https://www.originscanada.org/adoption-trauma-2/trauma_to_surrendering_mothers/effects-of-adoption-on-mental-health-of-the-mother-what-professionals-knew-and-didnt-tell-us/Effects of Adoption on the Mental Health of the Mother: What Professionals Knew and Didn’t Tell Us.
1968: GRIEF OF NATURAL MOTHERS.
Sister Mary Borromeo, R.S.M., B.A., Dip.Soc.Wk. (1968) in “Adoption: From the Point of View of the Natural Parents”
Borromeo based this article on many years of work with unmarried mothers. Its purpose was to draw attention to the grief reaction which the natural mother experiences after the adoption of her child which both she and her family are ill prepared for.
She compares the separation of adoption to the separation of a child through death. The loss is as irrevocable in terms of relationship.
Borromeo notes that the surrendering mother knows that acceptance back into her family circle is dependent on her ability to “put it all behind her,” and so she is under double pressure to do this and suppress her grief. In cases where this is done it is not unusual to find a severe breakdown in self control occurring somewhere around the child’s first birthday.
1976: ANNIVERSARY REACTIONS.
J. Cavenar, J. G. Spaulding, and E. Hammet (1976) from “Anniversary Reactions” in Psychosomatics, vol 17.
Anniversary reactions are among the most interesting phenomena seen in clinical practice. These reactions are time specific psychological or physiological events which occur or reoccur in response to traumatic events in the individuals past, or in the past of a person with whom the individual is closely identified. The individual attempts to relive or re-experience the traumatic event again in a repetitious way, in anticipation of being able to master the trauma which was not mastered previously.
Freud was the first to recognize anniversary reactions in 1885. Pollock. (1971) describes the anniversary reaction as a response of the mind which is triggered by the anniversary of a personal loss or disappointment. Various case histories are described, indicating that a variety of physical and psychological problems may occur as anniversary responses.
Depressive disorders, ranging from very mild depression to psychotic level disorders, may occur on an anniversary basis. Heart attacks, pleurisy and pneumonia, suicides, and phobic fear are also attributed to anniversary reactions. Pollock (1971) has written extensively on the subject. He believes that these reactions are due to incomplete or abnormal mourning over a personal loss or disappointment.
Hilgard (1953) has written extensively on anniversary reactions. She reports that depression or psychotic reactions may be precipitated as anniversary reactions to childhood sibling deaths.
Various disease processes have been described as somatic equivalents or expressions of anniversary reactions. Weiss et al. (1957) have described hypertensive crises, irritable bowel syndromes, and coronary occlusion as anniversary responses. Rheumatoid arthritis, migraine headache and dermatological conditions have also been described as anniversary reactions.
Anniversary reactions are much more common in medical practice than is generally recognized. This is true with physical complaints and illnesses as well as psychiatric or emotional problems.
1977: GRIEF OF NATURAL MOTHERS.
Cliff Picton, Lecturer in Social Work, Monash University, from “Some Insights Into Adoption: Unintended Consequences of Publicity” in Australian Social Work, vol. 30.
The following material is drawn from an unsolicited group of fifty one letters received by the Conference office, Sydney, prior to the First Australian Conference on Adoption in February 1976. One of the letters came from a hypnotherapist who wrote “many of my patients are women distressed by not knowing what became of their children who they gave up for adoption, and adults who were adopted as babies and desperately wish to know something of their biological parents.”
The range of feelings described in the letters runs the gamut from curiosity thirteen years after, to “complete and continuing agony and a sense of loss.” Several talk of repeated crying and one woman said she was in tears as she wrote the letter. One woman who relinquished her child twenty years ago said, “I have never gotten over it, it still upsets me.” Another, thirteen years later, says she still looks for the “lost” child and feels deep depression on the child’s birthday. In addition to years of grief and remorse, she now experiences the fear that retrospective legislation could result in the break down of her marriage.
In the main there was strong identification with the child with references to “my child” and “loving.” Six talk of seeing the child and wanting a meeting, ranging from “I believe he has a right to know me, to “I will find you one day fair means or foul.” One letter contained disturbing details of desperation and unhappiness and contained the speculation that “the child will wonder who she is.”
