Working with a traumatized adoptive mother

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Pseudonyms have been used to protect the families identity. Jane and her husband, Matt, adopted three boys following the diagnosis of significant medical problems. The
children were in foster care for two years before their placement. Sam (five) and Simon (seven) were biological siblings, and Larry (nine) was their half sibling. The children’s early years were shaped by their birth parent’s substance misuse and severe neglect.

Our service had been working with Simon for three years (he was initially referred through the local CAMHS team), before the ASF (Adoption Support Fund) was established. This enabled both Jane and the other children to access help. Parenting support was offered, but in conversation with Jane it was clear that she would benefit from therapeutic
intervention herself. She had recently received professional input that had left her feeling judged, criticized, had made her question her ability to parent, and resulted in very low mood.

Jane felt exhausted, worn down and utterly incapable of providing adequate care for her children. Matt, although supportive, travelled for work and was often away during the week. Jane had a supportive family, (although they lived far away), and a circle of friends who also had adoptive children.

Through conversations with Jane, discussions with the children’s therapists and the family’s social worker, I hypothesized that she may have been traumatized by parenting her children. In addition, Sam and Simon were presenting as dissociative. The therapists in our service use a long-term nondirective and child-led approach. The Adoption
Support Fund (ASF) for parents at the time (which is no longer available), was restricted. In light of what I had hypothesized, I decided to implement EMDR as the most effective treatment given the time restrictions. During an initial meeting to obtain information about Jane’s history and her needs, I made no assumptions about her motivation to attend. Commencing sessions, it became evident that Jane had experienced a happy childhood with ‘good enough’ parenting. Her relationship with her husband was supportive and stable, but the distance created by his work sometimes put a strain on their relationship and she occasionally felt that she was parenting as a sister parent.

The difficulties that brought Jane to therapy included:
• Low mood
• Doubts about her capacity to parent effectively
• Feeling scapegoated by the children
• A sense of indifference towards Larry

Prior to commencing work with Jane I pursued an internet search on secondary trauma. Minimal information was available in relation to vicarious trauma in therapists and I was unable to find anything on secondary trauma in adoptive parents. I did however, find that secondary trauma was also referred to as compassion fatigue. Many adoptive
parents we work with identify with this. They report feeling fatigued, depressed and ‘at the end of their tether’. This response to parenting traumatized children is completely understandable, but it still did not fit entirely with Jane’s experience of parenting her children. She spoke of freezing, feeling bullied and being unable to respond. I wondered about unconscious projection and the problem of the trauma bond between siblings. This unfortunately causes the sibling group to unify in their traumatic
experiences. They then unconsciously use similar physical and psychological ways of abusing the adoptive parents, that they experienced while living with their birth family. Sadly, this way of managing is also used by social workers and professionals who are not experienced in working with adoptive parents and place an enormous amount of pressure
on parents, blaming them for the bulk of the problems.

A pattern began to emerge during each session. Jane brought an issue or incident related to one of the children (rarely Sam), and was able to process this through EMDR, but not to full resolution. Resultantly, the session was brought to an end with an acknowledgement of a need to complete processing. The following week, Jane would have come to near completion of the problem independently, which we were then able to bring to resolution during the session. Jane would then introduce a new problem.

The boys continued to attend sessions with individual therapists and it was clear the relationships between them were developing, even when Simon’s sessions ended. The relationship between Simon and Jane was blossoming. She was able to talk about him with joy, aware that she had previously thought it was impossible to have a ‘normal’ relationship with her children.

Unfortunately, when Larry (aged eighteen) finished therapy (his therapist was going on maternity leave and he did not want another therapist), Jane felt she was back to square one. This was particularly difficult when all three boys were together and she witnessed them revert back to survival mode when ‘ganging up on another outside of their pack’. We continued to use parenting support and EMDR to work through what was happening. Jane was able to use techniques she had learned in order to move away from the ‘pack’, but at times was rendered helpless and was incapable of effective parenting. Helping Jane understand dissociation took some time and psycho education enabled her
to become familiar with the different parts of Sam and Larry. Jane was able to identify and respond more appropriately to each part which enabled her to be a more effective parent.

During one session there was a ‘light bulb’ moment. Jane reported trying to help Larry with his homework when she was gripped by a sense of utter panic. She was speechless as Larry angrily discussed his homework. Jane had a sudden realization that these were not her feelings but Larry’s. She was able to acknowledge this which enabled Larry to shift position and allowed his mother to help with the homework. We discussed this the next time Jane came to session. The situation allowed for us to consider that compassion fatigue alone was not just affecting Jane’s parenting capacity, but also being in receipt of her son’s unconscious projections.

With ongoing support, psycho-education and EMDR, Jane was able to process and work through fatigue and projections. She integrated techniques we had discussed in session, incorporated her learning and built upon it. Jane amazed me with new insights and strategies to better manage her children’s behavior. One day she reflected on how upset she was about Simon stealing. He only did this within the family and Jane experienced it as immensely intrusive. This affected her ability to respond effectively, instead she became angry, frustrated and responded punitively. Through discussion with my own supervisor, I was able to broach the idea of Simon scavenging as a young child and then
regressing to this position as a teenager. This would happen when he anticipated that his needs may not be met. We processed this through the use of EMDR and Jane was able to view it differently. She could see that the circle of punitive response facilitated Simon’s view of himself as ‘bad and unworthy’ and having to ‘take’ rather than allow himself to receive. Jane herself came to the conclusion that it was the relationship between Simon and the person he stole from that needed repair, not the replacement of the
material goods he stole.

Jane continues to come for parenting support. She acknowledges that work remains to be done with her children as a group, to address their sibling trauma bond. She has been able to feed back to us how much she and her children have benefited from therapy. Jane and her children are much more stable than when I first met them. As she feels
she conquers each challenge, a new one appears. Her children are growing up and developing relationships, which in itself can be fraught with difficulty. Jane’s ability to adapt and cope continues to amaze me, however, Matt also notices how Jane has changed and adapted and recognizes that he is not up to pace with her. He is addressing this.
This case highlighted gaps in how we provide a service to adoptive families.

The introduction of the ASF began with good intention and full of promise. However, governments continue to dictate how the money is used, so our capacity to do the job well diminishes. This was a very successful case for us, but we have many that have not fared so well. Parents have not had the input they need at the start of the work to
help them with their own feelings as individuals, and as parents. This makes the task of parenting traumatized children and young people traumatic. The vicious circle continues.