Things Attachment Therapists Want Adoptive Parents to Think

A very sensible, well-educated, and dear friend of mine and her husband adopted a little boy from another country some years ago. He did not come to them straight from his birth mother, but was with a foster family until he was about ten months old. The new family settled down quite quickly, and the boy has developed nicely in every way. They’ve followed everyone’s directions about his transition, kept a life book for him, and stayed in communication with the foster family.

I was surprised a few months ago when the mother, whom I’ll call Mary because that isn’t her name, told me she was concerned that the little boy was experiencing grief for his birth mother. I asked why she thought that, and she said she had been reading that all adoptees have this problem. She also described conversations in which he had expressed concern for what had happened to his birth mother and why it was that she couldn’t take care of him. But it seemed to me that he expressed a lot of concern about many people, animals, bugs, and caterpillars, and that he didn’t seem especially preoccupied with the birth mother-- nor did he seem greatly worried about the foster family to whom he had had some chance to attach.

Recently I had a chance to visit Mary and her husband and son and to see once again what a great job they’re all doing. And Mary solved a puzzle for me by showing me the book that had caused her concern: Sherrie Eldridge’s Twenty things adopted kids wish their adoptive parents knew. In my opinion, this book would be better titled “A bunch of things attachment therapists wish adoptive parents believed”, because people who hold the beliefs Eldridge proposes would be very likely to accept both the theory and the practice of attachment therapy. As neither attachment therapy practice nor its underlying theory have any support in conventional mental health information, it is not surprising that Eldridge’s “things” are also unsupported claims. It would be excellent if adoptive parents knew about these issues, but they need that information in order to avoid inappropriate choices, not so they can follow Eldridge’s advice.

Let me comment on a few of Eldridge’s twenty things. First, we see that Eldridge is a proponent of the “primal wound” theory, claiming that all adopted children are suffering from the grief of separation from the birth mother, and need treatment that focuses on that loss. However, all the facts about early development and infants’ emotional attachment tell us that babies adopted into a stable family in the first months of life show no sign of distress or grief over the separation from the birth mother. Babies’ attachment to adults takes time to develop, and it’s based on a history of social interactions and emotional maturation, not on prenatal experience or genetic relationships. The birth mother may miss and grieve over her lost baby, but the baby does not respond in the same way, as he or she is physically, mentally, and emotionally very different from any adult. Relationship or mood difficulties in adoptive families benefit from pretty much the same kinds of treatment that would help non-adoptive families. Where a different focus is needed, it may involve the needs of the adoptive parents rather than the children, because a history of infertility or loss of children can cast a long shadow on a family.

A second point is that Eldridge proposes that young babies exist in a form of shared identity with the mother, a state described as symbiosis by Margaret Mahler and others, years ago. Eldridge does not refer to Mahler, and appears to have picked up this idea from Henry Cloud and John Townsend’s 1992 book Boundaries, from which she also took some of Mahler’s language (like the term “rapprochement”). The idea of symbiosis suggests that separation would be traumatic. There are some problems for this argument, though. One was that even Mahler did not propose that symbiosis was in place at birth, so it becomes irrelevant to early separation from the birth mother. Second, much of what we now know about communication between mothers and babies tells us that even the very young have some capacity for intersubjectivity, or knowing that another person is not the same as the self. I’ve recently come across people commenting on blogs who say that “it’s accepted” that babies identify self and mother as the same, but, as I just argued, that acceptance, if it ever existed, is certainly no longer the case, and for that reason it is not “accepted” that early separations are traumatic.

I’ll just add one more item to my list. Eldridge gives the standard checklist for identifying children with attachment problems--- the checklist seen on many an attachment therapy website, the one that suggests that disobedience, lying, preoccupation with blood and gore, and so on, are indications of the need for attachment therapy. This simply is not the case, for two basic reasons. Those behaviors have nothing to do with Reactive Attachment Disorder, and may or may not have to do with other mental health problems. In addition, whatever the family’s problems may or may not be, treatment that focuses on infant attachment alone could not solve the problems mentioned.

A look through Eldridge’s bibliography shows that at least half of the sources she cites are attachment therapists. There are several citations to Foster Cline, who is [in]famous for his claim that “all bonds are trauma bonds” and that a child’s emotional engagement with his adoptive family must involve traumatic experience. It’s clear that, without referring to holding therapy or related practices, Eldridge produced a book that reflects the attachment therapy “party line” as it existed in 1999 when the book appeared.

If Eldridge’s material seems to speak to your condition, use it as you find appropriate. Strange things can help people, I know. But please don’t accept all her statements without careful examination, and don’t assume that there must be problems with your child for which there is no visible evidence.

"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.