Problems of Self-Esteem in the Analysis of A Seven-Year-Old Adopted Girl*

This paper was written some years ago , and therefore does not draw on the important work concerning the therapy of adopted children that was published subsequently, much of it in this journal (Hodges, 1989; Muller, 1989; Parsons, 1989; Salo, 1989; Green, 1990). I would also like to draw attention to the papers which arose largely out of the research in the Anna Freud Centre Study Group on Adoption (Berger, 1979, 1980; Berger and Hodges, 1982; Hodges, 1984, 1989; Hodges, Bolletti, Salo and Oldeschulte, 1985). This Study Group, set up by Maria Berger in 1978, explored two fundamental questions which adopted children have to face in their development, namely “Who were my first parents, what were they like?” and “Why did they give me up?” (Hodges, 1989). The Study Group also focused on the typical fantasies and theories of adopted children (Berger, 1979; Hodges, 1984), many of which preoccupied my patient, Sally. Jill Hodges (1989) referred to the universality of such fantasies in adopted children as a particular form of the family romance fantasy of the latency-aged non-adopted child. Sally's contradictory self- and object-representations were interwoven in her adoption fantasies, especially her view of herself as an unwanted child, and more specifically an unwanted girl.

At the core of Sally's problem was an inability to reconcile her intensely ambivalent feelings towards her parents, especially her adoptive mother. Her disturbance in self-esteem regulation was related in part to guilt and shame for aggressive wishes towards her adoptive mother, but was compounded by the mother's ambivalence towards her. Hostility towards her mother was so intense and unmanageable that Sally resorted to strenuous defence activity, including denial, repression and splitting of ambivalence. In the early stages of therapy this took the form of denying painful affects and conflicts, keeping knowledge of her adoption out of conscious awareness, and perceiving the adoptive mothe