In this article, you will find information on relinquishment trauma (aka adoption trauma, adoptee birth trauma, adoption separation trauma, primal wound) and how it impacts the way an adoptee views and interacts with their world. The relinquishment trauma information presented in this article synthesizes stories of relinquishment trauma with developmental trauma research, prenatal experiences, and how the human brain works. When relinquishment trauma occurs, it happens due to an infant’s traumatic experience after the separation from their mother and the loss of the familiar[1]. Relinquishment trauma is one type of adoption trauma. Additional traumatic adoption events adoptees may experience include an absence of information about birth family creating genealogical bewilderment, being transracially adopted, and learning you were adopted as an adult (late discovery adoptee). The adverse relinquishment and adoption experiences assessment is a comprehensive list of adoption traumas birth parents, adoptees, and adoptive parents might experience. While adoption trauma research can be found in an Internet search, this author was unable to find one research article specific to adoptee relinquishment trauma. Nancy Verrier’s book The Primal Wound is a testament to the impact of separation from birth mothers on adoptees, but it is not a research paper. This article includes how relinquishment trauma could impact relationships. It concludes with information on adoption counseling and resources.
How Does Adoptee Relinquishment Trauma Happen?
Research has shown that babies in utero learn their mother’s characteristics. Characteristics include the sound of their mother’s voice and her olfactory signatures during the pregnancy[2] [3]. The newborn child may become frightened and overwhelmed when the caretaker is not their first mother. The greater discrepancies between the adoptee’s prenatal and early life (sound of the mother’s heartbeat, language, sounds, facial features, smells, the personal gait of walking, level of activity) the greater stress on the infant. When an infant is not with their first mother day after day, the infant can become anxious and confused, causing the infant’s body to release stress hormones. Even newborns that are placed with the adoptive parent within days of their birth can feel the terror of their mother missing. Babies know their mother is missing and they are being cared for by strangers. Common sentiments expressed by adoptees are that they feel like something is missing, they have a hole inside of them, or their connections feel fragile and insecure.
The newborn’s trauma experience is multiplied when there are numerous caregivers and placements before the child joins their adoptive family. The number of caretakers babies and children have been exposed to in foster care, orphanages, lengthy hospital stays, infant homes run by adoption agencies, and college domecon classes can increase the likelihood an adoptee will develop anxiety, depression, attachment issues, post-traumatic stress disorder or complex post-traumatic stress disorder.
Birth psychology researcher, Paula Thomson [4] states “early pre-and post-natal experiences, including trauma, are encoded in the implicit memory of the fetus”. Many birth mothers had anxiety, depression, and post-traumatic stress disorder from their crisis pregnancy, the anticipated relinquishment of their child, and the horrible treatment they experienced. This could set the stage for their child -the adoptee- to inherit a predisposition for depression, anxiety, or post-traumatic stress disorders. This writer is unaware of any research that studies the impact of a mother not connecting with her child in the womb and the potential impact on the child’s ability to attach later in life.
Relinquishment Trauma as a Developmental Trauma Disorder
When trauma researchers saw the majority of children who experienced trauma did not meet the diagnostic criteria for post-traumatic stress disorder and were labeled with an unhelpful diagnosis that described behaviors, trauma researchers began to think of a new way to diagnostically describe how a child’s mind and body changes because of trauma. This led to the proposal of developmental trauma disorder[5]. The diagnostic criteria for developmental trauma disorder states a child or adolescent needs to have been exposed to:
“interpersonal violence or a significant disruption of protective caregiving as the result of repeated changes in primary caregivers, repeated separation from the primary caregiver, or exposure to severe and persistent emotional abuse”.
Tragically, most mental health clinicians and developmental trauma researchers do not acknowledge the separation of an infant from their mother due to adoption as meeting the criteria of disruption of protective caregiving or multiple primary caregivers as meeting the diagnostic criteria for developmental trauma disorder. This leaves adoptee relinquishment trauma to be overlooked by mental health professionals creating a significant lack of adoption competent mental health professionals. While the American Psychiatric Association declined to include developmental trauma disorder in the DSM-V, developmental trauma disorder has been accepted by many trauma researchers and mental health clinicians [6].
