Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, October 18, 2010

"Primal Wound" or "The Blight Man Was Born For"

Over the last week or so , discussions at http://osolomama.wordpress.com have centered around the idea of the “primal wound” (even though that was not the blogger’s plan). The “primal wound” in question is the posited emotional injury done to infants separated from their birth mothers. Those who support this idea believe that such an injury occurs even if the baby is placed with other caregivers at birth, and that the “wound” continues to cause pain all through life, unless it is resolved and healed in some way. Adult adoptees commenting at osolomama and elsewhere have made it very clear that they experience ongoing distress in close relationships, that they feel they have had this experience throughout their lives, and that they attribute their sense of distress to their history of early separation. (I am stating this simply and unemotionally for the sake of brevity, but the adult adoptees tell their stories vividly and with intense emotional engagement.)

But here’s the issue: nothing in all the careful work in developmental science done over the last century would suggest that it is possible for early separation to have a lasting effect on children who soon enter a stable, lasting adoptive family. All the information we have says that early-adopted children do very well (for example, Sharma, McGue, & Benson [1998]. The psychological adjustment of United States adopted adolescents and their non-adopted siblings. Child Development, 69, 69,791-802). Later-adopted children may have more problems, especially if they were in institutions for long periods or had risk factors that led to their being institutionalized to begin with, but often show good recovery over some years (for example, Rutter, Kreppner, O’Connor, and the English and Romanian Adoptees [ERA] Study Team of 2001.[2001]. Risk and resilience following profound early global deprivation. British Journal of Psychiatry, 179, 97-103).

In addition, the study of early development shows that infants do not show concern about attachment and separation until they are 6 months old or older. This does not mean that they cannot tell the differences between people, initially by smell and sound and later by looks. However, it does not seem important to the young baby to be close to a familiar person, as long as the caregivers they are with are sensitive and responsive to the baby’s needs (and of course familiar people may do a better job of reading the baby’s cues, first because they know the individual child well, and second, perhaps, because they may be highly motivated to take good care of that baby). It’s not until about 7 or 8 months that most babies will show by their behavior that they are afraid of a stranger, or temporarily disturbed by the absence of a familiar person, or deeply grieved and disturbed by an abrupt, long-term separation. It does not seem plausible that an event that a baby did not respond to at the time it happened would nevertheless cause later disturbance and grieving. The only possible argument that this could happen would seem to be based on the assumption that memories can be repressed and work some mischief from the unconscious, but the evidence is clearly against that idea.

These well-established facts suggest that there is no “primal wound”. The idea that there is such an emotional injury seems to have come out of the writings of a California marriage and family therapist named Nancy Verrier, whose thinking is strongly connected with that of William Emerson of APPPAH (Association for Pre- and Perinatal Psychology and Health). APPPAH is an organization that stresses the belief that unborn infants have conscious understanding of events going on around them, perhaps all the way back to conception or even before (you’ll have to read that part for yourselves). Verrier and her colleagues are committed to the idea that there is a biopsychological attachment between a baby and its birth mother, which when broken by separation creates a lasting emotional injury. This belief is based on some earlier views like those of Otto Rank, who suggested that birth itself is a traumatic experience for the baby; these approaches seem to be basically a reworking of the old “maternal instinct” assumption. Whatever the reasons behind the “primal wound” belief, it does not seem possible to integrate them with anything we can observe about early development.

A number of adult adoptees have found the Verrier viewpoint to make sense for them as more than a metaphor for their life situations. They feel an intense and disturbing sense of loss, which deserves to be treated with respect even though at the same time I argue against the cause they believe is behind it. People with this view of their life events ask, legitimately, “why do we feel like this if it isn’t because of our early losses?”. And of course I can’t really answer that question (certainly not to their satisfaction). I would suggest, though, that a sense of loss and loneliness is part of the experience of every thinking person. Gerard Manley Hopkins spoke of this in his poem about autumn and loss:
“Margaret, are you grieving… Over Goldengrove unleaving?.. Leaves, like the things of man you… with your fresh thoughts care for, can you?... ‘Tis the blight man was born for… It is Margaret you mourn for.”

We may not need to look to a history of early separation to explain why we human beings mourn for ourselves.

48 comments:

  1. I think this is a very objective and respectful analysis of the theory.

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  2. You often see statements to the effect that human mothers and babies are designed or *wired* to bond to each other exclusively, that the process starts before birth, is intended to continue after birth, etc. Can you comment on this from an evolutionary standpoint? Can you comment on this in relation to fathers?

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  3. I always find it's sticky to discuss these things from the evolutionary viewpoint. You never know but what you're just inventing a "just so" story. However, when we consider the number of deaths in or soon after child birth that occurred before modern medicine (just look at any 18th or 19th century graveyard for the evidence), it would seem not to be adaptive for a baby to be emotionally committed to the birth mother at such an early point. Grief in babies is accompanied by poor eating and by apathy as well as by crying and distress, so for a newborn to be affected by separation from the birth mother would mean that he or she would eat less than needed at a time critical for growth and health, and would fail to pay much attention to the world at a time when there is essential learning about language and how the environment works. The significant number of babies whose mothers died would then be a group whose physical, emotional and cognitive frailties took from the community, but did not give much back. This would not be nearly as adaptive as delaying attachment until the baby was older and the chances of a caregiver's death or disappearance were less. Of course, this doesn't really explain what happened, but it is interesting to see the disadvantages of prenatal attachment.