Picton goes on to speculate that most of these women have been left with unanswered questions and raw feelings and quote, “one is left wondering about the quality of service given to these women.”
1978: ATTACHMENT BONDS.
Martin Reite, M.D., Conny Seiler, and Robert Short, M.S. from “Loss of Your Mother is More Than Loss of a Mother” in the American Journal of Psychiatry, Vol 135
In a paper illustrating attachment bonds between mother and child they point out that: attachment bonds are central to the development of many higher organisms. In higher primates they are crucial for the maintenance of family and social structure. The relationship of the individual to such structures and their disruption may be closely linked to the development of serious psychopathology.
Separations and losses have been implicated in the etiology of affective disorders and maternal loss has serious psycho-physiological consequences in human infants and children.
A monkey-mother and infant were used for studying the behaviourial and psychological consequences of maternal loss and the attendant disruption of the most important attachment bond. They made observations through implant systems that permitted psychological monitoring of the unrestrained infant living in its social group.
The period of behavioural agitation immediately following separation from the mother was accompanied by increases of heart rate and body temperature. Sleep patterns on the first night of separation were characterized by increased sleep latency, more frequent arousals, less total sleep, increased REM latency, and decreased REM sleep. Most often both heart rate and body temperature showed pronounced decreases the first night of separation.
An infant monkey at fourteen weeks old was used in an experiment on separation from it’s mother. It starts with the infant and its mother being removed from their group and separated at 2 pm. The infant was returned to the group. The infant immediately exhibited increased locomotor behaviour and vocalization, characteristic of agitation reaction. Within seven minutes of its return it was adopted by a childless female adult.
Following lights out that night the infant was monitored. The separated infant spent all night sleeping in ventro-vental contact with the adoptive female. During the first night of separation the infants body temperature decreased 1.4 degrees below its pre-established normal baseline. The infant also suffered increased sleep latency, more frequent arousals, more time awake and the total of absence of REM sleep. Behavioural depression the morning following was manifested by decreases in activity and play behaviour and impaired motor coordination.
These observations demonstrate the physiological accompaniments of maternal separation in monkey infants at least in terms of body temperature decreases and sleep pattern changes. These occur even when the infant is adopted by another adult female who can provide the infant with body heat, physical contact and normal sleep enclosed posture.
They concluded that they can infer that these physiological changes are not due to the physical absence of the mother but are instead etiologically related, at least in part, to the perception of the loss of the mother on the part of the infant. They suggest that the monkey data will prove to be of significant value to our understanding with respect to man.
1978: MOURNING A STILL BIRTH.
E. Lewis and A. Page in “Failure to Mourn a Stillbirth: An Overlooked Catastrophe” from British Journal of Medical Psychology, Vol 51.
It was noted in a paper delivered in 1978 that failure to mourn a stillbirth can cause profound disturbance to the mother. In the hospital bereaved mothers are usually isolated. This was meant to protect the mother from the anxiety of the awareness of live babies. On returning home she was usually confronted by a “conspiracy of silence.” No acknowledgement of the tragedy can seriously affect the mental health of the mother and her family.
Bourne (1968) describes the stillbirth as a non event in which there is guilt and shame with no tangible person to mourn. A still born is a person who did not exist, a person with no name.
Memory facilitates the normal mourning process essential for recovery. With other bereavements there is much to remember, not so with stillbirth, there is no one to talk about and no one to talk to about it. The bereaved mothers may themselves avoid contact with people because of the unconscious feelings of guilt and shame associated with a sense of being a failure as a mother.
The effects of stillbirth on the mother can be easily be equated to a mother who has lost a child to adoption.
1978: GRIEF OF NATURAL MOTHERS
R. Pannor, A. Baran, and A. Sorosky (1978) from “Birth parents who relinquished babies for adoption revisited” in Family Process, Vol 17.
The findings of a thousand letters received from the three parties in an Adoption Research Project revealed that many exiled mothers had not resolved their feelings for their relinquished child that they were told they could never see again. Many were found to have a lifelong unfulfilled need for further information and in some cases contact with the relinquished child.
