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Welcome to 2022. Many of you have been waiting to close out another crazy and unpredictable year, but you may also be apprehensive to what the new year will bring. With no way to know what to expect in 2022 and after being conditioned for conflict, pandemic, and many challenges in the past few years, it is beneficial to have a few “tools” In your coping skills bag. Mindfulness is a favorite of mine and it takes different shapes at different times for me. It could be noticing elements in nature on an afternoon walk that helps me to feel closer to and in awe of my creator or it could be the recitation of scriptures or prayers that bring me peace and comfort. I value self-care, especially practical self-care skills that allow me to better manage my time, goals and life’s demands. There are other go to “tools” that I like as well. This year, I suggest creating a coping skills plan to help you be better prepared for things that you may face. What are your go to coping skills? When do you use them and how do they work for you? Ask yourself, “what would I do when…” Just having a coping skills plan may alleviate some of the worry that comes from the unknown future. Best wishes to you on your journey during 2022 from Hope in Healing Family Services, PLLC. 🎊

While sticking with the adoption focused blog posts, we will focus on the topic of grief and loss.  You can find a previous post on the subject of grief and loss, but this post will focus primarily on it in adoption.  For a clinician the topics of grief and loss are critical to assessment and treatment in work with adoptees and even other parties involved in the adoption network.

Loss is a core adoption issue, just like mentioned the the blog post focusing on core adoption issues, and it is a part of everyone’s adoption story.  The beauty of the process and event of adoption itself very sadly started with such profound loss.  However, loss has to be recognized and not avoided in order for grieving to take place, which is normal.  When grieving doesn’t happen or when loss is not recognized or allowed, the unresolved grief can wreak havoc in the person’s daily life and functioning.  It can even lead to greater psychological distress, such as depression and other clinical diagnoses.  What we often see in younger children and teenagers who were adopted is the expression of the loss and unresolved grief, which manifest through behaviors, such as anger and aggression.  Sometimes younger children will express fear and sadness as a result of the loss but not fully understand it.

Kubler Ross is pretty well known for the theory of stages of grief, and I often share these with clients who are grieving.  However, these stages look very different for different people. The stages (denial, anger, bargaining, depression and acceptance) are not usually moved through in a linear fashion, nor do they have a specific amount of time that is allotted  for each stage.  It is also okay to maintain bonds with a lost one versus completely letting them go, and it is essential to make meaning of the loss. For adopted children it is hard to move through these processes and make meaning because usually there are missing parts of information in their story.  Sometimes they may want and benefit from some continued connections with members of their birth family.

Grief and loss are complicated with adoptees, because our society doesn’t often recognize the negative aspects of adoption.  I mean, doesn’t focusing on the positive usually feel better for everyone.  However, that isn’t what your adoptee needs.  Another complicating factor is that parents often don’t realize that what they are seeing is just how children express grief and loss at various ages, and it can take professional help through psycho-education for some parents to be able to break away from preconceived notions about behavior and better understand the complexities of their child’s grief and loss.  Additionally, adopted parents often fear that acknowledging the child’s grief and loss will only further complicate their emotions and behaviors.  But, actually we know that it doesn’t.  These things need to be normalized, so the adoptee isn’t boiling over like a pot with the lid on at high heat on a stove.  It is hard for any parent to see their child experiencing emotional pain, so avoiding it is much easier, but the benefits of doing the dirty work of processing the adoptees loss and grief has much greater benefit in the present and future for all parties involved.  Since this can be so difficult for parents, I encourage them to seek out a counselor to walk beside them on this difficult journey.