    About the fathers: thanks for the nudge, I kept meaning to refer to this issue and forgetting about it. In my opinion, this is a matter where we have to focus on human beings exclusively rather than making the (sometimes tenuous) comparison to animal studies. In many mammalian species, although fathers will sometimes play with or care for older babies, they may kill and eat younger ones; of course, I should point out that animal mothers sometimes do this too, especially if the babies are not very active.

    For human beings, cultural differences play an enormous role in determining whether or not fathers pay attention to young children. Because parental bonding seems to depend on experiences with the child, these differences help to determine how interested and committed to a baby the father will be. Margaret Mead used to say that hunting-gathering societies didn't dare let the new fathers be around their babies, because if they had that experience they wouldn't be able to tear themselves away to go and hunt. (Whether or not that's true,I don't know.) In our society, abuse and murder of young children is more likely to be carried out by stepfathers than biological fathers, and it's possible that the real difference has to do with the amount of time each man spent with the child early in its life, rather than some biological connection like smelling similar.

    In the 19th century and before, even very young babies were considered to "belong' to the father and not to the mother, and they stayed with the father if the marriage broke up. Our emphasis on the mother-child relationship is a fairly recent one and is much affected by changes in attitudes. For instance, the Klaus and Kennell book "Maternal-Infant Bonding", published about 30 years ago, became "Parent-Infant Bonding" in a later edition.

    All these cultural and historical changes make it difficult to think about father-child relations for humans across the board, but you really have to exercise your imagination to think how they could involve anything "pre-wired". The same may apply to mothers and babies, but it's not so hard to imagine, which is no doubt why so many people imagine it.

    One more thing about this: we need to be so careful about the idea of "bonding to each other". That term suggests that the feelings of new mothers are similar to the feelings of very young babies, which is just what I've been arguing is not true. Using the term "bonding" for adults (related or not) and "attachment" for babies helps keep those parallel but different processes separated.

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  4. I have been reading Malcolm Gladwells work on the unconscious mind. Isn't it possible that there is a part of the brain that registers this information but is unable to express it or buries it for further processing once the need for survival as a dependant infant is over?

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  5. How would it do that-- in what form would the information be? And, forgive my bluntness, but how would that explanation be any different than "it just does"?

    Here's the thing: babies have very poor memories compared with those of older children or adults. They have to have things repeated quite often before they remember them for more than a short time.

    For example, in the work of Caroline Rovee-Collier, 2-month-old babies took 7 to 9 minutes to figure out that when they kicked, they made a mobile go around. They forgot this within two days and had to learn it all over. By 6 months, they remember for more than two weeks. Also, as other work has shown, babies who are crying at a time when they might be learning don't remember as long as babies who are calm at the time.

    So, unless you want to speculate on a special kind of memory, a special brain part something that doesn't follow the other rules of development, I don't see how you can argue that babies learn, repress or whatever, and later retrieve the information. And really, how could they process it later-- "hey, there was another mother here-- that's not how it supposed to be--- now I'm upset." It's just not plausible to take this adultomorphic view that assigns young children feelings and motives that could really only be part of experiences as an adult evaluates them.

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  6. Could it not be true for some and not for others? Could some babies in fact grieve the loss of their first mothers while others are more resilient? Could it be that there is another experience that is not grief (as we adults understand it) but is still loss? Perhaps there are other biological factors that create difficult beginnings for kids who lose their moms soon after birth. Perhaps the uterine environment is somehow more disrupted during a crisis pregnancy and this "primes" a child to be more alert?

    I have no idea and I think it'll be a long time before we do know. Personally I know my daughter is securely attached to me but that she also felt the loss of her birth mom when she was quite young. I don't know why, I don't know what that means from a psychological standpoint. I think much of it is cultural (and the importance we place on Mothers as singular, irreplaceable beings) and that she felt this early on. I also think it has been exacerbated by our transracial adoption since she was able to identify with her black mother as being OF her earlier than a child in a same-race adoption might.

    It's all interesting though.

    In practice (because I'm studying to be a counselor) I think my bias is that adoptees experience a cultural loss that is profound and that they may interpret as biological. Whether it is in fact biological or not seems less important to me than in treating and addressing that idea and sense of loss and moving forward in healing rather than on focusing backwards into the why/how but then it's all theory for me at this point so who knows if this will play out in practice.

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  7. Dawn-- I agree that the important thing is to help people who are distressed. But the reason i got into this in the first place is that I'm really concerned that those who are into the "primal wound" belief may easily accept the idea that unsupported treatments like "attachment therapy" are the way to do this, and even that conventional, evidence-based treatments will make their problems worse.

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  8. "Whether it is in fact biological or not seems less important to me than in treating and addressing that idea and sense of loss and moving forward in healing rather than on focusing backwards into the why/how but . . ."

    This is sort of where I am. To me, something isn't made "more real" by being looped back into a biological explanation or beginning. Sadness or sorrow may not be depression, but they are just as real.

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  9. The fact it's biological seems very relevant to the people who feel they suffer from a primal wound which does make it important, it would seem to me.