You can watch Marie’s workshop Relinquishment Trauma and Its Impact on Adopted Persons by clicking the link below. The workshop was done for the National Association of Adoptees and Parents Happy Hour in June 2022.
What are the Characteristics of Relinquishment Trauma?
Relinquishment trauma is one type of separation trauma. When trauma occurs it can change an individual’s brain chemistry and functioning. This causes individuals who have experienced trauma to view and interact with their world as if the trauma was happening in the present. An example is an adoptee that perceives their world as unsafe resulting in them having difficulty with trust. Developmental trauma disorder symptoms that adopted persons frequently experience include[7]:
- Emotional dysregulation – Children are easily upset and reactive. They stay fearful, angry, sad, or withdrawn due to difficulty recovering from emotionally provoking situations.
- Problems with sleeping, eating, elimination, overactivity to sound and touch
- Hypervigilant, extreme risk-taking
- Problems with goal-directed behaviors
- Low self-worth, feeling defective, helplessness
- Reactivity with physical or verbal aggression
- Poor capacity for self-protection, drawn towards relationships with individuals who repeat the pattern of poor attachment
- Difficulty in school, few peer relationships, and turbulent family relationships
Due to these struggles, difficult transitions and separation anxiety are common experiences.
Trauma may cause an individual to become emotionally stuck at the age that the trauma happens. Thus, we frequently hear adoptees described as “emotionally immature for their age”. This is a result of their brain chemistry interfering with a brain’s developmental trajectory. MRIs of children’s brains who have experienced trauma look different than their non-traumatized peers. Without resolution of the developmental trauma as a child, adopted individuals could have the symptoms of post-traumatic stress disorder and complex PTSD as adults[8].
The trauma experience becomes worse when the adoptive parent minimizes the adoptee’s grief and fears of abandonment. These experiences cause an adopted person to mistrust their inner self. It is common for adult adoptees to emotionally believe they must have caused the separation from their mother even though they intellectually know it was the decision of the adults involved, not them.
These feelings will impact how an adopted person interacts with family and friends. A traumatized brain often responds with fight, flight, freeze, or fawning (people-pleasing) when the implicit traumatic memories are triggered. Common scenarios of adopted persons reacting to their trauma triggers include: provoking an argument with a loved one and walking out knowing their loved one will go after them, running away as a teenager while leaving clues for their adoptive parents to find them, or emotionally freezing when boundaries are crossed. An example of a fawning response is going along with something that a person does not want to do for fear there will be negative consequences to the relationship. Fight, flight, freeze, and fawning are common reactions during early adoption reunion contact
When an initial trauma happens in adulthood, an individual can remember what they were like before the trauma. For example, a person would know what they were like before they experienced a war zone, and how they changed because of their experience in a war zone. With the relinquishment trauma happening soon after birth, an adoptee’s personality is often defined by their trauma symptoms. The adoptee’s trauma symptoms – hypervigilance, need for control, lack of close relationships -should be seen as trauma survival skills [9], not personality traits. The survival skills (trauma symptoms) are a normative response to abnormal life events. Survival skills have kept people alive.
When the trauma happens before the age of three, the memories of the trauma are stored in the unconscious part of the brain as implicit memories. Implicit memories are not coded in the brain as a coherent memory, but as fragmented sensory and emotional fragments- images, sounds, and physical sensations. Activation of the survival skills is often the triggering of implicit trauma memories. Individuals can learn to identify their survival skills, triggers for their trauma symptoms, and learn to be more present in their daily life.
With a strong need for relief of the trauma symptoms, adoptees can develop the fantasy that meeting the birth parent will heal their trauma. This is an unrealistic solution to healing the pain of separation and not staying in the family of origin. Even if the reunion with the birth parent goes exceptionally well, a wonderful relationship with birth relatives does not rewire a traumatized brain.
Isolation, Secrecy, and Shame Negatively Impact Trauma
The life of an adopted person is impacted by the lack of information on their story and lack of validation of what they have been through. Adoptees can easily be made to feel something is wrong with them when individuals dismiss their belief that their lost connection to their first family matters. This can lead to the adopted person not verbalizing their truth. When the painful truth is not spoken, it can compound the trauma. The secrecy, lack of acknowledgment, and isolation often create a feeling of shame.
