How exactly should applicants for adoptive parenthood be rejected? Should they be informed by letter or in person? Should they be told candidly about any disqualifying factors revealed during the home study or should they be let off the hook more gently, by referring to agency policies, baby shortages, or other equally impersonal factors? There were a wide variety of answers to this question in adoption practice, but it is fair to say that agency workers often withheld details from couples when they thought these might be needlessly destructive and hurtful. In the case described here, that is what happened. In consultation with agency staff, psychiatrist Viola Bernard suggested that greater honesty might have been a viable course in this case, but only if it ultimately served a therapeutic purpose. The excerpt is drawn from two separate documents: the case summary and notes summarizing the staff seminar about the case.

This case is being presented as a springboard for discussion around the handling of rejection. . . . The question has been raised as to the validity of direct handling with the client around reality factors in rejection rather than the continued statement of the Agency’s limitations.

Identifying Information:

Mrs. S is 30 years of age, her husband 34, and they have been married for 9½ years. They requested the adoption of a child under a year of age. . . .

Fertility Status:

The problem here is one of spontaneous abortion. There have been five altogether. The first occurred in 1940 and the second in 1945, all ending around the third month. In 1948 there was a six month pregnancy and delivery of a premature girl who lived for one hour and one-half. In 1949 there was another five month pregnancy again with the delivery of a premature girl who did not remain alive. . . . They wrote to us initially two months after the last miscarriage. They are presently using contraceptives and feel certain that they do not want to go ahead with any more pregnancies. . . .

Sexual Relationship:

Both Mr. and Mrs. S. presented material in this area with great pleasure and seemed always to want to center their discussions here. It was difficult to separate their feelings around infertility because of their stress of sexual denial made necessary by the miscarriages. Both felt that their inability to have a child was something which they should not be unhappy about but that their inability to have intercourse during this time did present serious problems. Mrs. S indicated to me that during the period when the doctor asked them to abstain her husband found this so difficult that he had to sleep in another bedroom. They had discussed this and decided that he would attempt masturbation during this time but he was unable to because he was “psychologically blocked”. She told me with tears in her eyes that her one regret during all this time that they were trying to have a child, was that she did not have the courage to tell her husband that she would not object if he had intercourse with another woman. She stated that she is the sexual aggressor by her husband’s wish.

Rejection:

In supervisory conference it was decided to reject by letter. Immediately following this Mrs. S called and asked to see me. I saw her three days after the letter of rejection was sent. She was visibly upset and indicated to me that since we were a casework agency, understanding the dynamics of human relationship, that she felt that her rejection here centered around problems within her husband and herself. She at no time indicated hostility but pressed for reasons. . . .

* * *

This meeting was concerned with the handling of rejection. In general it was felt that a worker can handle a reject directly only if she has conviction about the validity of the basis for the reject and about the need for direct handling. Sometimes the worker can be more sure in her conclusions than about the way in which she arrived at them and that makes it difficult to handle with the client. Some of our uneasiness comes out of our self questioning, which is good in the face of a problem of such complexity.

When rejection is handled directly we run into the possibility of a personal showdown and there is a natural hesitation to come face to face with the hostility of the client who has been rejected. We are seeking to achieve a balance between the personal feelings we have toward our clients and our objectivity which has to rest on our professional thinking. This balance is extremely important in handling rejection as well as in other aspects of the job. . . .

In discussing the S. case, Mrs. Goldart said that she had no doubt about the validity of the rejection altho she was not certain about the meaning of the material she got. Her thinking in rejection was based on (1) the feeling in this couple that their reproductive life was less important than their sexual life to the degree where there was an imbalance, (2) that their relationship was so close that the coming of a child might disturb it, and (3) their discussion about children was so vague and unreal as to indicate unreadiness on their part. Mrs. Goldart said that her conviction about rejection came out of the material which they presented, rather than about them as people, since she saw them as warmer and nicer than the material would indicate.

In interpreting the material Dr. Bernard felt that in view of the fact that habitual abortion represents habitual failure for a woman, it could well be that this couple’s way of handling this problem was to establish a closer sex connection. The material which Mrs. S. gave us about the difficulty which abstinence created for them and her concern about not having urged her husband to seek satisfaction from other women rather than by masturbation, might be related to the fact that in our culture children are taught to believe that masturbation is wrong, and as adults we tend to look upon masturbation as the less desirable outlet.

As regards the maturity of the S’s marital relationship, they seem to be somewhat narcissistic people who find their own idealized image in each other. If this is so it is valid to assume that their relationship may be based on a complementary neurosis which works for them both but which could be disturbed by the coming of a child. This impression of rather narcissistic immature people is borne out by their description of themselves as “model children,” Mrs. S’s activities since their marriage—college, part-time irregular employment, etc. As for the emphasis which Mrs. S. put on their sex activity, it was Dr. Bernard’s opinion that this would not necessarily militate against adoption, but could be a reaction to a repressed feeling of failure of her feminine potency, which is compensated for by her sex potency in another area. . . .

Dr. Bernard thought that rejection without clarifying our reason was an undefined threat, which left them only with the feeling that they needed in a vague way to get psychiatric help to find out the reason. A clear statement from us that we saw this togetherness as a liability in relation to a child rather than an asset, giving full recognition to how good that relationship is, could leave them with the freedom to disagree, and to then project their feeling on to us, rather than to turn it in on themselves. Dr. Bernard thought this would leave them as undamaged as possible under the circumstances.