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Adoption is a process and an identity, as well as an act. Born of the intent to care, it is not inherently psychopathological. While the birthparents set in motion a process through which the child is born, adoptive parents and maturing adoptees must together find ways to manage being borne by one another. Often distressed and disoriented by the sense that they were “left without a word,” adoptees can enact unexpectedly disruptive feelings that lack words. Because the sense of dislocation in adoption packs the shock of trauma while evoking the chronic sadness of bereavement, an important function of the therapist is to bear witness effectively to the patients' suffering and successes so that predictable interpersonal ruptures can be repaired. Psychotherapy can not only provide the containing, caring, and exploration that facilitates maturation and growth, but can also scaffold continuity, bridging occasional gaps in self experience that otherwise lead to inhibited curiosity or calamitous enactments of disorienting, unexpected behavior. Our goal is to help adoptees and their families to move from being “lost in translation” to being “found in relation.”
Consider the following clinical vignettes:
A severely asthmatic birthmother decided to give up her two-year-old twin sons for adoption. Scheduled for several sessions of conjoint therapy designed to help her say good-bye, she canceled the last one, leaving her sons without a word.
A 30-year-old adoptee, a severely depressed stockbroker who escaped the World Trade Center with only moments to spare,
entered treatment not after the 9/11 attack but after his girlfriend left him without a word. He had a history of ADHD, learning disability, school failure, and early (adoptive) father loss. At the end of two years of intensive psychotherapy, he left the therapist without a word.
A 35-year-old adoptee, a sculptor who makes art too large to fit in most galleries, entered therapy for anxiety and depression about conflict with hi