To complicate things even further, there are different types of grief.  Ambiguous loss is a type of loss or grief that comes with distress from confusion in the relationship.  If you think about adoptees, their grief is more complex due to it being ambiguous.  Finality of life isn’t usually what starts one’s adoption story, so without death there is confusion about the relationship with birth family or first family members.  For many adoptees, their first parents are alive but just unavailable to them.  For internationally adopted individuals, likely may not even know if their first family members are alive or not.  I know for my son, he will ask me from time to time if his first mom is alive.  I also remember a lot of confusion and challenging emotions (guilt and shame, sadness, longingness, etc.) that my daughter, whom we adopted domestically through foster care, experienced until she was about to turn eighteen and finally reunited with her first family.  Another reason for ambiguous loss is if someone is physically present but not emotionally available, as in cases of child neglect, and so your adoptee may have been experiencing this form of loss even prior to the event of adoption itself.  The clinical implications of ambiguous loss often overlap with those of trauma and attachment problems.  It is complicated and difficult, but the journey to processing and moving forward can be very beautiful in time.

I have heard people say that the child shouldn’t be experiencing loss or grief because they were adopted right at birth or a few days after birth, but I strongly disagree with this.  There has been plenty of research to support my stance as well, but it just makes sense to me that a baby growing inside of its mom for nine (or so) months has a connection, both physically and emotionally, to that host.  To abruptly be birthed and have all that familiarity stripped away must be shocking for a newborn.  Even if you disagree with that, I have worked with many adult adoptees who were adopted at birth or very early, and they do experience ambiguous loss and grief.  They usually begin to have a a big clue to what is happening within their inner experience in early adulthood as they are transitioning and all these emotions and confusions are stirred up for them.  I bring this up to encourage parents to be more aware and begin the process of dealing with  your adopted child’s loss and grief, which they surely have, sooner than later.

If you are not sure if your adopted child (or yourself as an adoptee) is experiencing ambiguous loss, here are a few symptoms: difficulty with changes and transitions, trouble making decisions, feelings of being overwhelmed, problems coping with routine childhood or adolescents losses (school, death of pet, moving, etc.), learned helplessness and hopelessness, depression and feelings of guilt. Other signs that your adopted child is experiencing loss and needs help include the following: frequently asking for help with things, cries a lot, performance declines, seem preoccupied or worried/anxious, develops fears that are unreasonable, cannot concentrate, play centers on family’s breakups and coming together (etc.), loss of interest in doing things children like to do, isolation, shutting down emotionally, exhibits low self-esteem, sleep problems, bedwetting, proactively sexual behavior, or difficulty attaching to others. This can be hard work for adoptees and all those involved in the adoption network, so please reach out to a professional that is trained to hold and support you and your family while using appropriate tools to process the loss and grief.

Information was taken from C.A.S.E. (Center for Adoption Support and Education) TAC (Training in Adoption Competency) Training Manual.  For more information about the loss and grief associated with adoption, please visit their website at https://adoptionsupport.org

For some families, communicating about adoption and all of its facets is just normal, and while it may be difficult conversation at times because it brings up all sorts of thoughts and emotions, it is seen as a normal and needed thing to happen.  For other families, communication about adoption is okay on a surface level only, as long as you don’t get into those yucky thoughts and feelings.  Then, for other families, communicating about adoption is a big problem that must be avoided.  The later always breaks my heart, especially after having worked with adoptees who really needed their families to be more open to communication about the hard stuff.  A few things that I have learned working with families over the years include the following things: The first thing is telling a child at age three or after that they were adopted is too late and will be much harder than if you had always talked about it with them.  The second thing is that telling your kids the adoption story when they were little and then stopping the communication about their adoption as they began to age may result in the child believing they were not told until later, and thus causing negative emotions in the child and confusion in the parents.  Thirdly, not telling the child at all that they were adopted will backfire on parents, because they will find out somehow and then experience betrayal and other very negative emotions.  So, my conclusion has been that communication with your child about their adoption story should start from day one and be a continuous, while age appropriate, conversation with no secrets. The Center for Adoption Support and Education (C.A.S.E.) recognizes three family communication styles: Blind, Balanced, and Blaming.  Let’s explore those a little more, and you can decide what communication style your family has.

