Adoption and Psychotherapy

by Mike Candon


This article outlines some of the issues that a psychotherapist may encounter in working with an adopted person. It includes the stages during which it is most common for an adoptee to present him or herself for therapy, the problems they may present, and most importantly, the special needs that an adopted person may have. I will start with a personal summary of what it is like to be adopted. It is important to be mindful of the fact that there are other parties involved in what is termed the adoption triad. These include the birth mother and adoptive parents who may themselves present with issues that overlap those of the adoptee.

What is it like to be adopted?

My experience of being adopted was like trying to wade through four feet of water at all times. The drag that one experiences was how it was to live my life. As a child it was scary to know that I was different, to know I was mum and dads’ child but yet I wasn’t. It was bewildering to see my friends look like their parents, brothers and sisters. I didn’t look like anyone else in the family. My questions of who am I? and where do I fit in? were confusing. I didn’t understand why I had been given away and not wanted. I was told, ‘they did it for you to give you a good chance in life. They loved you.’ It was distressing and unhealthy to live in fear and with constant anxiety that I could be abandoned again. I developed a need to be liked at all times and to please everyone.

It took all my energy to try to answer these questions in my head, to understand and to fantasize about my real parents and what life with them might be like. I played the role of a perfect, happy child for two people who were kind enough to adopt me. Thus I hoped that they would not abandon me and return me as damaged goods. Living this life filled with such loss, anger, sadness, grief, lack of identity and self was like a life with no joy. These deep feelings and emotions tainted everything in my life. I knew that something was wrong. I was surrounded by people who knew I was in pain. But they did not believe that adoption could have had such a devastating effect on me.

When will the adoptee attend a therapist?

The most common time that an adopted person will attend a therapist is when they are experiencing relationship difficulties. A significant number of adoptees attend therapy without paying much regard to the fact that they are adopted. It may be mentioned casually without the therapist or adoptee believing that the adoption so many years ago is still affecting life or relationships. It is my experience that there are counsellors and therapists who disregard adoption as a cause of trauma and distress. Most times they believe it is the client’s relationship with the adoptive parents that is the issue. Occasionally an adopted person will be brought to a therapist by an astute parent who senses that all is not right with the adopted child. Often an adopted person will attend therapy at the commencement of or during their search for their birth parents. This is not just a physical search for their parents but a search on all levels for them selves. Issues of secrecy, risk of rejection and abandonment and preparation for the eventual outcome are extremely difficult for the adoptee. Crucial to this search is support that may not be available at home. Advice on the practicalities of search and reunion will be needed. The birth of an adoptee’s own child can reawaken adoption issues by seeing for the first time another person that looks alike and is genetically connected. This can be problematic and may create a new strange sense of connection never before experienced by the adopted person.

Primary or Core Issues

The primary or core issues in the life of an adoptee are abandonment, loss, and bonding or attachment. When a mother or father and their families abandon a newborn, he has lost his name, his birth right to a family, the family name and the family’s genetic, medical and genealogical history. In most instances the adoptee has no information on any of the above. Following from this is the loss of identity and self and the ever-present question, ‘who am I?’ Just as there was no opportunity to bond with the birth mother, all further attempts at bonding through life are influenced by this primal experience. Therefore it is seen that these core issues relate to each subsequent issue and affect the clients’ behaviour.

Subsequent Issues

Arising from these core issues are subsequent issues that may be presented when an adopted person comes for therapy. These are: fear of rejection, issues of trust, intimacy, and loyalty, feelings of guilt and shame, struggles of power and control, and critically, identity issues.

Fear of rejection

The adopted person views his abandonment after birth as a rejection. He feels this to the core. Life becomes preoccupied with the idea, ‘I was rejected once and I will never let it happen to me again’. Adoptees search for what they did wrong and will, at the slightest hint of a change in a relationship, attempt to reject the other before being rejected. They constantly make attempts to please people so as not to be rejected.

Trust, Intimacy and Loyalty

Trust is a birth right. How can a baby who could not trust his own mother to love and care for him ever trust again? The birth mother is the universe to the new-born. To have lost that trust, not just in the mother but also in the universe, is a shock and a life changing disappointment. As all relationships are built on trust, trusting the adoptive parents, friends, bosses and lovers takes a lot of hard work and energy for the adoptee. Distrust of women is most common.

Similarly to the core issue of trust, intimacy involves closeness and letting someone in. For most people their first experience of intimacy is with the birth mother and the adoptee has no experience of this valuable life lesson. A thorny question of loyalty arises. To whom does the adoptee remain loyal? The parents that gave birth to me or the parents who are raising me? Who are the real parents?

Guilt and shame, power and control.

Originally, I believed that the guilt and shame that I felt was mine. I was shameful of being adopted, and guilty of being a bad person who was rejected and had to be adopted. I believe now that this guilt and shame is sometimes the guilt and shame that the mother experienced in her life while pregnant with the unwanted child.

