Adoption-Related Complex Trauma

Also called Cumulative Trauma – The research is definitive. Adopted kids are not only traumatized by the original separation from their parents, they may also have been traumatized by the events that led to them being put up for adoption. In addition to that, foster care itself is considered an adverse childhood experience.

I recently wrote a blog titled “It’s Simply NOT the Same.” Though the traumas may originate similarly, the outcomes are not the same because just like any other person, no two adoptees are exactly alike. That should not prevent any of us from trying to understand that adoptees carry wounds, even if the adoptee is unaware that the wounds are deep within them.

It is not uncommon for an adopted person and/or the adoptive family to seek mental health services due to the effect of the adoptee experiencing traumatic events. Unfortunately, for psychology and psychiatry clinicians, adoption related training is rare. In my all things adoption group, the advice is often to seek out an adoption competent therapist for good reason.

“What does an adopted baby know ? She knows her mother, she knows her loss, sadness and hurt, she knows that those who hold her today may be gone tomorrow and that she will be the only one left to pick up the pieces that no one seems to think are broken.”
~ Karl Stenske, 2012

The reasons a child is put up for adoption or relinquished are many – an unwanted or unplanned pregnancy, often compounded or driven by a lack of financial resources (poverty) or no familial support to care for a child. Becoming a single parent may simply seem too daunting to an unwed expectant mother. Sadly, for some, a chronic/terminal illness or certain diseases may lead the mother to believe she cannot provide proper care for her baby. Certainly, prolonged substance addiction and/or severe mental health issues (which may be related to addiction) can cause parental rights to be forcefully terminated by child welfare authorities. Adoptees who come out of the child welfare system (legal termination of parental rights by a court of law) cannot legally be returned to their birth families due to safety or other reasons that are considered serious.

Adoption is not always a success. Disruptions and dissolutions do sometimes occur.

Disruptions can happen after the adoption has been finalized when the adoptive parents then experience difficulties with their adopted child. The adoptive parents may have difficulty finding support and the resources they require to deal with the issues that come up.

Risk factors leading to a higher rate of disruptions are: older age when adopted, existing emotional and behavioral issues, having a strong attachment to their birth mother, having been a victim of pre-adoption sexual abuse, suffering from a lack of social support from relatives causing the adoption to occur, unrealistic expectations surrounding the adoption and the child on the part of hopeful adoptive parents, and a lack of adequate preparation and ongoing support for the adoptive family prior to and after the placement.

A devastating occurrence is a dissolution or breakdown. This applies to an adoption in which the legal relationship between the adoptive parents and the adoptive child is severed, either voluntary or involuntarily. Usually this will result in the entry or re-entry of the child into the foster care system, or less commonly a second chance adoption, or even the private transfer of the child from the adoptive parents to a non-vetted receiving parent.

Adoption has been subject to both positive and negative assumptions related to the practice and this is of no surprise to anyone who has studied the practice of adoption for a period of time.

There are 6 main assumptions about the practice of adoption –

[1] Adoption is a joyous event for all involved – known as the Unicorns and Rainbows Fantasy in adoption centric communities; [2] adoption parallels genetic birth experience and a biological family life – which close observation and mixed families (who have both biological and adopted children often belie); [3] once adopted, all of the child’s problems disappear and there will be no additional challenges – rarely true – and often attachment or bonding fail to occur; [4] creating a family through adoption is “false,” only biological families are “real” – this goes too far in making a case because many adults create chosen families – the truth is as regards children, family is those persons we grow up with – believing we are related to them – in my case, both of my parents were adopted and all of my “relations” growing up were non-genetic and non-biological but I have a life history with them and continue to have contact with aunts, an uncle and cousins I obtained through my parents’ adoptions; [5] the adoptive life is better than the biological life the child had or would have had – never a known assumption – more accurately, the adoptee’s life is different than that child would have had, if they had not been adopted; and, [6] closed adoptions are in the best interest of the child – this one was promoted with the intention of shielding adoptive parents from original parents who regretted the surrender, from the child who might yearn for their original family and often in some cases to shield a person operating unscrupulously, such as the baby thief Georgia Tann who sold ill-gotten children. Popular media has reinforced both the positive and the negative messages about adoption and many myths and stereotypes regarding adoptive families and birth parents are believed in society as a whole.