Blind communication style is exactly what it sounds like, going along blind to the adoption story.  In this communication style, there are no differences between the adoptive parents and the adopted child.  Often talking about adoption is brushed aside, and it can even be met with resistance or anger. For anyone who has been following my blogs, you will know that one of my favorite therapy lines is “speak the unspeakable”, and it applies to adoption stories as well.  When parents shy away from topics that the children are curious about it sends a message that there is something bad about that concern or something wrong with you for feeling that way.  There are many reasons why families have a blind communication style, which can include the parents shame around adoption or infertility or something else that is connected to the adoption, fears about how the child will feel about themselves if they know certain information, and anger that gets stirred up from other experiences that have not been dealt with.  This is one good reason why families of adoption should have an adoption competent therapist on their side, and especially if this is their communication style.  A therapist can help families become more educated about how children actually process the information and how that impacts their sense of self, as well as, helping families to deal with the reasons they become avoidant when communication about the adoption story.  I will say that my experience has been that less of my families have had this communication style, but I have worked with a handful of families who absolutely refused to talk about the adoption to their children.  What a shame.

Balanced communication style also implies what it sounds like, a balanced approach to communication with your child about their adoption story.  In this communication style, parents openly acknowledge the adoption of their child and the issues related to it.  Families with a balanced communication style do recognize that some things related to the adoption will be hard to talk about, and they are willing to communication the hard stuff anyway.  One other unique aspect of a balanced communication style is that they have an openness about birth family and, when appropriate, birth family searching.  I realize that later aspect of a balanced communication style can be really scary for a family who has already experienced forms of rejection and losses in life.  However, it can be done and done well in a way that not only supports the child but that actually brings them closer to you as the adoptive parent.  Again, I understand how scary it can be to talk about birth families, especially when the story is anything but happy, but leaving the child with unanswered questions will only create fractures in their own identity and worth.  I have seen how talking about the birth families openly can actually help adoptees have a more positive self-esteem when it is done in a way that demonstrates Godly love and respect for the birth family.  If you feel that a balanced communication style is just too difficult for your family, I urge you to seek support from a therapist who can help you with this process. If you have not had a balanced communication style, it is not too late, and your adopted child will both thank you and grow closer with you in the process of changing communication styles.

Blaming is another negative communication style but can be seen in some adoptive families.  In this communication style the parents often have a narrow view and perceptions.  Something the parents often express is an exaggeration of the importance of the adoption on the child’s status.  Also, shortcomings may be blamed on the adoption itself.  Conversely, when the adopted child meets the approval of the parents, this isn’t the case, and the communication then approves of the child as a claim to the family.  You can imagine the negative impact this communication style has on an adoptee, and it isn’t hard to see how growing up (or developing) in an environment with this communication style can cause a ton of damage to the identity of the adoptee.  Like all other communication styles mentioned, there are reasons that families employ blaming.  Sometimes the family has so much hurt or guilt or disappointment from unmet expectations that they are totally unaware that this is their communication style.  I would encourage you, as a family, to really think about your communication style and be honest about how you may use blaming.  If you feel that a blaming communication style is utilized by your family, please seek out professional help to repair and heal as a family.  You and your adopted child, and probably everyone else in your family or small circle too, will be very grateful if you work on changing this.

Communication styles are something that I work with many individuals on, and it is no different with adoptive families.  Communication styles help everyone in the family have a clear understanding, know where they stand as an individual, and most importantly, give the adoptee the gifts of truth, respect, and compassion.  When families have a balanced communication style, they help the adoptee to know that the parents are willing to sit with them in the hard stuff because they care that much about the child.  However, having a balanced communication style can be challenging for many families, but with the right support, it can happen.  If you know that your family doesn’t have a balanced communication style and you feel that you need professional support to move towards a more balanced communication style, don’t hesitate to reach out to me or even to C.A.S.E to find an adoption competent therapist in your home state. Information in this blog was taken by C.A.S.E. TAC Manual.