    When I think about a primal wound and the connection an unborn baby would need to have to it's mother I can't help but think about the trauma of a newly born baby. Birth itself should be shocking and at times fairly violent and if there's this congenital love, sense of safety and connection, why wouldn't the experience of birth be as, if not more, traumatic as separation? To me it would seem like a betrayal of trust full of the familiar sounds and smells that are used to support prenatal knowledge of the parents and their importance emotionally to the newborn.

    It just doesn't make sense to me how one event such as separation at birth can be so damaging while the other, the act of being born, hasn't the same negative impact.

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  10. That's an interesting comparison, although plenty of people have been claiming for some time that birth itself is traumatic.

    But what is their reasoning when they think birth should be shocking to the baby? Isn't this one of those adultomorphic assumptions-- "boy, I'd hate to be squeezed through a little space and pop out into something different from what I'd ever experienced!" Babies reflexively become very quiet and passive during the birth process, so their actions don't tell us anything about what they're experiencing. But why might their experiences not be just the opposite of what people like Otto Rank have assumed? Here's what we might imagine, if we attributed adult thoughts and feelings to the unborn baby: "Oh, it's getting so tight in here! I'm just too big to fit any more. I'd give anything for a good stretch-- I'm sick of being all bent over in this, what's it called, fetal position. And talk about boring-- I can't see a thing, and sometimes I hear voices somewhere, but most of the time it's just gas gurgling through Mom's intestines (eeew). When can I get OUT of here and have some fun?!"

    Just because we imagine that the baby was blissfully happy and comfortable in the wound, that doesn't make it so. Of course, my imagined scenario need not be so, either, but why not? We have just as much evidence for one as for the other.

    Applying similar reasoning to the "primal wound" issue gives similar results. The fact that we can imagine what we'd experience if we were in the baby's position doesn't say that the baby has that experience. The only evidence we can work with is that some adult adoptees feel distress that they attribute to their early separation. But as far as I can see we don't even know whether their distress is greater than that of some non-adopted people, or whether there are other experiences linked to separation that are the actual causes of unhappiness. And... therefore... I'd like to see people avoid mental health interventions that claim to deal with "primal wounds".

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  11. Primal Wound is BS. I know Nancy Verrier and like and respect her, but her theory has caused an extreme amount of harm to the restoration of bastard rights.

    Instead of positing adoptees as independent agents with rights, PWT infantalizes, medicalizes, pathologizes, and depoliticizes adopted people ultimately creating the I Want My Mommie crowd who cry at hearings and seem to suffer from arrested development. It opposes class struggle and props up the adoption industry. It's so middle class. And boring

    This is, it's a part of the larger theraputocracy that defines USians as irresponsible wimps.My life is miserable because I'm adopted, and I can't do anything about it except maybe throw money at it. A marketing scheme of psychologists and psychiatrists to convince people they are too inept and stupid to handle their own problems. You don't see the rest of the world walking around like psychiatric zombies.

    If there is such a thing as PW, then why don't babies who mothers die in childbirth or shortly after suffer from it? Why not children who are orphaned by war or natural disaster? Or whose mothers just split?

    I'd say instead of PW, that adoption practice and policy itself is the villain. Shame, family secrets, privilege, sexual repression, entitlement, pediocentricity, sealed records, phony "privacy" arguments, getting beat up whenever you ask a question, fake government records, etc. is what it's really makes people crazy. Read R D Laing.

    Hardly anybody wants to root that out on any meaningful level, because adoption is "good." Adoption as it is practiced, especially in the US, is dysfunctional, unnatural, unhealthy, and unethical. In a decent world adoption would be illegal. It's Let's Pretend.

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  12. I just came back from a generally lovely CUB Retreat attended by birthmothers and adoptees, but for me, there was one huge drawback. Almost all the presenters and presentations assumed that belief in the primal wound and related theories were a given. There was no room for skepticism or doubt.

    I felt that whether or not these theories were valid was not open to discussion, and I did not try but went to my room and took a nap during the presentation by Ms. Verrier and two others, one being a homeopathic practitioner even deeper into the woo. As I commented elsewhere, I felt as uncomfortable as a Jew at an Evangelical Christian revival meeting:-)

    I do not object to anyone's sincere beliefs, no matter how strange to me, as long as they are posited as beliefs, not as science. Like Osolo Mama, I do not need scientific validation for my private spiritual beliefs, nor for taking comfort in myths, archetypes, religions, art, music, and fictional narratives. I do not discount any of that. It is what makes us human and different from animals, and think that without addressing that component, we leave out a huge piece of human nature and what helps us to deal with the pain in all our lives and give it meaning. The arts are just as vital as the sciences, and just as true, but in different ways.

    Like Dr. Mercer, I am concerned about untested beliefs morphing into pseudoscience and the harm this can cause, and feel it demeans science and humanity to use it to prop up ideas that are not valid or provable as absolute because they are "scientific".

    It reminds me of the ads that were around when I was kid in the 50s, with the scientist in the white coat selling soap or cigarettes or cereal. "Nine out of ten doctors recommend..." It also reminds me of 19th century snake oil salesmen touting their miracle cures that at best were harmless placebos and at worst were poison.

    Many adoptees feel distress over being adopted. That is clear and none of us hear are denying that or saying it is not so. But I do not see where it shows disrespect of anyone's individual feelings to question where that distress comes from and when it starts.

