By Heather T. Forbes, LCSW, founder of the Beyond Consequences Institute
**Orginally published in the Winter 2007-08 Adoption issue of The Journal of API
The typical scenario of a young married couple adopting an infant from birth has changed dramatically and has been redefined. Historically, a traditional adoption was defined as a healthy infant placed with an infertile, middle-class white couple.
Today, adoptions can be characterized from a much broader spectrum. Many children being adopted are not infants, but are older children of various races being adopted from either the public foster care system or orphanages overseas. Often, children in these groups have suffered abuse, abandonment, and/or neglect.
Due to a history of trauma, these children are considered “special needs” and require special parenting once adopted into permanent homes. Many of these children are dealing with mental health issues such as oppositional defiant disorder (ODD), conduct disorder (CD), reactive attachment disorder (RAD), post-traumatic stress disorder (PTSD), and/or depression.
Mental Health Issues in Children with History of Trauma
Children with ODD show a pattern of uncooperative, defiant, and hostile behavior toward authority figures. The frequency and consistency of the behavior stands out in comparison to other children of the same age and developmental level. Consequently, their social, family, and academic lives suffer.
Children with CD consistently display extremely disturbed behaviors that violate the basic rights of others, outside of the range of what is considered normal or acceptable for their level of development. Many show little remorse, guilt, or understanding of the pain inflicted by their behavior.
Children with RAD display serious problems in forming emotional attachments with others. This complex psychiatric illness usually presents by the age of five. Most children with RAD have experienced severe problems or disruptions in their early relationships, and many have been physically or emotionally abused or neglected.
PTSD can occur when a child experiences a shocking, unexpected event that is outside the range of normal human experience. The trauma is usually so extreme that it overwhelms their coping mechanisms and creates intense feelings of fear and helplessness.
There are two basic types of depression: major depression lasts at least two weeks; and the milder but chronic dysthymic disorder, in which a long-standing depressed mood seems to be connected to the child’s temperament or personality. Depression can be linked to unresolved grief, and may reflect that the child has learned feelings of helplessness rather than empowerment. Some seriously depressed children have experienced early life or environmental stresses.
Special needs children can be difficult to parent. Adoptive parents of these children do not start with a clean slate; they adopt not only the child of the present, but they adopt the experiences of the child’s past. These experiences imbedded in them often make adoptive parenting a serious challenge and can compromise the child’s ability to join with and be accepted by a family.
What the Research Shows
Research in the area of infant adoption and special needs adoption has focused primarily on two parts of the adoption triad: the birthmother and the adopted child. Numerous articles and books have been written on the birthmother’s experiences. Other resources and studies have focused on the adopted child’s adjustment, characteristics, and behavior.
However, the third piece of the adoption triad, the adoptive parent, has been virtually left untouched. Much less is known about the adoptive parent’s outcome. Most studies are centered on the problems of the adoptee alone, with solutions centered on how the adoptive parent can help resolve the problems.
A research study published in the Journal of Social World, coauthored by myself and Dr. Sophia Dziegielewski, was conducted to identify and understand the issues facing adoptive parents. This study focused specifically on adoptive mothers, due to the consensus from professionals working in this field and from practice literature that indicated that, in most cases, it is the adoptive mother in particular who is targeted and it is she who is at the epicenter of a child’s negativity and fear. The study explored the challenges and adversities adoptive mothers of children with special needs face, as well as the challenges they face that are considered well beyond the scope of “normal parenting.”
The specific issues that this study identified for these adoptive mothers included: stigmatization of adoptive motherhood, infertility issues, grief and loss issues, marital issues, extended family issues, behavioral alienation, mother’s family of origin issues, post-adoption services, mother-directed behavior, culmination of the stress, development of physical symptoms, society’s lack of understanding, feelings of isolation, financial stress, feelings of intense anger, and changes in self-image. The full results of this study can be found at www.beyondconsequences.com/issues.pdf.
Understanding the Child with Special Needs
Before understanding the extent of these specific issues, it is important to acknowledge that adoptive parenting of a child with special needs is different from parenting a child without special needs. Although adoptive parents may face many of the same child-rearing issues as biological parents, adoptive parents of children with special needs face numerous issues related directly to traumatic experiences of the child. Adoptive parents often find that this significantly alters the balance of the family system, resulting in overt stress and disequilibrium, sometimes to the extent that the child is returned to foster care or to the adoption agency.
The demands and stress that result from the adoption of children with special needs result in approximately one-fifth to one-fourth of the adoptions being reported as unsatisfactory and contributes to the approximately ten percent or more of these adoptions that disrupt (in which the child returns to the foster care system). Conversely, research shows that less than one percent of infant adoptions disrupt, demonstrating that the issues facing these infant adoptive parents are significantly less.
John Bowlby’s writings on attachment suggest that early separations, discontinuity of loving care, and unresponsive or abusive care have a lasting impact on a child’s attachment framework. From this perspective, many adopted children have less than optimal beginnings. As parents transition into parenting these children, they are often faced head-on with the repercussions of these beginnings. Internal states of fear resulting from the early care are most commonly communicated through the child’s negative and rejecting behaviors.
These behaviors are a byproduct of the break in the attachment relationship, which has left the affected child without the ability to calm themselves and in a state of constant stress, unable to control feelings of anger and frustration. As a result, many adopted children with trauma histories are often characterized as aggressive, defiant, controlling, and lacking empathy.
Stress from the Disconnect
These problematic behaviors between the child and the parent can then quickly lead to problematic relationships and a cascade of the issues identified earlier, such as financial stress, marital stress, extended family stress, and physical symptoms. As the child works to attain safety through avoidance of the very relationship that the parents are working to develop, tension, fear, and discontent can quickly create stress in all aspects of the parents’ lives.