Last blog post, I discussed the increased rates of mental health services utilization and contributing factors for that within the adoptive population. This post, we will examine some of the core issues of adoption.  The Seven Core Issues Framework provides a a great value for clinicians working with adoptive families and was introduced in 1982 and expanded in 2019 to include foster care, kinship placement and third party reproduction (information taken from C.A.S.E. TAC training, Module Three, Slide Eighteen).  The Core Issues of Adoption framework is also valuable to adoptive families as well, as it provides an awareness and insight on how to address complex challenges that will arise.  Let’s face it, adoption has impacted everyone’s life and life relationships.  The framework of the Core Issues of Adoption allows all members to have a unifying lens in which they can communicate and better understand one another, which will help them to better address challenges and feelings they are experiencing.

The Seven Core Issues in Adoption and Permanency include the following:  loss, rejection, guilt and shame, grief, identity, intimacy, and mastery/control.  Loss is something that is present in all adoptions, and it must be grieved.  Multiple members of the adoption experience grief, and in a society where adoption is mostly seen as a positive solution, it is hard and not always accepted to express or process the grief experienced.  However, for successful and healthy development, it must be processed, and it will surface again and again at different developmental periods and transitions in various ways. Rejection is a force that multiple members of the adoptive party experiences as well, and many adoptees view their initial placement into the adoptive home as a rejection.  Adoptive families and their extended families may anticipate rejection, provoke rejection through projections and displacement, and even defend against possible future rejections.  Birth families also experience rejection in a host of different ways, and the social rejection and/or familial rejection that comes with choosing the path of adoption for your birth child can be unbearable for families.  Guilt and shame, which many are familiar with as belonging in the psychosocial stages of development, is an issue that many members of the adoptive party can also experience.  While guilt can sometimes be an emotion that produces positive change in individuals, in adoption it can often be a long going experience of the self and one’s being.  Not only does it impact self-esteem and worth, but it also impacts the way that one is able to connect with others in the present and in the future.  Identity is one of the seven core issues that I have seen be so powerful in the adoptive community; which sometimes I have seen this as positive, but mostly negative.  We all experience issues with identity, especially as we move through developmental periods, but it is an issue that is complicated further by adoption.  Having worked through previously mentioned issues will help with the adoptee’s identity, and sometimes further work needs to happen on a clinical level to address identity issues for those who have experienced being adopted. Intimacy, also another recognized element in the psychosocial stages of development, is an issue that can be further complicated by adoption as well. With a multiple losses, and adoptee can feel rejected and have the perception a fragmented self.  An adoptee may learn to protect themselves from future painful losses by not allowing themselves a healthy attachment with others, or they may simply believe they are undeserving of an intimate relationship because of their low self-esteem.  If these issues are not addressed, the future can be predicted with difficulty in relationships and when becoming a parent themselves, a pattern of unhealthy attachments to be passed on generationally.  Matery/Control is an issue that I hear the most about from working with the adoptive parents, and it is something that they and the adoptive child will struggle with until they realize the enormity and complicated facets that drive the issue. Regardless of the adoption, all members had to give up control in some fashion, and as humans that is something we all try maintain or rebalance.  This can set the tone for complications, but with the right opportunities to explore and integrate mastery/control, members of the adoption party can appropriately gain that sense of mastery/control.

If you are experiencing any of these adoption related issues and feel that you or your family would benefit from professional counseling services that are adoption competent, please reach out for more information.