    I do not see any scientific way to prove that Primal Wound theory is true. But that does not make it not true in an existential way for those who feel it. The important thing is not so much what caused the pain, but how to help heal it so those suffering can live a more comfortable life today. And any decent therapy needs to deal with the person's life now and how they can go forward, not some impossible attempt to relive the past or ruminate endlessly over it.

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  13. BD, as I understand it, some PW fanciers do claim that the mother's early death has the same impact as separation followed by adoption.

    If people are going to read R.D. Laing, as you suggested, I hope they'll do it with a saltshaker nearby, for taking things with grains of. If you look at the history of some of these ideas, you see Laing and the anti-psychiatry movement encouraging regression and defining psychosis as the way to reach mental health.

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  14. I see the "Primal Wound" as an example of labeling or defining a problem (often by someone with a personal stake in doing so) in such a way that the label then becomes attached to the people for whom it has been created and they then accept and internalize it and come to believe it is a part of them and their experience (whether in fact it has been or not).
    The trouble with using such a powerfully emotive term is that it leans towards the absolute. It is reductionist because it preempts the possibility that similar or related experiences can be received in many different ways

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  15. @ BD as the good Dr. Mercer explained, it is relevant to babies whose mothers die. Also on what do you base the PW theory is B.S.? What scientific data do you have? Oh yeah, none. Do you consider yourself a model of achievement, enlightenment? Because if that is the case, I prefer to stay where I am.

    I think your problems dealing with legislators are chiefly organizational. I have never talked to a legislator about the primal wound, they don't know about it, I don't bring it up. It is just a bloody book.

    I have worked or failed to work with BD on adoptee rights issues, her personal issues got in the way of being able to cooperate with a group. I suppose that is because she is so psychologically healthy that she can't work with a group.

    How silly.

    The thing is , there is a big "I don't know" about this issue. I would like to know why if the adoptees who feel no connection with their mothers, a la BD, make it their life's work to get birth certificates. I mean after all, it is just paperwork. One name is as good as any, one history, is as good as any if there is no connection. Who cares? If there is no connection between babe and mom, who cares?

    You know everything you need to know BD, it is on your amended b.c. Why did you fuss with your mom? Why did you vomit on the way to see your mom? Did you have the flu? You talk about Benedict Bastards all the time, what are you worried they will steal your crown?

    As for our dear Dr. Mercer. Well, I can only say you are right as far as I know about development issues. I and my adopted brat-brother were precocious developmentally. We were both at the top of our f*cking classes and he was exceptionally coordinated, I am kinda lame that way, but good enough.

    Yes, we both were golden shining stars in our respective schools. So what? How on earth you could be considered a part of this golden gifted class and deny everything that anthropology sets forth is beyond me. Acadmeia is academia, nothing else. Don't comfort yourself with intellectual exercises, that you have already proved yourself clumsy in.

    I have real phsyical experience, I have something that BD does not. I have experienced all this BS without ever reading the primal wound.

    You have no basis, scientific or otherwise, you were so ridiculously condescending as to suggest there may be some other reason I felt the way I did toward my "birth" mother? I mean WTH?

    I want you to know something. I want you to know that I know a person who killed himself over what you dismiss. I want you to know that I suffered greatly for something you dismiss out of hand, I want you to know that what fueled my own break-down is what you dismiss out of hand.

    When I read your words, I see blood on your hands. When I read the words of people who support you, I see blood on their hands too.

    You may think I am hyberolic, but you have not walked a mile in my shoes. You have not heard the stories I have heard and you have not cleaned up the blood spatter afterwards.

    I am very angry with you.

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  16. )By the way, I am maryanne, not trying to change my identity but this is the way the google account does it for some reason)


    Agreeing about Laing nor being a good source when dealing with actual mental illness. We have learned so much more since he wrote about the organic basis of serious mental illness like schizophrenia, bi-polar, and severe depression. Those illnesses are not romantic or counter-cultural in real life, they are devastating and destructive for the sufferer and those around her.

    I love the Hopkins quote, and it is one that has occurred to me as well in relation to some of the adoption blogs I read. "It is Margaret that you mourn for." Yes!

    My favorite Hopkins quote is one that ends on a note of hope, from "God's Grandeur".

    "And for all this, nature is never spent;
    There lives the dearest freshness deep down things;
    And though the last lights off the black West went
    Oh, morning, at the brown brink eastward, springs—
    Because the Holy Ghost over the bent
    World broods with warm breast and with ah! bright wings."

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  17. Joy, why is it condescending to suggest that there may be an alternative reason for your feelings, or even several reasons operating at the same time? I can see why you'd be furious if someone said you didn't have those feelings, but I really don't understand why you're locked into a single explanation.

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  18. Joy, I know of an adopted person who killed himself as well, and I know his mother in person. She said that far from primal wound theory being helpful to him, it made him feel more hopeless as it led him to believe that what he suffered from could never be cured, and that he could never get better. People in adoption reform telling him that primal wound was what ailed him helped to push him over the edge.

    Anecdotal evidence can cut both ways. I believe pseudo-science can be dangerous and can make vulnerable people worse, not better.

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  19. Where are the studies that show that PW is relevant to babies whose mothers die or leave them? I tried to research this one afternoon and couldn't locate any research, though I did find a lot of research on the socio-economic impact of the death of mother on remaining children in the developing world (disastrous). Dr. Mercer, you said some PW advocates say the same effect applies but do you know on what basis they say this?