The child’s internal blueprint for relationship says that love equals pain, rejection, and abandonment. When parenting a child with such a definition of love, adoptive parents soon find that conventional parenting techniques are profoundly ineffective. Too often, parents find themselves in a state of helplessness and at a complete loss as to how to handle the behaviors.
These negative attachment behaviors can then leave the parents feeling emotionally depleted and depressed. Homes become chaotic. Friends disappear. Parents become isolated. Job-related stressors become more difficult to handle. Stress-related physical symptoms become evident. Changes in self-image shift from confident and complete to insecure and empty. Even for experienced parents, who have raised biological children in the past and believe that they are fully prepared for the children’s lack of responsiveness can find themselves overwhelmed and feeling as if their lives are out of control. The entire household can switch from a state of light to a state of utter darkness.
Early childhood experiences of fear, void of a responsive caregiver, have created this dynamic. It is the lack of ability to self-regulate internal emotional states that is at the helm of this powerful and stressful force, restricting the child’s ability to engage in positive social interactions with the adoptive parents.
Relational Focus Required
Children with trauma histories typically project their fear, anger, resentment, and sadness onto the mother; the mother becomes the main target. Attachment theory explains this reaction in its definition of the mother’s job: to keep the child safe. For children with trauma histories, their mothers were unable to fulfill this role. Thus, the trauma occurred within the construct of the relationship.
In helping families of children with severe acting-out behaviors, the focus of the intervention needs to be the relationship, not the behaviors. Emphasis should be placed on creating a secure base for the child within the relationship with the parent. Research has demonstrated a direct correlation in the quality of the relationship between the adopted child and the parent to the adoption outcome.
From Love to Fear…to Love Again
When traditional parenting techniques prove ineffective, and as parents work to implement strategies to connect with their children to no avail, the feelings of rejection and helplessness can be devastating. As stress builds in the home when parenting a child who does not respond positively and who does not seek his parents for comfort, parents find themselves disconnecting in an attempt to maintain their own level of existence.
Before long, the entire family can find themselves living in survival mode and parents often demonstrate difficulties in responding to their children in nurturing ways. Parents find themselves asking how they went from a state of love, in wanting so badly to adopt a child, to a state of fear – wanting to so badly to get away from the child.
The shift from an initial emotional state of love to this resultant emotional state of chaos and helplessness is simply the outcome of living with a child whose internal stress level is in a state of perpetual overdrive. This level of stress energy within a family system is a powerful force. The adoptive parents often find themselves yelling, screaming, and verging on the edge of abusiveness. This can be so severe at times that parents feel as if they could physically hurt or injure their child.
This type of reactionary behavior is simply an internal safety mechanism used to avoid uncomfortable feelings and memories of their own past. In the study by me and Dziegielewski mentioned previously, the findings showed that of the adoptive mothers of children with special needs interviewed, 77 percent either strongly agreed or agreed that since adopting their child, they had experienced more rage and anger than ever before in their lives.
There is, however, hope for these families. Neuroscience tells us that the brain is ever changing, and neuro-plasticity tells us that the brain has the ability to continually formulate new connections. We were previously told that once we were hard-wired one way, we simply had to accept what we were given. However, brain scan imaging shows us that we are actually creating new connections all the time.
When the parents can reduce their stress and return to a state of calm, their interactions with the child have the ability to create new healthy and functioning connections in the child’s neuro-patterning.
It takes reducing the stress created from the issues affecting the adoptive family, related to both the trauma history of the child and the effect of that on the parents. It takes the willingness to be honest with oneself in order to face the pain, frustration, and feelings of helplessness to then create experiences with the child that are characterized by sensitivity, understanding, patience, and attunement.
Parenting a child with special needs requires living at a higher level of consciousness in order to stay attuned to one’s own emotional state. Attachment, bonding, and healing cannot occur when the parent is stressed and disconnected at the emotional level. It takes the intensity of positive emotional experiences to heal a child whose early messages, whether direct or indirect, were “You’re not wanted” or “You’re not lovable.”
Such interventions extend beyond that of behavioral management or cognitive thought. It takes addressing and releasing the core fear, which has become the child’s reality, through changing the environment and either reducing or eliminating the stressors for the adoptive parent.
Children inherently want to please their parents. It simply takes identifying the stressors and being willing to address the fear in order to allow the emotional space for this intrinsic drive and for the biological need for the relationship to be activated.
Thus, the child labeled earlier as a “special needs” child is in reality a misnomer. Instead, a child with a trauma history and a history of an attachment break should simply be seen as a child with “a special need.” And that special need is a well attuned, loving, and emotionally safe parent. It is in this dyadic relationship that the child (and his parents) finds his way back to love and healing.
About the Beyond Consequences Institute
The Beyond Consequences Institute was created to educate and provide the resources for helping children with severe acting out behaviors. Many of these children have been previously diagnosed with such disorders as reactive attachment disorder, bipolar, oppositional defiant disorder, conduct disorder, and depression.
Most traditional techniques accepted amongst nationally recognized professionals in this field are fear-based and child-blaming. While some of the traditional techniques may seem to help in the short-run, in the long-run, they simply create more fear in the parent-child relationship, many times resulting in chaotic and unsafe homes.
The Beyond Consequences Institute promotes a research-based approach outlined in the book Beyond Consequences, Logic, and Control and has proven to help even the most difficult of family cases find stability and healing.
For more information, log onto www.beyondconsequences.com.