ADOPTION AND ADDICTION  –  REMEMBERED NOT RECALLED

PAUL SUNDERLAND                               notes from LIFEWORKS LECTURE

Adoption is a word that does not describe what has happened to a child that results in them coming into services at a very high rate.  It is a word that works to cover up, or deny the wound of relinquishment, a wound that is a developmental Post Traumatic Stress Disorder (PTSD).  There cannot be relinquishment and adoption without trauma.  The word adoption also hides another aspect of the trauma of relinquishment.  Adoption usually only happens once, whereas there may be many relinquishments for the separated child.

Adoptees are massively over-represented in therapy.  Adoptees are situated within a duality.  They have divided attention with two sets of families.  They are conflicted over wanting to belong yet fearing belonging.

Adoption is the enormous grief of a child who has been waiting nine months to meet someone they are not going to meet; the enormous grief of a mother who cannot live without her child, and the enormous grief of the adoptive mother who is not able to have a child.

The normal biology of pregnancy has the baby set up for bonding with its mother, and the mother who relinquishes her baby goes against her biology.  The child experiences life-threatening abandonment.  The ‘chosen child’ is the story of a child entering a family that does not genetically fit them, with an impossible job description to be someone they can never be – to fix a wound of infertility.  Infertility is a failure of expectations and contract within a marriage that sex will result in family.  There is enormous grief for everyone, but for the child this stuff is pre-verbal and can’t be recalled but it is remembered.

The human brain starts working before it is fully built.  Experience is the architect of the brain.  Experience is the cue for connections and hook-ups of the billions of neurons formed before birth.  In other words, neurons that fire together, wire together.  If life begins with a trauma of separation and abandonment, that feels life-threatening, that is how the neurons will fire and wire.  The human brain is a reflective organ, reflecting on past experiences, so it would be normal for abandonment issues to always be there in relationships.

For the adoptee there is real fear in relationships.  There is a great desire or hunger to attach, causing you to sometimes behave against your best interests, but with the conflicting feelings that this is not safe.  The feelings are held in the limbic system which will always override the frontal cortex, but it is the thinking brain – the frontal cortex which takes people into therapy.

So for these adults who have a very early trauma, which cannot be recalled, there is no pre-trauma personality as a reference point.  They believe the post trauma personality is part of them.  So it is referred to as Developmental trauma, rather than PTSD.

Bowlby was the first person to describe attachment theory and the internal system of a child that means the child is born ready to meet its mother.  We now know human infants can detect smells within 24 hours of birth, and they show a preference for their own mother’s milk.  Mothers who read aloud to their child before birth had babies who showed preferences for their mother’s voice and the story she read.  The preferences are shown by head turning and changes in physiology such as respiration.

Mary Maine asked the question about how an adult will be as a parent after difficult life experiences.  People say they try to do the opposite of their parents.  But doing the opposite is not necessarily a healthy option either.  Maine showed that the emotional stability of the human child is 75% dependent on the parent being able to know herself – to tell an emotionally coherent story about herself.  Then the child has a good chance of being emotionally stable.  How does this work for an adult who believes their post trauma personality is part of them?

Sunderland sees many adoptees in his addiction clinics.  He says people come into therapy in a small window between one relationship and another.  They have other addictions as well, but he calls them love addicts, and says he gets incidental disclosures of adoption.  He describes love addiction as the need to regulate mood by having the positive regard of a significant other; its about anxiety and shame, and using the positive regard to regulate these.  Addiction is genetically proposed and environmentally disposed.

The adopted people he sees often appear very well put together.  They rarely talk about being adopted – it’s just by the way.  When he does a bank of psychometric tests, he finds these people score very extremely high on the measure of depression, but you can’t actually see it.  Sunderland began to question what this was about and found there is an awful lot these people have in common.

It used to be said that; ‘You can’t remember, you were only a baby’, but that is such a nonsense.  It is remembered, it just can’t be recalled.  Looking at traumatology research it is no surprise that adoptees are over represented in addictions. The break in the mother infant bonding has an enormous impact on brain chemicals and neurotransmitters.  Cortisol and adrenaline are raised in trauma, and there are reduced levels of serotonin.  These things happen from very early on, and may be repeated with multiple relinquishments, which result in new and unrecognised environments.  ‘Where am I’ is the constant question.

Concentration and focus are affected by cortisol and adrenaline levels.  Increased concentrations result in the person living on red alert.  It is not surprising that Nancy Verrier found 90% of adoptees are diagnosed with ADHD.  ‘What do I have to do to get on around here?’  There is a slow loss of self.  The child fears they cannot be themselves because the first time they did it was pretty disastrous.  ‘I’m going to have to be hypervigilant.’  Being on red alert affects sleep regulation, gastrointestinal disorders and mood difficulties.