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  20. Jessica, I don't think there are any systematic studies on this question. It would be very difficult research to do, because you'd have to allow for the cause of death (was it something that could have influenced prenatal development or the birth process), for the care the baby later received, for the stability of the care situation, for the concerns of any other family members,etc., etc., because all of those could affect development too. As the old blues song says, "Motherless children have a hard time when they mother is dead."

    I have no idea why some PW advocates say this (or anything else), but it's certainly logical to think that if separation followed by adoption has an ill effect, death would too, as the ultimate separation, also followed by adoption. I doubt that many people attribute to newborns the ability to say, "Oh, Mom didn't mean to leave me-- she died-- so I'm sad, but I can't really be mad at her.".

    You know whose opinion would be interesting to have-- the Baby Blue Foundation people, who advocate for the state "safe haven" laws that allow a baby to be surrendered in certain places, no questions asked. Do they think the babies will have PW problems? It's not that I think they have relevant research, but I'm curious about their take on the surrendered baby's later life. Does anyone know?

    Maryanne, you bring up an important point that I've been cravenly avoiding: whether the publicity for PW thinking actually does make people despair of improvement. We don't have the evidence to say yes or no on this particular issue, but there has been discussion of what's called a "looping effect" in which people hear their group described in certain ways and then change to fit the description better. There are some poorly-understood effects that cause changes of this kind. For instance, in Freud's day, there were lots of conversion hysterics (emotionally caused blindness,paralysis, etc.). Now there are very few, but loads of mood disorders. How come? I don't claim to have the answer, but publicization of certain views is certainly a candidate for the cause.

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  21. Dr.Mercer, could this loop effect (which I think is very relevant to adoption reform groups) be related or a milder form of what is referred to as mass hysteria? That is a documented phenomenon where people can become violently physically ill, panicked, or in other cultures and times believe they are possessed by evil spirits, just by the power of suggestion in a group. It spreads like a virus and anyone can be vulnerable in the right setting. There is a cult-like aspect as well, that can be seen among adherents of primal wound theory that allows no "heresy" from the One True Faith in universal adoption trauma from birth onward.

    The power of suggestion and subconscious and sometimes overt peer pressure to conform to a group norm is a strong motivator in any peer support group dealing with a specific issue, especially an issue that is very emotional like adoption. PW provides an easy , one size fits all answer to complex questions about the genuine pain that surrender causes many adoptees and their natural mothers.

    I was puzzled as to why mothers would gravitate to a theory that seems to induce guilt for harm that can never be ameliorated. What I think appeals to some mothers is the notion that they are in all ways irreplaceable; that they are the only "real" mother and adoptive mothers are an inferior substitute. Personally this leaves me cold, but I can see why some mothers would find it attractive. For some adoptees, it provides a simple rationale for all that is wrong in their lives.

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  22. I can go with peer pressure on this PW question, but maybe not agree with the "mass hysteria", which I think involves symptoms that come on and then resolve fairly quickly.

    In addition to peer pressure, there may be a matter of confirmation bias, in which convinced persons pay attention only to information that supports their beliefs, and may choose to associate only with people who share their view. I don't think PW proponents seek out adoptees who don't consider their history to have been traumatic, nor would that group be inclined to go looking for PW supporters. If I'm wrong on either of these, I hope someone will tell me.

    As for the mothers who are PW believers, I can only assume that they think they were wrong to place their babies and believe they should suffer for their actions, which they do by declaring how much their children are suffering. Maybe there's a dose of sexual guilt too (if women have sex outside marriage, they should suffer plenty, and so should their babies). Maybe that will alter as more and more babies are born to and reared by women who have never been married.

    It's a curious thing-- you'd think that anti-abortion groups would concern themselves with these negative views of adoption and would encourage adoption as an appropriate handling of any unwanted pregnancy (including those of married women). But as far as I know, they don't refer to such issues at all.

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  23. Dr. Mercer, I need to clarify a bit. When I cited Laing, I was speaking specifically of his stories of "crazy" adopted people who were made crazy by adoption secrets and lies. Like the woman with the A-Bomb in her stomach. I tend to believe that many people are driven to "craziness" through their families and the bourgeois culture that surrounds them. Therapy is simply a society-approved means for people to decrazy themselves and fit in, when in truth, there is nothing worthwhile fitting in to. It is greatly open to abuse by quacks, and subject to junk science, and those with agendas, such as evangelical Christians. (see how contemporary Protestant Christianity is nothing but a form of therapy.)

    I believe also that therapy, especially PWT, is opposed to political action. I don't think Nancy intended that,but that's what's happened.

    I'm certainly not opposed to all therapy. It is clearly good for some people. And some people need it! But to blanket adoptees as suffering from PW, as the woundies who proliferate in the movement do, and which I believe Nancy ever intended to do, depoliticizes the sickness that is adoption in the US today, essentializes women, and disempowers adopted class, making us, to the general public. whiney entitled ungratefuls. I've never attended a hearing where some leggie along the line tells an adoptee witness they should be grateful they weren't aborted.

    Obviously, adoption psychologically harms many who are subjected to it, but why use a band aid when a Kalishnikov is needed? How adoption effects one is personal, how it affects rights is public.