Many report varying degrees of grief, the persistence of troubled feelings, and no viable alternative that would have made it possible to keep their child. Their findings reflect the fact that the exiled parents seem to be functioning on two levels. They are functioning well within the existing marriage or family, but they harbour deep unresolved feelings and sharp memories of the bearing and losing of the child.
Fifty percent of the exiled parents interviewed said they continued to have feelings of loss, pain, and mourning over their child. Some expressed the feeling that “I have never got over the feeling of loss, I still have feelings of guilt and pain when I think about it. Giving up my child was the saddest day of my life.”
They summarized by saying that feelings of loss, pain and mourning continued many years after the relinquishment. An overwhelming majority experienced feelings of wanting their children to know they still cared for them.
1982: TRAUMA TO NATURAL MOTHERS
E. K. Rynearson, M.D. “Relinquishment and its Maternal Complications: A Preliminary study” in the American Journal of Psychiatry, Vol. 139
The twenty women in this study were drawn from a population of psychiatric out patients. The fact that a woman had relinquished a child was established during psychiatric assessment.
Twelve of the women had a DSM-III diagnosis of dysthymic disorder, and eight had a diagnosis of generalized anxiety disorder, borderline personality or dependent personality disorder. No one with a psychotic or schizophrenic disorder was included in the study.
All women had lost a child between the ages of 15-19, all were unmarried and dependent on their families. When they entered the centres for unwed mothers they all agreed to relinquish their babies. In spite of this, 19 mothers developed a covert maternal identification with the fetus. This was manifested more in the second trimester with quickening.
During this time the subjects developed an intense private monologue with the fetus, including a rescue fantasy in which they and the new born infant would be “saved” from relinquishment.
All the women dreaded delivery. All remember labour as a time of loneliness and painful panic. All received general anaesthesia at time of delivery, which heightened the extirpative quality of their last contact with their baby. Eighteen of these were not allowed to see their babies after delivery. All reported the signing of the adoption papers as being traumatic, all felt a feeling of numbness and disassociation during the hospitalization.
All the women left the hospital with the question of what happened to the baby. Use of general anaesthesia during the final stage of labour and postpartum period inhibited the open expression of mourning and intensified the fantasied attachment to the lost child.
All the women returned home, they all reported dreams concerning the loss of the baby with contrasting themes of traumatic separation and joyful reunion. All experienced curiosity when seeing a stranger with a baby as to whether this was the baby they lost. When there was “enough” physical resemblance they would follow the baby as if to visually retrieve it. Underlying fear, was a constantly acknowledged urge to get pregnant, an overdetermined need to undo the act of relinquishment.
All of the subjects continued to experience symptoms of mourning at the anniversary of the relinquishment and presented the co-existent themes of sadness regarding the loss, and joy in the conviction that the child was happy and well.
In summary the women’s fantasies and behaviour related to the act of relinquishment may be viewed as compensatory, allowing a sustained internalized attachment and maternal identification in spite of its external interruption.1982: ANGER IN THE NATURAL MOTHER.
Kate Ingles, “The Relinquishment Process and Grieving.” from the Proceedings of the Third Australian Conference on Adoption: Changing Families. Adelaide, 1982.
Ingles talks about the anger of the natural mother following the loss of her baby. Anger at her helplessness and the officialdom that represents the power to decide what happens to her baby, a power she is without. Anger at all those known and unknown persons who could not and would not rescue her. Anger at her prolific body, so at odds with her circumstances. Anger at her parents, anger at friends, anger at the “unfairness” that allows the man involved freedom from the experience she must endure and integrate.
Anger at the adoptive parents for all they have and all she needs. Anger at the world that elevates motherhood to sanctity but failed her as a mother. Anger at her discovery that “approved of and supported motherhood” is very rigidly defined and excludes her. Anger on behalf of her baby who she feels is defined as unwanted unless she is removed. Anger that must be suppressed and contained that could provide a list of causes and directions too immense and personally derived for us to take account of.