Shame negatively impacts healing from trauma. Research by Regina Hiraoka [10] found fewer post-traumatic stress disorder symptoms in combat veterans that practiced self-compassion than veterans with higher shame and self-judgment. I believe this trauma research can be extrapolated to birth parents and adoptees in that the shame placed on birth parents and adoptees (society, others, and themselves) can potentially increase the symptoms of their traumas.
Adoption Trauma and Relationships
The beginning of an adoptee’s connection to the adoptive parent often starts with anxiety and confusion. The infant knows their caretakers are not their birth mother. Key to the adoptee child’s ability to attach to the adoptive parent is the adoptive parent’s ability to attach to their child without taking their child’s grief and anxiety of missing their first parent personally. When the adoptive parent does not feel entitled to parent, the infant can sense the parent’s ambivalence creating further anxiety for the child. A strong bond to an adoptive parent is a protective factor against a child developing developmental trauma disorder. That being said, an excellent relationship with an adoptive parent does not replace the birth mother.
When the adoptive parent has attachment issues (from their childhood or feeling their bond with their adopted child will never be as good because they are not the birth parent) it increases the risk of developmental trauma disorder. The relationship between the adoptive parent and child becomes further damaged when the adoptive parent minimizes the adoptee’s true story that they have a history prior to placement and a first family. It is traumatizing to an adoptee to be told they should feel “grateful” for being adopted and that they are “disloyal” for wanting to talk about their birth family and how it feels to be adopted. The little t traumas in interpersonal relationships -lack of validation, shaming- are often more damaging than big T traumas because the trauma injury happened in a relationship that should be supportive. The little t traumas in family relationships happen day after day, year after year. The extensive number of little t traumas over the years can cause extensive damage to an individual’s self-worth, identity, and ability to have healthy relationships. There is extensive research that when adopted persons can talk to their adoptive parents about their adoption experience with genuine openness and no shame, the stronger the parent-child relationships and the adopted person’s risk for mental health issues decreases [11] [12].
Paul Sunderland has a fascinating lecture “Adoption and Addiction: Remembered Not Recalled” which describes relinquishment’s impact on a child’s brain and their view of their world [13]. The lecture can be watched by clicking the video to the left. The title of his lecture includes addiction because he believes addiction (drugs, alcohol, sex, the adrenaline rush of risky behaviors) is often the result of adoptees trying to soothe the imbalance of their brain chemistry caused by relinquishment trauma.
“The legacy of this trauma for the relinquished child is a conflict between wanting to connect and fearing connection. This is often experienced as hypervigilance that has an enormous impact on relationships and functioning which can disrupt the ability to be present, with feelings that one is both “too much” and “not enough.” Paul Sunderland quote
Adoption reunions have complexities due to ghost images [14] of the lost relative, expectations for what the relationship should be, the triggering of implicit memories, and trauma. Contact with lost relatives often brings answers and a relationship (even if it is not the original type of relationship desired). Genetic mirroring can often fill the hole inside the adoptee. Reunions cannot rewire the traumatized brain. With the fear of losing their relative again, reunion relationships sometimes have an obsessive need for contact. Some reunion relationships have a genetic sexual attraction that is caused by a combination of brain chemistry and the adoptee and their birth relative’s desire to heal their traumas. Intimate contact between an adoptee and a birth relative will not heal the primal wound. Adopted persons and birth families do better when they have realistic expectations for the reunion relationship to not heal their trauma.
Adoption Counseling for Healing Relinquishment Trauma
While there is research on helping adoptees with identity issues, grieving losses, and other “adoptee issues”, there is a lack of research specific to relinquishment trauma counseling. We know from trauma therapy research that recovery can be achieved when an individual feels free to know what they know while desensitizing themselves to their emotional triggers. In other words, finding a way to stay calm in response to images, thoughts, sounds, or other physical sensations that remind a person of their trauma [15]. Thus, therapy techniques that focus on helping individuals stay grounded in the present when stressful events happen may be helpful. The Stress Management Techniques blog post has exercises for managing strong feelings and stress. Talking about a traumatic experience is often not enough to rewire a traumatized brain because the part of the brain that stores the implicit trauma memories does not work in unison with the speech part of the brain. Some individuals with a trauma history may find evidenced-based trauma therapies more helpful than traditional talk therapy. Evidenced-based trauma therapies include eye movement desensitization and reprocessing therapy (EMDR), brain spotting, neurofeedback, and emotional freedom technique (tapping). Julie Lopez’s book Live Empowered! – Rewire Your Brain’s Implicit Memory to Thrive in Business, Love, and Life includes case information on adopted individuals and detailed information on trauma therapies. Information on evidenced-based counseling for children who have experienced developmental trauma can be found on the Attachment and Trauma Network’s website. Adoptees may also benefit from adoption support groups. When an emotional injury occurs from an interpersonal relationship, healing may happen from the interpersonal nature of support groups.