    The middle class obsession in the US with therapy grew out of the USians', hung up on "democracy" and "individualism," reluctance to acknowledge class demarcations and issues. Therapy is a fulfillment of "the American Dream." With it I can straighten up and get what I want. Therapy is also a product of consumerist "expert" culture that developed in the early part of the 20th century. It's "your" problem you are "fill-in-the-blank." An expert can straighten you out. God forbid you might be screwed up because of systems of oppression and economy.

    Interestingly, I never saw a pathology of blacks in the 1960s. No one ever suggested that blacks suffered from some kind of "wound" that need "healed." Any pathology that was proffered women's liberation (as opposed to namby-pamby liberal feminism) like stupid penis envy was rejected. It seems that only queers, and bastards and their mothers are subjected to and beat up daily by wacky psychological theories. Could that be because we're all about inconvenient sex stuff?

    Therapy may be appropriate, but is is not appropriate in the public sphere. PRT may ressonate with some people, but it is not appropriate in the pubilc sphere. That's my bottom line.

    BTW, when I read PM I didn't see any reference to children who lost their mothers through outermeans, though it's very possible some promoters may have amended it.

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  24. Anti-abortion groups are all over encouraging adoption. Did you ever see "Adoption, Not Abortion" bumper stickers? They are also the main source of "crisis pregnancy centers", many of which feed into adoption agencies. They gloss over the pain of surrendering a child, while magnifying the pain and regret some women feel over abortion. Here is one link but there are lots more:
    http://feministsforchoice.com/the-crisis-pregnancy-center-adoption-racket.htm

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  25. Someone writing here referred to maternal deaths. I must say, for any consistency about this, PW would have to result from any form of separation. You can't privilege maternal death and still claim PW as the cause of poor outcomes.

    You might want to think about the Counter-Enlightenment as a factor in social-control-by- theory like this-- and I'd certainly argue that it produced R.D. Laing, as well as much other similar thinking.

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  26. Of course they are advocating adoption, Maryanne, but what I said was, they ought to be fighting the PW belief if they want their agenda followed.

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  27. "Someone writing here referred to maternal deaths."

    That was yours truly and I see what you mean. Actually, was only looking into it as *one* comparison base but the situation is also quite dissimilar when children are raised by their fathers and extended family who talk about mom. Not at all like what many adoptees experience, which one would think would be a constant reminder of dislocation and part of the loss.

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  28. You mean,the fathers and all talking about the loss would be a constant reminder? I would certainly think this would be one of many types of experiences that would help determine the subjective outcome for the adoptee.

    Unless someone can figure out how to detect the baby's posited wound, I can't see how the outcome in adulthood can be attributed to any one thing.

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  29. No, actually, I meant being raised by your bio-family and knowing what happened to mom would probably be sad but anchoring. For adoptees, there's usually that where-the-heck-am-I moment, especially for TRAs (trans-racial adoptees). What I was trying to say winds up being in sync with your conclusion though--outcome in adulthood could be attributed to a bunch of things.

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  30. The thing is, to understand what might be happening, we have to get into the details and pay attention to ordinary developmental events as well as to experiences over the years. Regrettably, most people aren't interested enough in children to take the trouble to do this, so they accept simple one-factor theories to explain complex stuff.

    A mantra in infant mental health circles is "This isn't rocket science-- it's a lot more complicated than that!"

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  31. I see what you mean about PW and right to life, but I do not think that PW theory is even known outside of the insular world of adoption reform. It is not even on the radar of most other groups to approve or oppose.

    That very strange APPAH group touches on it, but they are into so many fringe beliefs that it is small part of their agenda. I would imagine they are not much respected in the larger field of child psychology either. When you start talking about consciousness before conception, and circumcision of male babies being a major cause of violence, you are on very shaky territory as far as science is concerned.

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  32. And anti-abortion organizations, particularly National Right to Life and its state affiiliates and the American Life League are in the forefront of keeping records sealed.

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  33. Few people in child development, even in infant mental health, have ever heard of either PW or APPPAH. The only cross-over has been that Michael Trout, now an APPPAH leader, was once very well thought of in conventional circles, and I know that many people are unaware of his present views. I only know anything about PW because of coming across Verrier while trying to figure out attachment therapy about ten years ago. At that time, PW was considered valid by AT practitioners, but they believed their methods could "fix" it by getting the child to reject the birth mother and attach to the adoptive one. I don't know the present position of ATTACh on this,if any.

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  34. "These well-established facts suggest that there is no 'primal wound.'"

    I read the articles that you suggested, but none of them deal specifically with research focused on neonates. If you could point me to some research dealing specifically with the period of development in question here, I might have an easier time accepting that you've demolished the PW as nonsense. I would agree that more research needs to be done, but it seems hubristic and premature to say that there is a definitive answer that babies are malleable little people who are indifferent to their caretakers.

    As for "mass hysteria," can't say that I've noticed any of that in discussions. Just a lot of adult adoptees being told that what we think is wrong, and that APs and "experts" know better than we about our own lives. I agree that the circumstances that affected me in childhood are complex. I have never said that the PW caused all of my ills, nor that it can't be overcome, nor that it's universal. But in my life it makes sense. I talked to my two therapists this week who also believe that it remains a possibility, though unproven.

    What do you make of the research done by pediatricians John Kennel, Marshall Klaus, and T. Berry Brazelton, all of whom have researched and agree that infants are involved in the bonding process as much as mothers and fathers?

