Adoption, Trauma and Attachment Disorder in Teens

It surprises many of the parents we work with to learn that 30 to 35% of our students are adopted as compared to the general population, which is comprised of only about 2% of adoptees. This greatly inflated rate of adopted kids in treatment is pretty typical for residential treatment programs.

What’s largely behind this inflated population of adopted girls is difficulty with attachment, the ability to connect effectively with others and form sustainable relationships. We now know that a child’s attachment to her mother starts in the womb, so even a child adopted at birth can experience severe attachment disruption later on in life.

An infant’s world changes radically when her biochemical connection to mom is suddenly absent. The baby is programmed at the neurological, biochemical and limbic level, to attach to its biological mother. Separation can constitute an actual trauma and drive significant developmental changes. Some experts are even entertaining a diagnostic label of “developmental PTSD” for infants or children who experience attachment issues as a result of separation from the birth family.

We generally see a lot of emotional dysregulation as well as generalized relational difficulties with parents and peers. When I administer or analyze assessments, I often see what I call the “adoption cluster,” which includes symptoms of bipolar, ADHD and learning disabilities. When this cluster is evident in an adopted teen, a clinician has to wonder if, for instance, the girl’s emotional dysregulation is symptomatic of underlying abandonment issues or bipolar disorder.

Abandonment is often the core issue for the young women we’re discussing; it’s what typically drives all of the other issues. “Imagined abandonment” is part of what these teens are dealing with. Because of early attachment trauma (which they’re usually not even conscious of), the teen imagines that all the important people in her life will leave her. She’s braced against imagined future abandonment, which of course leads to high levels of relational ambivalence.

The first step in the healing process is to get the parents and child talking about the impact of adoption; acknowledging that there is loss involved. Adoption is a beautiful and redemptive event, but it’s one that does involve loss. For the child, the loss is not remembered but it’s also not forgotten; it can operate as an invisible force and, therefore, has to be brought to consciousness so that it can be dealt with.

Often there is loss on both sides; the parents inability to have children and the child’s loss of her biological family. For the teen, we work to help her realize that she is continuing to behave as if she is going to be abandoned at any moment. We try to help her understand the very real (but until then mysterious) source of her fears, and then to distinguish between real and imagined threats of abandonment.

With a loving, supportive approach that addresses the core issue of abandonment, treatment results can be profound.

Dr. Jack Hinman is the clinical director at Sunrise RTC whose clinical specialties include trauma, adoption and family systems. Dr. Hinman can be reached at [email protected]