Saying relinquishment trauma is the primary cause of an adoptee’s mental health struggles is frequently inaccurate. Other big T traumas and little t traumas need to be taken into consideration for the cumulative effect on an adopted person.
Counseling for individuals with trauma symptoms should include an adverse childhood experiences assessment. It could be harmful to assume that all trauma symptoms were caused by relinquishment trauma. The assessment should include prenatal trauma (alcohol, drugs, lack of nutrition), number of caretakers before placement and after placement, psychological, physical, or sexual abuse, or other traumatic events (homelessness, an adoptive parent with a significant mental health issue). Additionally, the assessment should evaluate for other adoption traumas. Other adoption traumas include being a person of color raised to have a white identity, late discovery adoptee, adoption microaggressions, and being shamed for wanting to talk about how it feels to be adopted and birth parents. The Adverse Relinquishment and Adoption Experiences Assessment discusses the extent of adoption traumas for adopted persons, birth parents, and adoptive parents.
Discussion
So, where do we go from here? First, we need to change the narrative around adoption and allow the losses, trauma, and other negatives to be acknowledged. The mental health professional community needs to recognize relinquishment and adoption traumas have an impact on an adopted person’s mental health. Having a loving family does not heal the brain. If it did, most mental health conditions would disappear if individuals were in a loving relationship. Developmental trauma researchers need to acknowledge that relinquishment may lead to infant separation trauma which may cause developmental trauma disorder. The research needs to look at why some adoptees are more resilient than other adoptees and what can be done to reduce the impact of the traumas.
Adoptee traumas need to be taught in all levels of clinical training – college level, continuing education, and adoption competency trainings [16]. Research has repeatedly shown adoptee teens are over-represented in the clinical population- outpatient counseling, residential treatment, and psychiatric hospitalization. Additionally, the suicide rate of intercountry transracial teen adoptees is higher than the general population [17]. Mental health professionals frequently are not understanding what is behind the depression, anxiety, or acting out behaviors of many adopted youth. Too often, adoptive parents are blamed for their child’s emotional struggles.
The length of time a child spends in foster care and orphanages needs to be minimized as much as possible. The more caretakers the greater chance of trauma. Adoptive parents must be educated on adoptee traumas and adoption issues before a child is placed with them. Adoptees with “issues” should not be labeled as having bad genes or ungrateful.
It is important to conclude that this blog post should not be construed as proof that adoption is so harmful to an adoptee that adoption should be discontinued. As you can tell by reading this blog post, I believe in reading the research. What I have found by reading the long-term metanalysis research on adopted individuals is that in studies of individuals outside of the clinical population, adopted persons do as well as nonadopted individuals when adoptees are evaluated in middle age. Notice I did not say teenage adoptees. Too often poorly designed research studies on adoptee mental health issues are being used as proof that adoption is predominately harmful. Examples of poor research designs include research that only studies adoptees in therapy – not the general public, research without a control group of non-adopted persons, research that did not control for adverse childhood experiences (i.e. prenatal alcohol exposure) prior to the adoption, or the researchers that coded the results were not blind to the adoption status of the individuals they were evaluating. Using statistics out of context like adopted teens are over-represented in residential treatment programs only furthers the malignment that all adoptees are messed up. Adopted teens are over-represented in residential treatment, but if the research does not control for preadoption traumas (abuse prior to adoption, prenatal alcohol exposure, multiple caregivers due to foster care) then there is no delineation of what caused the need for residential treatment – preadoption risk factors, adoption as the risk factor or both. Well-designed research on adoptees that show mental health issues can be insightful to the risk factors. An example is Keyes’s [18] research Risk of Suicide Attempted in Adopted and Non-Adopted Offspring found teenage adoptees in their study had a four times risk of a suicide attempt. The demographics of the adopted teens in this research – non-newborn placement age, transracial adoption, transcultural, and poor relationships with adoptive parents – are risk factors for mental health issues for teen adoptees. Ideally, a follow-up study would have teens and adoptive parents who are the same race, newborn placement, and adopted teens who had good relationships with their parents with a control group of non-adopted teens with similar demographics.