    And have you read Annie Murphy Paul's new book, "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives"? It wasn't as thoroughly researched as I would have liked, but Paul does point out many grey areas that may prove to be important down the line.

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  35. I have seen Trout speak and present his awful video where he speaks for and as the baby about "gentle transitions" in open adoptions. The whole thing was nauseating. This was in the late 90s at an Open Adoption conference that used to be held in Traverse City, MI every year.

    The video has to be seen to be believed. Big hairy guy as voice of "everybaby" just does not make it.

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  36. Ms. Marginalia, what sort of research on neonates do you have in mind? I really don't know what you'd be looking at other than crying or perhaps heart rate when held by mother or others, and crying at least ought to be easily detectable as the baby gets handed back and forth from one person to another. No one has reported such a difference as far as i know-- should you find such a report, I'd like to know about it.

    However, even if babies were shown to behave differently with their mothers in the first days after birth, I don't see how that would be evidence that there was a long-term "wound". To substantiate that claim, you'd need to show differences between early adopted and non-adopted children or adults.

    But part of the problem here is that it's not possible to show that something does NOT happen, unless you can demonstrate that something mutually exclusive DOES happen. The lack of evidence against a possibility is not the same as evidence for it, either.

    Klauss and Kennell's original work focused on the response of the adult to the young baby. They said, and Brazelton and plenty of others agreed, that characteristics of the baby facilitated or discouraged a positive response from the adult. But that's not the same as saying that the baby is emotionally involved in the same way. The fact that a baby is cute,alert,or socially responsive doesn't mean that he or she can make a lasting emotional commitment to someone.

    If you and your therapists find it useful to use this "primal wound" metaphor, I can't argue with you. However, it may be of interest to you to know that people who study babies don't think it's true in a non-metaphorical sense.

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  37. I agree with you on many counts about things not being proved. I don't have the answer, but neither do you. And to suggest that you do is disingenuous. I am not talking about babies 6 months old and up. I am talking about what happens to neonates who are separated from their original mothers. There is voluminous research on neonates who are separated from their mothers for medical reasons in NICUs; this separation correlates with increased levels of anxiety later on in childhood. These are longitudinal studies that assessed attachment, pain, eating, etc. If separation can affect these babies, is it really such a stretch to suggest that separation in the case of adoption might cause similar long-term effects, if not for all babies, for some of them? I am not saying that it does, but I believe an open mind is a good thing.

    And as for your last paragraph, it is like a backhanded slap. You say, "Well, good for you and your therapists. But you're wrong, and if you can't see that, you're not very intelligent. Metaphors are not scientific or useful." It goes back to our painful earlier discussion on O Solo Mama's blog in which Joy, Mei Ling, and I tried to say in various ways that adult adoptees' opinions are not given the same kind of weight and respect as others. I am not sure why it should be so difficult to wish someone well in dealing with their pain without adding a value judgment. I think it's for the best that you are not a clinical psychologist.

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  38. Ms. M., tell me,how would research on those NICU babies etc. tell you which problems were due to separation, which to their NICU experiences like getting their heels stuck for blood every four hours, and which to whatever conditions took them to the NICU to begin with? The only way you could isolate the effects of separation is by looking at babies who are separated purely for social or personal reasons. It's the same kind of problem as studying Romanian orphanage children and having the results complicated by the fact that some have FAS.

    As for the metaphor thing,you have read into my statement the position that you want me to be taking(because it would be so easy for you to oppose). Metaphors are extremely valuable ways to understand both the personal and the public worlds. The use of metaphor in psychology has received much study over the last 20 years or so. In fact, I just finished writing an article about the concept of regression that's largely about the changing metaphors underlying that concept. Metaphors are an aspect of science in that they guide us to explore particular questions.

    I was suggesting that the PW metaphor can be useful to you whether or not there's evidence for it in infant behavior. But you seem to want me to capitulate entirely and confirm your belief that how you feel today indicates how you felt as a neonate. This I can't do, nor do I understand why your viewpoint needs to "trump" everything else (so, yes,we're back to the osolomama discussion).

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  39. I never said that my opinions or feelings trump everything else. What I want is respect. I don't want you to capitulate. You are welcome to disagree with me, but there are ways of disagreeing which show respect and those which don't. The power imbalances in these discussions are unbelievable. You don't have all the answers, no matter how hard you want to argue that you do. Nor do I, although I can say I've lived it. Again--NOT TRUMPING ANYTHING. Just another viewpoint.

    I agree that the NICU analogy isn't perfect. You have a point. It is a difficult thing to measure the effects of separation, but that doesn't mean that the effects aren't there. As for your calling for "pure" research: life isn't pure. There are always multiple variables at work. Smart people learn to work with them or around them, and don't dismiss things as impossible.

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  40. As I understand it, the heart of the PW is an acute sense of loss and of feeling alone and isolated even under the best of replacement family circumstances. The reasons are largely self-explanatory, require no apology and especially should not need to be medicalized in order to gain wider acceptance and recognition.
    I don't believe adopted people need to be pathologized in order for their multiple losses to be recognized. In fact I believe that to do so would be counterproductive to their case. Not that I think the developing fetus is immune from external influences or the psychological state of the mother, or that early separation is benign, without impact - and certainly not that it is desirable.
    But I believe that Jean Mercer is right to be concerned about the Primal Wound being appropriated by self-interested elements in the world of attachment therapy. Disease mongering is not just the preserve of pharmaceutical companies.

