Adoption Risk Factors and "Strong Idealization of Motherhood"

A recent publication discusses the emotional difficulties associated with adoption and takes a much more complex view than the Primal Wound approach advocated by Nancy Verrier. The paper (St.-Andre, M., & Keren, M. [2011]. Clinical challenges of adoption: Views from Montreal and Tel Aviv. Infant Mental Health Journal, 32, 694-706) examines a variety of risk factors and recognizes that no single problem determines a good or bad developmental outcome for the adopted child.

Among other issues, St.-Andre and Keren consider the effect of post-adoption depression (PAD), a problem that has received little study but that probably occurs at least as often as post-natal or post-partum depression (PND or PPD-- also called perinatal mood disorder, PMD). They point out a number of reasons why PAD may have received so little attention, including the view of adoption as a happy ending to a sad story of infertility, the fact that there are no obstetrical problems to deal with, and the apparent absence of the abrupt hormonal changes that follow childbirth. There may also be an assumption that an adopted older child will be less “trouble” to take care of than a newborn, and that the adoptive family can thus just go on with its life without missing a step. Whatever the actual causes of depression following birth or adoption, there is no question that maternal depression contributes to developmental problems.

St. Andre and Keren suggest that, just as birth mothers should be screened for PND, adoptive mothers should also be screened for factors that make PAD likely-- and that the factors contributing to the two forms of depression are quite similar. They list among the risk factors a past history of depression or anxiety, a family history of depression or bipolar disorder, low social support, and early relationship difficulties. To these, they add a risk factor that I find very interesting: “strong idealization of motherhood”.

To the best of my knowledge, there has been no systematic investigation of the role of “idealization of motherhood” in postpartum depression or in problems of adoptive families. It’s not even clear how such an attitude would be measured or detected. From a purely speculative viewpoint, though, I must say it rings a bell.

Idealization of motherhood has been mentioned in two popular books (Estela Welldon’s 1992 Mother, Madonna, whore: The idealization and denigration of motherhood, and Susan Douglas and Meredith Michaels’ 2003 The mommy myth: The idealization of motherhood and how it has undermined all women). As well as discussing other feminist issues, these two volumes touch on the idealization of motherhood in the sense that I think St-Andre and Keren intend-- the belief that being a mother is woman’s highest calling, the crowning achievement of life, and a state of nobility and virtue. This kind of idealization is also much to be met with on web sites that specialize in what we might call “motherhood porn”, sentimental descriptions of mothers’ love and sacrifice in the face of their children’s indifference or even hostility. These approaches are nothing new, going back to Victorian times and before; when seriously annoyed with me, my own mother once sent me a verse that described how a mother was the only person who refused to believe that her child had committed murder (and he actually had!).

Why would idealization of motherhood be a factor in the development of post-adoption depression? Motherhood (and fatherhood too) in reality involve a tangled skein of joys, pains, boredom, overexcitement, social isolation, financial terrors, and exhaustion. The adoptive family additionally experiences both praise and criticism from outsiders, fears about the nature of the “stranger child”, and the impact of being observed by agency staff. They have had a roller-coaster ride of timing, sometimes having to “hurry up and wait” for long periods and sometimes being told that the baby is here right now. To represent this life stage as a crowning achievement is about the same as suggesting that having your appendix out is a transcendental experience. (It’s much better than not having it out when you need the operation, of course.)

I don’t mean to downplay the wonderful things about having children. But parenthood is real, not ideal. It has all the gritty, dirty, discouraging aspects of any part of real life, and however well we manage it we cannot realistically consider later on that we did everything right. As a Massachusetts DMV worker once told me, “we’re doin’ the best we can”. If we’ve idealized what it means to be a mother, and can’t accept that all we can do is “the best we can”, the meeting with reality may trigger depression in people who are vulnerable to that emotional problem-- whether it’s labeled PND or PAD. On the other hand, if nobody idealized motherhood at all, how many people would adopt?

Of course we can’t completely prevent depression by reminding people of the realities of parenthood and arguing against idealization of motherhood. And there is more to the picture than parents’ mood disorders, wherever they come from. In thinking about the potential problems of adoption, St-Andre and Keren emphasize the importance of taking a transactional view-- looking not only at multiple factors, but considering how parents and children influence each other, and how those influences change over time. Although a mother’s vulnerability to depression is of great importance, characteristics of the adopted child also contribute to the risk of problems. For instance, difficulties are more likely if the child has experienced extreme deprivation of care in the first two years or when adoptions are later in the child’s life. Multiple simultaneous adoptions are problematic (and unfortunately appear to be encouraged by Russian orphanages).