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Despite the indisputable challenges confronting children and adults who have been adopted, it is difficult to gain access to such issues with adoptees in psychotherapy. This paper contends that transference and countertransference developments can symbolize adoptees' conflicts and thereby be an essential tool to reach such concerns in treatment. The paper reviews the literature, which contains many descriptions of characterological and behavioral patterns of adoptees but minimal reference to the transferences that give life to these dynamics in treatment. As we review the clinical literature, we propose transferences that could accompany the broad behavioral patterns discussed. Thereafter, we present portions of a treatment with a 9-year-old adoptee where issues illustrated in the literature are highlighted and new transference-countertransference paradigms are presented as potential conduits to patients' adoption concerns, as well as tools to deepen our understanding of the experience of adoption.
Patients who are adopted are often highly resistant to exploring this fact in psychotherapy. Our culture also discourages the openness required to help members of adoptive families work through their difficulties (Nickman 1996a). Clinicians who work with such patients are well aware of this phenomenon, and the literature on psychotherapy with adoptees documents the difficulty exploring patients' conflicts about adoption (Kernberg 1985-1986, Sherick 1983).