrome exhibit a pattern of tension and denial surrounding the issue of adoption. It soon becomes apparent however, that communication about adoption is not simply absent; much worse, the parents are tacitly communicating a message that the topic is dangerous and taboo.
The child, sensing his parents' insecurity and anxiety, is left to imagine what terrible truths they might be hiding. He feels an ominous pressure against voicing his feelings and curiosity. He senses that his adoptive parents would feel his interest in his birth parents was disloyal. He not only experiences a dread of the truth but also the stifling of his normal c