Origins Presentation Westmead Hospital Conference 2005

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 Raising Community Awareness of Pathological Trauma and Grief in Adoption Separation and Loss.

By

Dian Wellfare

presented by Lily Arthur

Historically, mothers who lose their children to adoption have been the most neglected party in the adoption triangle: both in the literature and in the practice they have been afforded little attention compared with adopted people and the adoptive parents. It is estimated that less than five percent of all adoption literature deals with the consequences of separation on the  mother herself.

 

The bonding process between the mother and child in utero has been widely acknowledged in society and by the  health profession. However those same principals have been lost on the mother and child  who are separated by adoption, as if somehow that bond does not occur between them. The silence of the mothers and the refusal by the adoption profession to acknowledge the harm caused by severing the maternal bond  has compounded  into a general unawareness of the damage created by adoption to both mother and child.

 

In order to better understand  a mother who has lost a child through adoption it is important to know the background  to her adoption experience.

 

A recent NSW Parliamentary inquiry into adoption practices of two years duration released the final report titled "Releasing the Past" which publicly exposed and confirmed that what had become routine adoption practices throughout Australia, were deemed unlawful, unethical and  have been known by the adoption profession, since 1965, to be harmful to both mother and child.

 

This Inquiry gave mothers the first real opportunity to tell of their expericence and to finally break the silence that protected a sytem that saw over 300,000  women nationwide loose their children to adoption.

 

After finally being given a voice mothers are slowly going out into the community and telling of their experinces. It is only though working in partnerships with the whole community that there is hope for understanding the complex and traumatic dimensions of  adoption.

 

 An Overview of Adoption Practice

 

Athough the young unwed mother remained the legal guardian of her child “most"  hospitals around Australia introduced practices which discriminated against the unwed mother and  exacerbated her already traumatised state by imposing  upon her the most unnatural  expectation demanded of any mother during the process of giving birth and thereafter. The following practices were imposed upon her without warning and without consent.

 

They involved  the  rule of preventing bonding by forbidding the mother to see or touch the baby she had given birth to. This was accomplished by using pillows or sheets as a screen while the baby  was secreted from the labour ward and hidden behind locked doors, immediately upon birth.

 

Some of the major hospitals transferred the heavily sedated mother soon after birth to another hospital or annex, without her baby. Occasionally the mother was permitted to see her baby upon discharge but only on the condition that the  adoption consent had been signed.

 

Pre-empting the adoption of her baby her lactation was deliberatly suppressed by the use of DES Stilboestrol, three times the legally recommended dosage.

 

Heavy sedation during labour and  the post partum period  consisted of a lytic cocktail made up of  Sodium Pentobarbital, Amytal, Doriden, Chloral hydrate, and others,  to  be given as required until a consent was taken, further impeded the mothers cognitive processing of her loss.  

 

Apart from the misuse of drugs her treatment and adoption counselling consisted of  a denial of her options, isolation, incarceration, suggestion, forced labour, repetitive indoctrination, humiliation, and moral coercion, including social role subjugation.

These elements of damage were over and above the damage they were to suffer from the loss of their baby.

 

Adoption surrender involves a grief process not unlike death but with a marked difference.  While the closed adoption legislation was described in law as being “a separation so permanent as to emulate the veil between the living and the dead”  there has been no attention given to  the trauma caused to the mother  who loses a living child forever in such a permanent and  unnatural way.

 

Condon. John of Flinders University, explains how 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.

 

Few had contact with the child at birth or thereafter. Nor did they receive 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.

 

Because the child continues to exist and develop while remaining inaccessible to them, the situation is similar to that of  having a child kidnapped,  or relatives of servicemen "missing believed dead". Similar disabling chronic grief reactions were particularly common during the war, in such relatives. (Condon Flinders University 1986) 

 

In her training  courses for Adoption Workers in 1968, Miss M Nicholas of the Anglican Church Adoption Agency outlines the effects caused to the mother in relinquishing her child to adoption and the criteria to look in referring natural parents on for either  diagnosis or treatment.