While it is true that the vast majority of adopted individuals are well adjusted, there is an elevated need for psychosocial (as well as biological and experiential) supports ranging from factors that predate adoptive placement.  And, these needs must be addressed in the appropriate ways in order for that individual to have a healthy development process.  Some statistics taken from C.A.S.E.’s TAC training in 2021 include the following: “Adopted children are two to five times more likely to utilize outpatient mental health services than non-adopted children, four to seven times more likely to utilize inpatient mental health services or be placed in residential treatment centers (RTC’s) than non-adopted children, and in most recent survey, twenty-five percent to thirty percent of those in residential placement programs were adopted” (taken directly from slide twelve, module three, Training for Adoption Competency, Center for Adoption Support and Education, Cohort 4, April 2021).  And, to me, this is why it is important to be as proactive and prepared as possible for what could become a journey in mental health healing for yourself as an adoptee or for your family as an adopted parent.

While the statistics continue to differ at times between types of adoptions (domestic, international, from foster care, etc), it does appear that individuals who experienced foster care in their histories may be at a higher risk of emotional and behavioral health problems.  Some of the factors that contribute to this include the following: greater genetic risks (such as parents with addictions or mental illnesses), in utero exposure to harmful substances, histories of complex trauma, frequent changes in situations and living transitions, disrupted family relationships, inconsistent and inadequate access to mental health services, and over prescription of psychotropic medications. This is not to say that children adopted internationally, domestically as an infant or through private adoption, or kinship placements will not have experienced these factors, as many of them have as well.

Just to clarify, it isn’t exactly the act of the adoption itself that contributes to manifestation of mental and behavioral health problems, but it is likely a contribution of various factors that were occurring prior to the adoption.  However, adjustment problems can also arise after the adoption takes place, especially if the adopted parent isn’t aware of the normative adoption issues or they don’t know how to respond appropriately to the normative adoption issues that will surface for the child they have adopted.  Some examples of the ways adoptive parents may not be aware of or understand how to respond to those normative adoption issues include: not knowing how to communicate the child’s adoption information or not knowing how to share it in a developmentally appropriate way, not understanding the multiple facets of grief and how to support the child’s journey through the grief process, and not knowing how to support the child with or in finding more information about birth family and birth family connections.  To summarize, adoption as the act is not the cause of mental health and behavioral health problems, but rather it is the factors that come before the adoption and how normative adoption issues are shared, communicated, and dealt with in the adoptive family.  While an adoptive parent cannot control the factors that occurred prior to adoption (another issue that often leads to guilt and frustrations in which the adoptive parent may need to be supported by a therapist of their own) they can control how they deal with the normative adoption issues, even if this means seeking out professional help to have greater awareness and understanding or just support to deal with the hard stuff! We will look more at the core issues of adoption in the following blog post.

Last blog post, we discussed the importance of having a therapist who is an adoption competent therapist, but what are the adoption competent clinical practices? There are quite a few, so I am going to summarize them here: Adoption is a lifelong process, it is an experience different from giving birth to a child, adoptive family is permanent, child’s past and current relationships with birth family play a critical role in adjustment and development, kinship networks must be acknowledged, adoptive parents have a critical role in facilitating the child’s adjustment and identity formation, post-adoption services are important, services demonstrate respect and sensitivity to all differences in identity, approaches are family-based and strength-based as well as evidenced based, therapist employs an ecological perspective including biological and psychosocial considerations, therapist avoids pathologizing normal developmental process, services are attachment-focused, therapist promotes appreciation for child’s unique story, approaches acknowledge child’s historical relationship with parents and impacts of birth parents’ psychological and sometimes physical presence, and core issues of adoption are consistently assessed and addressed.  (The core issues of adoption include issues such as loss, rejection, guilt and shame, grief, identity, intimacy, and mastery/control). These were summaries of the original Adoption Competent Clinical Practices Principles taken from TAC Training through C.A.S.E. – For more great information from C.A.S.E, help finding an adoption competent counselor in your state, or about participation in TAC (Training in Adoption Competency), visit: https://adoptionsupport.org

Continue to follow this blog series as we discuss various issues in adoption.  The next blog will cover mental health needs of adopted individuals and their families.  And as always, please contact me if you would like to find out more information about specific services I provide or with help finding a therapist that may be a good fit for you and/or your family near you.  Thank you!