    But to return to the role of metaphor as a means to understanding the human condition; metaphors are by their nature humblingly imperfect. They also have a tendency to take on strange lives that can stray in unexpected directions, and possibilities for mis or re interpretation abound. As they become more and more hackneyed, metaphors lose potency. Unfortunately they don't retire easily. A metaphor which might have been a force for discovery and emancipation when fresh can harden into a thought-stopping cliché over time. Once calcified in this way it ceases to be a force for liberation but becomes just another sort of prison, one which now has the double-edged sword of having a label attached to it.

    I also think that when used to describe people's feelings, the more extreme and emotive the metaphor is, the more likely it is to cause conflict between factions of the group it was intended to help.

    Kippa (that was)

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  41. These are two very interesting and insightful comments, and I suggest we end the discussion with them for a while. I need to write about something else, myself!

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  42. I have argued on both sides of this issue and find the difficulties lie in a catagorical mindset. While I refute the concept by Verrier that all adoptees are traumatized and will experience a primal wound it is supported by research that infants can create long term affective memory represesntations that will result from a pre mature maternal separation(Gaensbauer,T. 2002).Is that a trauma ? It can be in some rare circumstances but not in all as Verrier states. It will alter the optimal developmental progress of the child. Notice I did not say normal. What does occur is a dissconnect between the limbic memory and the cognitive memory. Assume an infant forms an emotional memory caused by the separation of the birth mother. When the child developes verbal skills they cannot map those skills on to their affective memory(Richardson, R Hayne, H. 2007). Memories recorded ina preverbal stage remain encoded that way into adulthood(Richardson,R, Hayne, H. 2007.)This creates a child who has powerful emotions that cannot be identified in words. The result are the coping/survival behaviors that drive the family into therapy. Sadly thats where the missdiagnosis begins but thats another story. Is this a primal wound or a trauma? No its a childs inability to identify grief, loss, anger, shame, and feelings of isolation. Imagine that one can know they are loved but feel they are not, know they are safe but feel unsafe, know they belong but feel they do not. This is the great dissconnect, cognition and emotion, that is present in adopted children and adults. It is not pathological, a trauma, or a disorder. Its the childs attempt to cope and it can be dealt with by an enlightened family. I am adopted, a published author, and a Marriage and family therapist. I have worked extensively with traumatized children, I know what it looks like. Many adoptees will take Verriers theory and use it to validate their anger but in fact they are rationalizing and perpetuating their anger. I spent last niht debating them and they just started name calling. Telling them they are not victims of a trauma invaidates them in their minds.Imagine people demanding to be seen as pathological in order to feel validated? Anyway I just needed to vent.
    Gaensbauer, T. (2002). Representations of trauma in infancy: Clinical and theoretic implications for the
    understanding of early memory. Infant Mental Health Journal,
    23(3), 259-277. doi:10.1002/imhj.10020.
    Richardson, R. & Hayne H. (2007). You Can't Take It With You: The Translation of Memory across
    Development. Current Directions in Psychological Science, 16, 223-227.

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  43. Thanks for your comments. As I'm sure you know, my arguments against the PW are not meant to suggest that unhappy adoptees are not "really" unhappy, but that the mechanism suggested by Verrier is not congruent with other things known about early development.

    In a more recent post, I asked Verrier to answer some questions about her beliefs. She said she would answer but hasn't done so yet. You might want to keep an eye out for her responses.

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  44. The Primal Wound has cult-like propensities.
    As Joseph Campbell said in The Power of Myth, "Every religion is true in one way or another. It is true when understood metaphorically. But when it gets stuck to its own metaphors, interpreting them as facts, then you are in trouble."

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  45. Robert Allan HafetzJanuary 10, 2012 at 7:15 PM

    The effects of premature maternal separation are in fact long term and will alter the optimal development of adoptees. We must be careful to keep this out of the realm of pathology. Research indicates that this effect is so significant that even the human genome is changed in response.
    “As adults, most of our memories are stored, retrieved, and expressed using language. “

    “In order for memories encoded during infancy to be verbally expressed, we would need to translate out preverbal representation into language at some point during development.”
    (Richardson & Hayne, 2007).


    “Infant memories are stored not as words, but may be encoded in the mind as affective scheemas.” (Gaensbauer, T. 2002).

    These studies have also shown that it is difficult if not impossible, for children to map their new language skills onto their existing nonverbal memory representations.”(Cheatum & Bauer, 2005).

    The pre-mature separation from the bonded mother creates a state of cognitive-affective dissonance within the child. This incongruence of emotion and thought can produce ambivalent beliefs that cause attachment disturbances in the adoptive family. The child can know he is loved and wanted but harbor a great fear of abandonment since that was the result of the first maternal relationship. The child can believe he belongs to this new family but feel, unconsciously, that there is no firm connection to them. Adopted children may even experience stress when they are drawn close to the adoptive mother as their pre-verbal memory of abandonment becomes triggered and intensified. The resulting disruption in the family system compels them to seek professional support in the form of therapy or counseling.

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  46. Wait a minute-- you gave sources to support all your claims except the essential one. What makes you think that the separation causes "cognitive-affective dissonance"? And how do you define a "bonded mother"? It seems to me that you're just sneaking this unsupported statement in under the cover of some citations of quite different material.

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