She may, if the common numbness described by such mothers does not lift for many years, only come to anger years after her lost baby is grown up and the specific persons involved are far distant or dead in her present life. She may begin her pregnancy in anger and resentment and continue for years with a randomly placed rage.
1983: MOTHERS SUFFER AFTER ADOPTION.
Danielle Robinson from “Mothers Suffer After Adoption” in the Weekend Australian, March 5-6, 1983.
“Research has found that the forgotten natural mothers of adopted children are suffering serious psychological problems up to forty years after being parted from their children.”
The research financed by the Institute of Family Studies has found that many mothers never get over the trauma of giving up their babies.
The research also found that of at least 50% of the women studied, a deep sense of loss had never left them since the time of relinquishment of their babies. In many of these mothers their sense of loss only got worse with time and in some cases lasted forty years, Professor Winkler said.
Most women found it difficult to cope and some needed psychological help to come to terms with their sense of loss.
Professor Winkler and fellow researcher Ms. Margaret Van Kepple were struck by the enormity of the response the women gave to the study and were alarmed by the strong emotions expressed.
1983: FEAR IN THE NATURAL MOTHER: AFTERMATH OF ADOPTION.
Eva Begleiter, “The Medium and Long-Term Aftermath of Relinquishment.” Conference Paper, April 26, 1983. Mission of St James & St John (Melbourne).
The range and extent of fear expressed by the natural mother as the aftermath of adoption can relate to:
1. Fear that the adoptee will never know of his adoptive status.
2. Fear that the adoptee has suffered negative feelings and had other problems related to his adoption.
3. Fear that the adoptee has hateful and angry feelings toward his natural parents. Natural mothers often question how they will cope with this if contact occurs, although one recently stated she would prefer to hear negative feelings voiced directly rather than never have the opportunity to meet the adoptee face to face.
4. Fear that the adoptee will believe his natural mother did not want him, and never know she did and still cares and continues to be concerned about his progress and welfare.
5. Fear that the adoptive parents have told the adoptee lies, “your mother is dead,” or painted a very bleak picture of his natural parents.
6. Fears that the adoptee is dead or fears for his welfare should his parents die while he is still dependent.
7. Fears that the child relinquished for adoption was not placed and instead grew up in an institution.
8. Fears that the adoptee will not search, despite his desire, because of his adoptive parents opposition or because he feels they will be really hurt if he searched.
1984: GRIEF OF NATURAL MOTHERS.
Dr. Kathryn McDermott, “Rights of the Relinquishing Mother.” Human Rights Commission Discussion Paper, July 1984. Sec. 55, Canberra, ACT.
The bereavement experienced by the natural mother and her continuing concern about the fate of her child, can take many forms. Some mothers report posting unaddressed birthday cards to their children each year.
Another possibility is that the bereaved mother will attempt to “replace” the lost child, either by adopting or getting pregnant again as soon as possible. In either case, she is likely to realize too late the new baby is not a substitute for the lost one.
McDermott quotes from Shawyer (1979): “The emotional havoc wreaked on the natural mothers of adopted children is frightening and it reaches into every other relationship they have with subsequent children and partners” and the mother who repeats her pregnancy in order to recover her adopted child becomes evidence of “the kind of woman” who is unfit to raise a child.
1985: PARENT-CHILD RELATIONSHIP OF EXPECTANT MOTHERS AND FATHERS
Dr. John T. Condon, MB BS, MRANZCP, Consultant Psychiatrist, Department of Psychiatry, Flinders Medical Centre ” The Parental–Foetal Relationship -a Comparison of Male and Female Expectant Parents” Journal of Psychosomatic Obstetrics & Gynecology, Vol 4, pp. 271-284.
In a questionaire issued to 54 first time expectant couples. Three of the major findings were. (1) thoughts and feelings about the foetus are strikingly similar between pregnant women and expectant fathers: (2) the behavioural expression of this antenatal attachment is considerably attenuated in the men, most likely due to perceived conflicts with the sex role stereotype of masculinity: (3) Attitudes towards the foetus per se are not necessarily correlated (in either sex) with attitudes towards “being pregnant.”