The term “adoption-related complex trauma” is rarely used in discussing symptoms and behaviors. It is more common to see terms such as “developmental trauma” or “complex trauma” to describe the psychological effects found within the adopted population.

The terms complex trauma and complex post-traumatic stress disorder have been used to describe the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an personal nature such as sexual, physical, verbal abuse or of a societal nature such as war or community violence. These exposures often have occurred within the child’s caregiving environment and may include physical, emotional and/or other forms of neglect and maltreatment that begin early in childhood. In the case of infant adoptions, the trauma is non-verbal but stored in the body of that baby – not conscious but recorded.

Some of this content has been sourced from a long dissertation titled Treatment Considerations For Adoption-related Complex Trauma. Anyone interested is encouraged to read more at the link.

Adverse Childhood Experiences

For several months now our entire country and most of the world has been living with toxic stress.  It’s the kind of stress that puts you on edge and keeps you there, day after day after day.  If you have felt stressed, imagine what it would be like to experience adversity and/or abuse — not having enough to eat or being exposed to violence – then think, what if the one experiencing this is still a child.

Factors such as divorce, domestic violence or having an incarcerated parent are called adverse childhood experiences (ACEs). Four or more ACEs can result in chronic health conditions such as heart disease or diabetes. In the long term, living with ACEs or other negative factors, such as poverty, can literally change your brain chemistry.

What does it look like for a young person to live with several ACEs and no supports ?  What does a foster parent experience when bringing a middle school or teenage foster youth into their home ?

It might be not being able to sleep without a light on. Or it could be eating even when one is full or not hungry. Some children become “runners” — they leave school whenever they become upset.

And the symptoms can become even worse.  The child may become a cutter; may be suicidal. Such children can have trouble forming appropriate friendships. Maybe they trash their room; in one fight-or-flight moment, climb out of their window and tumble to the ground. Even jump out of a moving car.

A foster parent could find themselves restraining the child physically by wrapping their arms around the child’s shoulders or waist, using all their strength to keep the child from leaving or hurting their self. Maybe you raised your hand only to motion toward something and the child flinched or even ducked.

And your heart breaks for this young person.  You had hoped they knew you would never hit them.  You are a foster parent.  You signed up for this because you thought you had something to give — time and care and love — to kids who desperately need that.

You might become the person the county calls when a child is removed from a home and has nowhere else to go, or when a foster family needs a break. This is known as emergency respite.

Most foster kids want to be happy.  After a lifetime of abuse and neglect, they may not know how.  A foster parent is also there to be a support for reunification with the biological family.

The best foster parents build a fortress of protective factors around their foster children. Protective factors are those things that most of us take for granted — a friend to call when we need advice; someone to help whenever we aren’t enough on our own.

Some of us are born privileged to have built-in protective factors (a supportive family, enough money).  Most foster kids will need to collect them from somewhere else (perhaps a chosen family made up of friends). At school, they require trauma-informed teachers and staff who understand how ACEs can be reflected in behavior.

National data shows that more than 20 percent of children up to age 17 have experienced two or more ACEs.  Beyond abuse (physical, emotional, sexual) and general neglect these include the loss of a parent to death, divorce and abandonment.  A family member addicted to drugs or alcohol.  A family member that is incarcerated. Being exposed to domestic violence and mental health issues among the family’s members.

Brain toxicity exists. A child can have post-traumatic stress disorder. ACEs are not limited to low-income neighborhoods, domestic violence and substance abuse take place in higher income homes and are every bit as toxic. Learn to look at all people through a trauma-informed lens. Ask, if you suspect this, “What happened to you?” and then listen without adding your own opinions.

Every domestic-violence shelter worker or child-care provider, anyone who works for child-protective services, anyone associated with family court, law enforcement personnel and physicians – ALL need to be trained appropriately to deal with trauma related behavior

Trauma is not the fault of any child.  Understanding ACE impacts allows adults to see the reason behind the behaviors.  Baby steps in a positive direction are progress.