The adoptee lost the power and control of self-autonomy at the time of adoption and struggles through life trying to regain both. This may be evident in all inter-relationships. However I have found that it becomes particularly difficult in the work place.

Identity Issues

Many adoptees experience a lack of identity. ‘I do not know myself so how could you know me? If you did know me, you would not like me.’ Adopted people create many selves due to lack of personal identity and loss of self. They fear that if others were to see the real person they would be rejected.

Life problems and behavior related to adoption

Psychotherapists working with all clients must look at present day behaviors as a key to unlock the unmet need or drive behind that behavior. The infant or baby logic that coped with all that happened will have influenced the grown-up behaviour, habits and life patterns. The following are a few patterns of behaviour pertaining to the adopted person.

  • Acting out  Fears and anxiety press the adoptee to create painful scenarios repeatedly.
  • Antisocial behavior.
  • Outbursts of anger.
  • Old head on young shoulders.
  • Wreaking havoc at celebrations, Christmas and birthdays particularly.
  • Reluctance to apply for or get a job for fear of rejection.
  • Sabotage of friendships and relationships.
  • Extreme stress and anxiety.
  • Shocked facial expression.
  • Inability to bond.

Working with adopted people

Many psychotherapists may ask how the issues, problems and behaviour of an adopted person differ to many of their clients who were not adopted. I would like to suggest a few. The rejection and abandonment of a baby within hours of his birth inflicts primal trauma. The absence of ego development to assist the baby to cope with the shock, pain and confusion contributes to this trauma. For the client this means that the foundations of the ego and personality development are very weak and often difficult to build on. As a therapist it is important to discover where there is a strong block on which to build. I had to discover a bond and love that had existed between my mother and myself in the hours after my birth. This took me about six months of psychotherapy.

Related to this is how the therapist works? I believe it is crucial to build up the ego and peel away the layers. I suggest that the therapist needs to take a very gentle approach to the client. Adoption is a solution to the problems of the birth parents and a time for celebration for the adoptive parents. The adopted person may never be given the permission needed to grieve the losses and most times the trauma is not even acknowledged. He has been affected by the adoption and may feel responsible for allowing it to happen. It may be necessary to explore the dynamics of secrecy and discretion, of whether the adoptee has publicly acknowledged his adoption, and of growing up in a family with the birth child of the adoptive parents. A further complex issue may be that of inter-racial adoption. Adoptive parents often do not want to discuss adoption with their child because of what it brings up for them. This makes the adopted person feel very isolated and alone on his journey. It is important again to stress that adopted people may not want to believe that adoption is causing problems in their life because of the unbearable pain it causes. And many therapists may believe this also.

Time for change

For many years I told myself I was unwanted and unlovable. I then realised that this was not accurate. I was not wanted or loved for two years of my life as I was not adopted immediately. But I am loved and wanted now, and this means I do not feel unlovable or unwanted anymore. For the client some of the real healing comes about by the re-framing of thoughts and patterns and the re-wording of the story they are telling themselves. I believe that the therapist must view the adoptee as a survivor, not a victim and communicate this to their client.

Adoption in the past has been seen as a solution to unwanted pregnancies and as a supply of babies to those who cannot conceive. It was shrouded in secrecy. No information was passed on to the adoptee. He had no legal right to it. Most importantly, adoption was seen as the end of a problem with no regard to the adopted person, their special needs and acknowledgement of their abandonment, loss and suffering. Things are changing slowly. Understanding of and compassion for the great loss and needs of the adopted person is required of all those involved, particularly the therapist. Adopted people have been held in institutions. Those are the same institutions that we read about daily. Therapists must be aware that an adopted person may have suffered physical, sexual and/or emotional abuse at the hands of their carers. In my experience most were cared for very well. But due to the circumstances and a child’s logic or perception at the time, a different vision could be created.


Barnardos Adoption Advice Service assists adoptees in their search and reunion. As a lobbying group they put pressure on the Irish government for legislative change to provide information and promote a more open, healthier approach to adoption. Contact; Christine Hennessy or Patricia White, Barnardos, Christchurch, Dublin 2, 01-4530355.

Adoption Board. This is the second stop after Barnardo’s. They hold all adoption information and decide who gets it and who does not. 01-8871392

APAI – Adoptive Parents Association of Ireland. 01-8252043

Adoption and Fostered Persons Association of Ireland is a lobbying group for legislative change in Ireland. At present it is focusing on the adoptees’ right to information about the circumstances of their adoption.

Michael Candon is a psychotherapist and an advocate of best practice for the needs of children in adoption and fostering. Anyone interested in attending his workshops on adoption issues may contact him. Ashfield Cottage, Beauparc, Navan, Co. Meath. 086-8167376


Verrier, N. (1996) The Primal Wound, Understanding the Adopted Child London:Gateway Press.

Lifton, B.J. (1994)  Journey of the adopted self, A Quest For Wholeness.  New York: Basic Books.