Greenburg and Morris observed that a group of fathers, first presented with their neonates, exhibited “engrossment” which was virtually identical with that of their spouses. The authors concluded that the encounter with the infant “released an innate potential” for fathering.
The present writer (Condon) has observed profound grief reactions in fathers bereaved by stillbirths, suggesting a significant antenatal attachment.
1986: PSYCHOLOGICAL DISABILITY IN NATURAL MOTHERS.
Dr. John T. Condon, MB BS, MRANZCP, Consultant Psychiatrist, Department of Psychiatry, Flinders Medical Centre, from “Psychological disability in women who relinquish a baby for adoption” in The Medical Journal of Australia, vol. 144, 117-119.
Existing evidence suggests that the experience of relinquishment renders a woman at high risk of psychological (and possibly physical) disability. Moreover very recent research indicates that actual disability or vulnerability may not diminish even decades after the event.
Condon defines how the relinquishment experience differs from perinatal bereavement in four crucial psychological aspects.
- Although construed as “voluntary” most relinquishing mothers feel the relinquishment is their only option in the face of financial hardship, pressure from family, professionals and social stigma associated with illegitimacy.
- Their child continues to exist and develop while remaining inaccessible to them, and one day may be reunited with them. The situation is analogous to that of relatives of servicemen “missing believed dead.” The reunion fantasy renders it impossible to “say goodbye” with any sense of finality. Disabling chronic grief reactions were particularly common in the war in such relatives.
- The lack of knowledge of the child permits the development of a variety of disturbing fantasies, such as the child being dead, or ill, unhappy or hating his or her relinquishing mother. The guilt of relinquishment is thereby augmented.
- The women perceive their efforts to acquire knowledge about their child (which would give them something to let go of) as being blocked by an uncaring bureaucracy. Shawyer describes poignantly how “confidential files are tauntingly kept just out of reach, across official desks.” Thus the anger that is associated with the original event is kept alive and refocused onto those who continue to come between mother and child.
On a study of twenty women who relinquished their baby, all but two of them reported strong feelings of affection for the infant, both during the late pregnancy and in the immediate postpartum period. None reported negative feelings toward the child.
Feelings of sadness or depression at the time of relinquishment were rated on the average as intense and “the most intense ever experienced.” Anger at the time of relinquishment was rated at the time as between “a great deal and intense.” Only 33% reported a decrease over time, and over one half said their anger had increased. Guilt at the time was rated as “intense” with only 17% reporting a decrease over the intervening years.
Almost all the women reported they had received little or no help from family, friends or professionals. Over half of them had used alcohol or sedative medication to help them cope after relinquishment. Almost all reported that they dealt with their distress by withdrawing and bottling up their feelings. One third had subsequently sought professional help.
A most striking finding in the present study is that the majority of these women reported no diminution of their sadness, anger and guilt over the considerable number of years which had elapsed since their relinquishment. A significant number actually reported an intensification of these feelings especially anger.
Taken overall, the evidence suggests that over half of these women are suffering from severe and disabling grief reactions which are not resolved over the passage of time and which manifest predominantly as depression and psychosomatic illness.
A variety of factors operated to impede the grieving process in these women. Their loss was not acknowledged by family and professionals, who denied them the support necessary for the expression of their grief. Intense anger, shame and guilt complicated their mourning, which was further inhibited by the fantasy of eventual reunion with their child. Many were too young to have acquired the ego strength necessary to grieve in an unsupported environment.
Few had sufficient contact with the child at birth or received sufficient information to enable them to construct an image of what they had lost. Masterson (1976) has demonstrated that mourning cannot proceed without a clear mental picture of what has been lost.
The notion that maternal attachment can be avoided by a brisk removal of the infant at birth and the avoidance of subsequent contact between mother and child is strongly contradicted in recent research. Condon and others have demonstrated an intense attachment to the unborn child in most pregnant women.
There is a strong impression from data that over-protectiveness is part of the phenomenon of unresolved grief and serves both to assuage guilt and compensate for the severe blow dealt by relinquishment to the self esteem in the area of being a “good mother.”
The relatively high instance of pregnancy during the year after relinquishment invites speculation that this represents a maladaptive coping strategy that involves a “replacement baby.”