 

In her paper The Natural Parents Needs after Placement of her Child, Nicholas acknowledges  depression and anxiety with their varying symptoms along with loss of self confidence, self-esteem, undue weeping, strong feelings of rejection, social isolation and mothers who become incoherent after the loss of their child.

 

Changes in behaviour such as withdrawal from people, loss of interest in her appearance,  lack of self esteem, self respect and self confidence may be very low; there are  marked feelings of unworthiness, attempted suicide, fear of being alone, self destruction, personality disturbances,  obsessive and compulsive behaviour,  aggression and hostility.  Another concern with some were repetitious destructive  dreams about babies being tortured. 

 

Sister Berromeo of the Catholic Adoption Agency in her presentation to the  inaugural preceding to introduce the adoption of Children Act 1965,  acknowledges that the separation from a child through the process of adoption is to a great many intents and purposes comparable to separation from a child through death.

 

The loss is irrevocable in terms of relationship and that  such a loss can be viewed as a  traumatic event indeed. Often, she explains , the mother cannot put  the past behind her and move on.  That her ability to do so is dependent on her ability to do just this, and so she is under double pressure to suppress her grief.

 

In cases where this is not possible it is not unusual for a mother who loses her child to suffer severe breakdown around the  time of the child’s first birthday.  Berromeo acknowledges that forbidding the mother to see her baby appears to  encourage the re-enforcement of the strong elements of denial of her  pregnancy and so, in the long-term view, prevent her from coming to terms with  the whole experience.

 

Rose Burnstein in her 1968 paper Are We Stereotyping the Unmarried Mother? acknowledges  the professionals own part in fostering a state of denial in the mother to make her experience as unreal as possible so that  “she can  resume her place in the community as though nothing has happened.  What we interpret as pathology may be the girl's valid fear of a frightening  reality. She is behaving the way society requires in order to avoid permanent impairment of her social functioning.”

 

Symptoms

The  primary source of pain for the mother who loses her child to adoption has been in the area of trust and loss. Trust was lost to her through the process of adoption rhetoric which told her adoption was in her child’s best interest and that she would recover and move on, only to be reviled by the same society which had encouraged adoption and gave her little alternative but to comply.

 

The consequence which resulted in a lifetime of shame filled sorrow and silence.

The loss  she has suffered has not only been the loss of her child/ren, but the total loss of trust in herself and other,  the loss of  her sense of wholeness, her sense of control over her life, and loss of self-esteem.

 

In some cases she has lost a home or has lost or suffered damaged relationships with members of her family. Often she has lost identification with her mother as a role model. She has suffered loss of being accepted by society and loss of her adolescence, as well as loss of her sense of trust and self-worth.

 

For approximately half who had no other children she has lost her right of passage through the evolution of life as a mother and eventually a grandmother.  What most people take for  granted, she will never know. 

 

This magnitude of loss is  difficult for her to overcome. Sometimes the mother survival relies on remaining in denial and numbness for the rest of her adult life, unconsciously encumbered by her silent loss and sorrow. For those mothers who eventually seek help, it is up to the mental health community to validate their loss which in turn gives them the permission to grieve that which they have long been denied.   

 

Symptoms of Post Traumatic Stress Disorder.

 

Sue Wells 1993 explains that many mothers say they split themselves off from their trauma as a coping mechanism. This avoidance as a strategy is one of the key symptoms of PTSD which may be caused by the trauma being internalised to avoid immediate pain.

 

Many say they escaped into drugs and alcohol especially in the immediate  years  after relinquishment. Most say they felt numb, shocked, empty, sad and many said they felt the same way many years later.

 

The distress associated with the loss may cause Psychogenic Amnesia which many mothers have verified by saying they are unable to recall important events associated with the birth or adoption.  Many who had no further children  had blocked out the memory of giving birth and the adoption process entirely, until legislative changed open records and allowed them to find their child.

 

Strategies for reducing distress means that exposure or events associated with the trauma, e.g. anniversaries, child’s birthday, Christmas, family gatherings etc, are experienced by most mothers as  painful or causing "intense psychological distress".

