During the years 1948 through 1953,
some 120 children were seen in private practice. Of this number,
16 were adopted. In checking how this number compared with the numbers
of adopted children in the general population, we find that approximately
0.134% of children under 21 years of age have petitions filed for
adoption. This number includes not only those placed by public agencies
or through independent adoptions but also petitions filed by relatives
in whose home the children have lived or by stepparents coming into
the home through the marriage of the child’s natural parent.
In my series of cases the percentage of adoptive children seen equals
13.3, as compared with the national average of 0.134 (statistics
compiled for 29 states). This indicates a hundredfold increase of
patients in this category as seen in my practice, compared with
what could be expected in the general population. . . .
It was not only the tremendously greater number that was of interest
but the symptom pictures of the adopted children, their object relations,
parental observations, and the question whether children who are
adopted should be told of their adoption as early as has generally
been recommended. These points will be discussed in what follows,
as is highlighted in the clinical material presented by these cases. . . .
Case 8, a girl of 10 years, was presented for persistent enuresis.
She spent most of her time in treatment telling of her fantasies
regarding her real parents and her attempts to find her hidden birth
certificate that contained the information she sought.
Case 15, a 12-year-old boy, was referred because of lying, stealing,
and a lack of integration into the children’s institution
into which he had been placed. His activities suggested his desire
for affection and a desperate feeling that he would never get sufficient
amounts of it. He had constant fantasies of his real mother having
red hair and of having the last name of Smith (which was not his
adopted family name). . . .
In the foregoing case reports we could see how the idea of adoption
had woven itself into the framework of the child’s personality
configuration. It played a role in symptom formation and object
relationships. It certainly also had an effect in later development,
giving the stamp of an antisocial character in one of the cases
and in another that of a paranoid delusional system. . . .
It would appear that children who have been adopted have potentially
a more fertile soil for development of neurotic and psychotic states.
The knowledge of their adoptive status, so often coming in at the
time of the Oedipal conflict, can seem to prolong and actually prevent
the resolution of this particular area of personality development.
There is a lack of boundaries constituting a self; rather, what
can be seen is a diffuseness in poorly integrated identifications.
The anxiety these children manifest often refers to the possibility
of returning to their original parents or, having been given up
once for undetermined reasons, they may be given up again at some
future time—also for undetermined, fantasied reasons. These
concepts enhance the feeling of lack of closeness, and we again
raise the question as to the timing of the knowledge of adoption
prior to the resolving of the Oedipal phase.
The material presented suggests that the immature ego cannot cope
with the knowledge of the rejection by its original parents, representing
a severe narcissistic injury. The child tends to react to this information
by character change or symptom formation. It is, therefore, recommended
that the thorough investigation of the child and his environment
should be accomplished to determine the method and timing of giving
the information of his adopted status.