“Why did you adopt?” The therapist asked my husband. Glancing at our four children, I offered a silent prayer and held my breath while we waited for the response.
“We adopted because for us it was right–and that didn’t change just because the going got rough,” my husband responded. I exhaled; our shared sense of commitment was intact.
“So,” said the therapist next, “you got one that has problems. Tough!” Thus began our family’s first nightmarish experience with mental health services.
Internally, I bristled at the therapist’s attitude toward how we became a family. We needed him to understand our children were not “damaged goods”; they had been deeply wounded. Our family felt wounded too, and we needed to heal. We were not seeking a scapegoat to blame for our pain.
After that experience, we became much more savvy “therapist shoppers,” and have since had positive and healing experiences with mental health professionals. We learned to identify, state, and seek help for our family’s needs.
Trauma, Grief, and Loss Issues
One need was to learn about the effects of early trauma, loss, and grief–the painful aspects of adoption. Recent brain research has demonstrated the devastating long-term effects of early trauma, and ongoing work looks at how children deal with and express grief. Many children who are adopted experience a kind of open-ended grief because they are separated from family members who have not died.
Deep grief is not something any of us “just get over.” The stages of grief some of us learned (denial, anger, bargaining, depression, acceptance) describe the grief cycle of terminally ill people, not the bereaved. Time alone does not heal wounds; healing requires both time and grief work. Without grief work, time merely passes while inner wounds fester.
As parents, we must understand our loss experiences as well, and acknowledge our areas of vulnerability. When something going on with our child triggers our own magnified emotions, the results are not usually helpful in getting us where we want to be as a family.
A therapist skilled in grief and loss can help families negotiate the tricky paths of intersecting losses, and help them understand that anger covers pain. The longer the child’s anger goes untreated, the longer the child lives with the profound pain driving the anger.
As we worked through our family’s issues with therapists, we realized that we also needed to know more about the dynamics of attachment and forming a family through adoption and birth. Like many families, we received no training on how to help our adopted children meaningfully connect with new parents and siblings. Another barrier to helping our children connect was the lack of information about their backgrounds.
When deciding whether to proceed with an adoptive placement, parents can and should request as much non-identifying information as is available. If the social history shows alcohol use or mental illness in the child’s birth family, you will want to know what that may mean for your family down the road. Therapists also need to know as much as possible about the child to offer useful suggestions.
When we adopted, people assumed you could take a child from any situation and simply let love fix any problems. Humans, however, aren’t made to forget significant events, places, and people. A certain smell or the texture of a piece of fabric can instantly transport us to a place and time far removed from present-day realities. It takes time to develop new positive associations, and sometimes trained professionals need to help children put early memories into perspective.
One client in his 40s who had been adopted at birth told me that he always felt “disconnected” during a certain week every year. That week, we discovered, coincided with the days between his birth and going home with his adoptive parents. As a newborn, his physical needs were met, but caregivers changed every shift. We discussed ways he could create new associations with that particular week. With his wife’s and children’s help, he created a plan for a family week filled with fun activities and meaningful conversations. Now, he says, he experiences that anniversary week very differently.
Choosing a Therapist
Some of the good adoption information available in professional literature reaches mental health providers and social workers as part of their formalized training; much of it does not. It cannot be assumed that because a particular mental health provider or placement social worker is professionally trained and licensed, he or she is also adoption competent.
When seeking a family or child therapist, adoptive parents need to present themselves as willing team members working with professionals on behalf of their child’s and family’s well-being. They need to identify professionals who accept parents as part of the team. Below is what we learned about finding a good therapist:
- As a consumer, you are in a power position. You may not feel powerful when you need mental health services, but you truly are in the driver’s seat.
- Interview potential therapists. Identify your family’s needs, and find out if your needs and the therapist’s strengths are a good fit.
- If you wonder about something the counselor or therapist says or does, ask questions. You or the therapist may learn something important.
- At least some of the time, the therapist should meet with your whole family at home or in the therapist’s office. It’s nearly impossible for a therapist to help a family work on relationships if he or she never witnesses those relationships.
- You have a lot invested in therapy–both financially and personally–and you have a right to expect a return on your investment. If, for whatever reason, a particular clinician is not working well for you and your family, it may be time to shop for a new therapist.
My personal advice: Don’t set your sights too short. It is quite normal for our kids to reach around age 30 some of the stages of development we might expect of someone younger (18 to 22). Even in the absence of any disability or pathology, their internal world is very complicated. It would be unrealistic, self-defeating, and discouraging for a parent to expect a quick fix to the effects of early loss and trauma.
I fondly recall a couple who attended a support group meeting for the specific purpose of telling struggling parents they were enjoying a relationship with their 35-year-old daughter they would not have thought possible in the years leading up to that time. Happily, our kids haven’t waited quite so long to tell us that having a family was and is important to them. As parents, we also know that finding therapists who had the knowledge and skills our family needed, and who worked with us as peers, also made a difference.
Therapy Survey Results In
The results of a survey NACAC conducted this year suggest that some therapists harm adoptive families by blaming parents, misdiagnosing problems, and seeing children who have attachment disorder without parental presence or input. Survey respondents also offered these positive comments and suggestions:
- “The most helpful thing our therapist did was to work with the whole family and see us individually. To be able to honestly speak out my frustration and just have someone listen and not condemn was better than any seminar or parenting class.
- “We have learned that anger begets anger, and though we have kids who have a great gift for evoking anger, it is very counter-productive to go there, and causes hopelessness in a child who can’t control his own anger and who needs to see grown-ups control theirs.”
- “I think the best advice has been to not make issues out of anything that isn’t absolutely crucial to the child’s and the family’s survival–to put controls on the child’s behavior that are enforceable and that the parent can live with comfortably.”
- “The most beneficial advice we received has been to take time for ourselves before we take care of our children.”