Serotonin levels are decreased in the early trauma, and serotonin is the chemical of soothing.  These children can be so hard to soothe, and are often reported as crying, or screaming a lot as babies.  Addiction is about self-soothing.  Attempts are made at self-soothing with, for example sugar, or early masturbation, sex and love addiction, and drugs.  A low level of serotonin means the person will not feel OK.  Serotonin helps you manage shame.  They will feel ‘I’m not OK’.  We know that failed mother child bonding creates this.  People become addicted to adrenaline, and return to dangerous situations repeatedly to keep the adrenaline high.  They try to create stress to manage mood, and develop rashes, nervous disorders, gastro problems and sleep disturbances.

Because the trauma can’t be recalled, many other life events can’t be recalled either.  These clients will often record counselling sessions, because they can’t recall the sessions once they’ve gone.  This is due to the link with the preverbal condition – there is some link to not being able to recall the session.

There are clients who ‘give up on themselves’.  They start out with good intentions on any new project, and manage well at the start, but then just give up.  When you listen to their words, you hear what they are saying about themselves.  In early life, they were given up on.  It is no wonder they then give up on themselves repeatedly.

There is so much evidence for a trauma of relinquishment.  They exhibit enormous amounts of hyper vigilance, anxiety and catastrophic thinking – because the wound was a life-threatening one.  They develop shame and anxiety, afraid to show who they really are.  And they develop self-reliance – ‘if you want to get something done, do it yourself’.

Shame and Anxiety are the underpinnings of addictions.  Anxiety is played out in the script – the world is not a safe place; they’ll kick you when you’re down; better not be vulnerable; don’t show who you are.  Shame is the ‘bad baby’ script – there’s something wrong with me; I’d better not tell anybody; how do I need to be to be accepted because being me in not acceptable, I’m unlovable’.  People who were adopted have this in bucketloads.

Addictions are places to put the shame and anxiety and make it acceptable.  And when addicts try to reform, and get near their goal, they often self-sabotage, because the reform does not have anywhere to put the shame and anxiety.  There is a need to create a new catastrophy as a creative attempt to contain the anxiety.

This is why 12 step programs are successful – because they are mood altering, and shame and anxiety management programs.  And all addictions are about shame and anxiety and how to manage insecurity.  Compulsive behaviour is another way to manage.  ‘As long as I keep busy I can focus all my attention on what I have to do.’   Compulsive debtors think it will be OK when the debt is paid off, but when they get near their goal they get really anxious again – because the money was just a stage for anxiety.

Shame for adoptees – If my mother gave me up, I don’t have value – I’m a bad baby.  It’s an attempt by the infant to explain the unacceptable by saying it is their fault; to organise it by taking responsibility – to make it manageable.  Freud talks about “his majesty the baby’ – the frontal cortex is not fully there even at age 20.  The child up until the age of 10-12 sees itself as responsible for everything bad that happens – self-centredness of a human child. Bad baby hypothesis plus, taking all the responsibility for everything bad that happens.  So for a child with no pre-trauma personality – this will be the way they resolve their insecurity.

Bowlby – divided up secure and insecure attachments.  We now know, it’s not what happens to you in life that throws you, but how secure your beginnings are.  Looking at the storm analogy – the trees that blow down in a storm are the ones whose roots are not strong enough to hold them up; it is not because the wind is strong – it is the poor attachment to the ground.  For children with a secure base, they have more resilience when the wind comes along.  These early experiences make an enormous difference.

One of the functions of trauma is that the part of the brain that regulates time is missing.  The child’s brain has to adapt like a tree that has to grow around a rock.

What we are talking about is not adoption, but adaption, due to relinquishment.  Not talking about adoption may be because of the insecurity of the adoptive family who may have infertility problems.

The original trauma, remembered but not recalled, results in a compulsion to repeat itself later in life, which is played out with anxiety and fear and catastrophic thinking, such as with sex and love addiction.  There is an enormous hunger for attachment which often has people acting against their own best interests; a desperate need to bond and the need is so great that partners can’t possibly provide because of the enormous need for attachment.

Catastrophic thinking has the person saying ‘what does it matter, I’m on the streets now; everyone knows it’s my fault’.

The person believes the person they have become is who they are, and that is not the case.  But they have no reference point of a pre-trauma personality.

Addiction and adoption/adaption will often go together.  Sunderland sees them as having co-occurring disorders of addiction and PTSD, due to developmental trauma from relinquishment.  The developmental PTSD is stored in the limbic system, where the fight, flight or freeze response is initiated.  And the limbic system deals with trauma and kicks in straight away before there is a chance to experience the feeling of rejection.  These people often feel schizophrenic – living with a duality, and have an ambivalence in decision making because making decisions feels life-threatening.  Never give advice to a person with developmental trauma.

In couples work – If you have an attachment wound you have not managed to become a separate person – you spend your time trying to work out what you have to do to be accepted here.  The challenge in a relationship is to be ‘myself’ and everything in the limbic system says ‘DON’T!’  Relationships can’t work when one person is trying to please the other, rather than be themselves.