We should not only believe in family preservation but provide financial resources for those who want to parent their child. When adoption does occur, it should be done as humanely as possible with having the least number of adverse conditions experienced by child adoptees to decrease the risk of them being traumatized. The goal of this article on relinquishment trauma is to help adoptees, birth parents, their family members, and the mental health professionals that work with them to have a framework for understanding relinquishment trauma. The more individuals know about adoption traumas, traumatized adoptees can receive support for their healing journey.
Please do not conclude or cite this blog post as anti-adoption.
[1] Gonzales-Gonzalez, N. L., Suarez, M.N., Perez-Pinero, et al., (2006), Persistence of Fetal Memory into Neonatal Live, Aca Obstetricia et Gynecologica, 85: 1160-1164 discusses the ability of newborns to remember in utero experiences.
[2] Paul, A. (2011, November 29). What We Learned Before We’re Born, Ted Talks
[3] Porter, R., Balogh, R., Cernoch, J., Franchi, C., (1986). Recognition of Kin Through Characteristic Body Odors, Chemical Senses, 11(3), 389-395
[4] Thomson, P., (2004), “The Impact of Trauma on the Embryo and Fetus: An Application of the Diathesis-Stress Model and the Neurovulnerablity-Neurotoxicity Model, Birth Psychology, 19, (1)
[5] van der Kolk, B, (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Penguin Random House
[6] Attachment and Trauma Network https://www.attachmenttraumanetwork.org/developmental-trauma-disorder
[7] Attachment and Trauma Network https://www.attachmenttraumanetwork.org/developmental-trauma-disorder/
[8] Judith Herman’s book Trauma and Recover: The Aftermath of Violence – From Domestic Abuse to Political Terror (1997) was the first to discuss complex post-traumatic stress disorder as a result of childhood trauma. The book predates the discussion of developmental trauma disorder which was not proposed until 2009. Read van de Kolk’s The Body Keeps the Score to learn about the diagnosis of developmental trauma disorder in children who have experienced trauma.
[9] Fisher, Janina, Transforming the Living Legacy of Trauma (2021) discusses trauma symptoms as the living legacy of trauma. This book does not discuss adoptee traumas, but it can be helpful to individuals wanting to learn about how to decrease the use of their trauma survival skills.
[10] Hiraoka, R., Meyer, E. C., Kimbrel, N. A., DeBeer, B. A., Gulliver, S. B., Morissette, S. B., (2015). Self-Compassion as a Prospective Predictor of PTSD Symptom Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans, 28(2), 127-133.
[11] Brodzinsky, D. (2008). Family Structural Openness and Communication Openness as Predictors in the Adjustment of Adopted Children, Adoption Quarterly, 9 (4), 1-18
[12] Triseliotis, J., Feast, J., Kyle, F., (2005), The Adoption Triangle Revisited: A Study of Adoption, Search, and Reunion Experiences, British Association for Adoption and Fostering, pp. 146
[13]Paul Sunderland’s lecture can be found on YouTube at https://www.youtube.com/watch?v=3e0-SsmOUJI
[14] Lifton, B. J. (2009). Ghosts in the Adopted Family, Psychoanalytic Inquiry, 30(1), 71-79
[15] van der Kolk, B, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (2014)
[16] Research has shown the majority of college degree programs for mental health training do not teach adoption issues. Even the best-known adoption competency training program does not present information on relinquishment and adoption trauma.
[17] Keyes, M., et al. (2013), Risk of Suicide Attempt in Adopted and Nonadopted Offspring, Pediatrics, 132(4), pp 639-646
[18] Keyes, M., Malone, S., Sharma, A., Iacono, W., McGue, M., (2013). Risk of Suicide Attempted in Adopted and Nonadopted Offspring, Pediatrics, 132(4), 639-646.
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