Psychic numbing, where the mother feels detached or estranged from others who have not been through the same experience is also substantiated as an isolating  factor. The burden of secrecy can perpetuate this.

 

The description of Dissociation as a mental process which produces a lack of connection in a persons thoughts, memories, feelings, actions, or sense of identity. during the period of time when a person is dissociating, and where  certain information is not associated with other information as it normally would be, is an apt description of  the defence responses of a large number of mothers who lose a baby to adoption.

 

For example, during a traumatic experience a person may dissociate the memory of the place and the circumstances of the trauma from his ongoing memory, resulting in a temporary or long term mental escape from fear and pain of the trauma and in some cases, a memory gap surrounding the experience. Because this process can produce changes in memory, people who frequently dissociate often find their senses of personal history and identity are affected.

 

In addition, individuals  can experience headaches, amnesias, time loss, trances, and "out of body experiences." All are definitions  that can be attributed to  these mothers.

 

Anniversary reactions also feature strongly in the post adoption experience. 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.

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

 

Damage

Psychiatric observations of the type of  damage caused by adoption separation and it’s practices   by Child Psychiatrist and adoption expert Dr Geoffrey Rickarby  are as follows:

1.   Pathological Grief.

2.   Personality damage associated with the defences used against grief, against post traumatic stress phenomena and against depressive decompensation.

3.   Personality damage associated with the isolation of the birth experience and the loss of the baby, where this is a secret and there is no significant other to share the feelings and unresolved issues associated with the loss.

4.   Axis 1 Psychiatric Disorder

1.   Post Traumatic Stress Disorder.

2.   Major Depression

3.   Dissociative Disorder

4.   Panic Disorder (and other anxiety disorders)

5.   Dysthymia

6.   Situational Stress Disorder (often associated with reunion)

7.   Alcohol Dependent Disorder

8.   Prescription Drug Dependent Disorder

9.   There are other drug dependent disorders which are uncommon

among these mothers.

 

 

Rickarby includes personality damage associated with psychiatric illness  as a sequel to loss of a baby to adoption, personality damage associated with long term Pathological Grief, aggravation and precipitation of a wide variety of physical illness which are related to stress, disorder and incapacity in human relationships, educational failure and poor employment status, failure of bonding to other babies, as  being additional consequences to  the experience of adoption practice and separation.

 

What seems evident is that routine adoption practice in Australia were specifically designed to create in the mother a state of denial of her experience and her loss. This in turn served only to create in the mother a  lifelong pathological grief from which most have been unable to find a resolution.  It is little wonder then that the majority of mothers now need help  with their debilitating mental health problems which have since  de-compensated into  Major Depression.

 

Infant at birth adoption  was a social phenomenon, an experiment, that came and went within a period of 40 years. Never in the history of mankind were mothers expected to relinquish their newborn children en-masse to strangers in any other period in history

 

The question is how do we come to terms with the damage past adoption practices have had on women.

 

Origins having called for the Inquiry and having the legal and ethical issues of adoption defined, now has to take on representative role of women who have entrusted us to speak on their behalf of their mental health issues.

 

It has only been in the past few months that we as a group have approached mental health agencies for the first time. Our first encounter has been with Ettinger House and the support of Tracy Phillips has finally given us the encouragement to start networking with other agencies who can take an interest in our issues.

 

We have started to network with agencies such as the Liverpool Womens Resource

and are now in the process of putting together a 2 day national conference to be held at Liverpool Hospital on the 10-11 October 2002. As the Inquiry did not recommend any funding for our group we have had to find the finances to put together the conference and literature to inform the mental health community of our issues.

 

Fairfield Council has also been supportive and has helped us with a much needed donation. We are hopeful of leasing an office from the council where we can set up a support network and have an avenue to network with other agencies

 

In Conclusion I would  like to thank the organisers of this Conference for  giving  me the opportunity to represent those once silent mothers today.

 

 

Copyright   Origins Inc, 1995

Origins Inc Supporting People Separated by Adoption