1986: THE LIE
Kenneth W. Watson from “Birth families: Living with the Adoption Decision” in Public Welfare, Vol 44.
Exiled parents who surrender children for adoption are expected to live a lie the rest of their lives. The adoption eliminates the public record of the child’s birth, and the exiled parents are counselled by family, friends and social agencies to go on with their lives as if the pregnancy never occurred. This socially sanctioned denial not only interferes with the resolution of grief, but intensifies the parents’ poor self-image by reinforcing the idea that what they have done is so heinous that it must be concealed forever.
1987: GRIEF OF NATURAL MOTHERS.
M. Van Kepple, S. Midford, and M. Cicchini. 1987, “The Experience of Loss in Adoption.” Paper presented at the National Association for Loss and Grief.
Van Kepple, Midford and Cicchini state that perhaps the most obvious loss experience in adoption is the loss of the child relinquished by his/her natural parents. The significance of this loss, however has either been denied or grossly underestimated by society in general and by adoption practices in particular.
“It is our contention that their grief has been cruelly exacerbated by the long standing conspiracy of silence which surrounded adoption practise.”
The loss of a child by death is generally accepted to be a very traumatic event for parents and family, and is followed by traumatic and complicated grief reactions. The loss of a child through relinquishment is similarly, for many natural mothers, a tragic event but is complicated by the fact that the natural mother suffers in silence.
Many natural mothers have reported extended periods of depression, anxiety, feeling suicidal, as well as alcohol and drug use, and poor physical health immediately following the relinquishment. In many instances the mother didn’t necessarily attribute these physical and emotional disturbances to the loss of their child, primarily because they had been led to believe they would not suffer and if they did, it would be short lived.
Research has demonstrated that in the long term relinquishing mothers are more susceptible to a variety of physical and emotional difficulties: they experience an on-going sense of loss, which for some fluctuates according to events such as anniversaries.
1987: PRIMARY PROCESS THINKING IN PREGNANT WOMEN.
Joan Raphael-Leff (1980).”Psychotherapy with Pregnant Women.” In Psychological Aspects of Pregnancy, Birthing, and Bonding, ed. B. L. Blum (ed) New York: Human Science Press, a quoted by Condon (1987) in “Altered Cognitive Functioning in Pregnant Women”
Raphael-Leff writes: “the pregnant woman has immediate and direct access to her well of fantasies, her earlier modes of symbolic thinking she is in touch with her unconscious, and at times feels most overwhelmed by the power of the irrational within her.”
She suddenly finds herself different from others, and unable to communicate the “mad” content of her experiences, which she recognizes and is embarrassed by. Her dreams too, have become extremely vivid with often explicit symbolism and with little attempt to “censor” or disguise forbidden content.
1988: PARENT AND INFANT ATTACHMENT IN THE EARLY POSTNATAL PERIOD.
John T. Condon “Nature and Determinants of Parent-to-Infant Attachment in the the Early Postnatal Period” from the Journal of the American Academy of Child and Adolescent Psychiatry. 1988.27.3. 293-299.
Says that inquiry into the early development of mother-to-infant bonding has been heavily dominated by the “critical period” theory or “bonding hypothesis” of Klaus and Kennel (1982). In its simplest form, the theory states that skin-to-skin contact between mother and infant during the first 24 hours after delivery is necessary for the normal development of maternal-infant bonding. Conversely, the absence of such contact during this “sensitive period” carries a significant risk of deficient bonding that may endure throughout early childhood and exert potentially detrimental effects on the childs development.
In Condons view, the critical period theory, with its strong overtones of animal behavioural psychology, provides a very limited perspective on the richness of a human mothers cognitive and emotional experiences during the early postpartum period and the complexity of the factors that determine these experiences.
Twenty five years ago, Gerald Caplan (1961) wrote:
You can predict this time lag ( between the mother seeing the neonate and experiencing attachment) by paying attention to her attitude to the foetus. In extreme cases there is no time lag at all: she continues to have the relationship with the baby which she had to the foetus, interrupted only by the mechanics of delivery (“Now he’s outside but he’s the same person”).