Attachment theory, started by John Bowlby and Mary Ainesworth, studied the attachments of mother and child which had a profound effect on the study of how humans attach to one another.   The term bond, often can be interchanged with attachment, refers to the emotional connection of the mother to her infant [3]. Bowlby focused on the mother child relationship and stressed the importance of having a warm, loving, stable relationship with the primary caregiver during infancy. The relationship between the primary caregiver and the infant is the most important tenet in attachment theory.  Another important tenet discussed by Bowlby furthered this idea by discovering “if there is no possibility for such an affectionate relationship in infancy and childhood, persons may be crippled for life, may never ever be able to develop emotional relationships, and may develop all sorts of behavioral and mental problems” [2].  Bowlby believed that children enter the world preprogramed to form attachments with others.  Attaching to care givers is a survival skill. Infants have a way to communicate, which is either crying or smiling in early infancy.  More often than not the infant is seeking comfort and connectedness with their caregiver.

Attunement is an important aspect of the developing infant and mother.  Attunement means being responsive to one another.  Attunement and attachment are related in that, caregivers who are available and attuned to their child, or responsive to their child’s needs beginning in infancy, establish a sense of security within that child. Attunement is an important aspect of the infant and mother relationship.  Attunement means being responsive to one another…but how else can we look at it….  How does my child feel?  Is my child happy or sad?  Is she hungry or wet? By having their needs recognized and met the child learns that their caregiver is dependable, which establishes a sense of security in that child. “As children gradually gain knowledge about the world and learn skills to cope with it, they can increasingly rely on themselves and thus create a gradually increasing basis for independent security” [1]

References:

[1] Ainsworth, M., & Bowlby, J. (1989). An Ethological Approach To Personality Development. American Psychologist, 333-341.

[2] Van der Horst, F., & Van der Veer, R. (2010). The Ontogeny Of An Idea: John Bowlby And Contemporaries On Mother–child Separation. History of Psychology, 1, 25-45.

[3] Else-Quest, N. M., Hyde, J. S., & Clark, R. (2003). Breastfeeding, Bonding, and the Mother-Infant Relationship. Merrill-Palmer Quarterly, 49(4), 495-517. doi:10.1353/mpq.2003.0020

Object relations therapy is rooted in psychodynamic therapy.  Object relations therapy infers that personality and interpersonal relationships displayed as functioning adults are in fact caused and influenced by our earliest relationships.  “According to this theory, the infant is driven to attach to an object, defined not as another person but as the internal mental structure that the infant forms of that person through introspection” [1]. Two important concepts in Object Relations Theory are empathy and narcissism.  Empathy is important to the child because it allows them to verify and then imitate this important behavior learned from their parents or caregivers.  “Children need empathy from their parents to promote the development of children’s psychological strengths” [1].  This is a strong statement when dealing with adoptive families.  Many adopted children are unfortunately institutionalized or abused or neglected before finding their forever families.

Narcissism often comes with a negative connotation, but in object relations theory there are in fact two types of narcissism in this theory, healthy narcissism and unhealthy narcissism.  Healthy narcissism is necessary to help children develop a sense of self-esteem and self-confidence.  Unhealthy or pathological narcissism occurs when “the healthy development of the cohesive self is blocked” [1]. Unhealthy or pathological narcissism can be displayed as a sense of entitlement, promiscuous behaviors, and inflated self concept.

When dealing with adoptees it is important to find out if the adoption occurred at birth, as an infant or toddler or as an older child.  Heinz Kohut describes the following three self object needs as occurring at 18 months.

1. The need for confirmation, validation and mirroring responses from others
2. The need to internalize an idealized self object, which provides nurturing and helps the child learn to self soothe.
3. The need for a twin or alter ego, which seeks mutuality and equality in relationships with others, as well as sharing of values and preferences [1].

Being attentive to the timing of the adoption will determine which caregivers offered the child the initial support to develop their psychological strengths.  It is also possible that if the child was neglected, abused or not well cared for in an institutionalized setting that these needs were not met at all.  Clinicians need to be aware of this aspect in the adoptees past, which can be determined in the initial interview.  When object relations therapy is applied correctly clients should be able to view the clinician as a source of strength when working on these core developmental issues.  The clinician should be skilled and apply a combination of empathy and transference to help adoptees meet their unmet developmental needs.  “Empathy allows clinicians to contain and rebuild the early self object reflected in the transference relationship”[1].

Object Relations therapy can be useful in treating adoptive parents as well.  Consider this statement from an adoptive mother:

When I was a little girl, I used to give birth to my doll Kate several times a day as I let her fall out from under my T-shirt. Careful to support the baby’s head, I’d pick her up and stick a little plastic bottle filled with pretend milk to her lips. That was 35 years ago, and as close as I ever came to giving birth. Let’s face it. Few women grow up wanting to be an adoptive mother. Little girls don’t act out scenes in orphanages or airports. They, like the women they become, assume that they will one day marry a handsome man and make beautiful babies. Adoption is not in the repertoire of child’s play. And it’s an experience for which we, as adults, are woefully unprepared. As my husband and I went through the process of an open, trans-racial adoption, I sensed that I was on uncharted ground emotionally, with no road maps or role models. I was having feelings that weren’t the kind I had read about anywhere [2].

This adoptive mother is experiencing several of the core adoption issues including grief of a fantasy child/child rearing experience and is questioning her identity as a mother in a transracial situation.  The adoptive mother is extremely insightful into issues that are arising within her because of her sensitive situation.  The mother in this situation has internalized her fantasy child as her object.  Interpretation is important in object relations therapy and it appears that the mother is resisting letting go of the fantasy child and child rearing experience.  She feels alone.  An object relations therapist should use project identification to help the adoptive mother relearn her expectations of how parenthood is obtained by recreating the internal object (fantasy child) throughout the therapy process.  A similar client-clinician relationship will occur when the mother is ready to accept her role as a mother in a transracial family.  Her current view of what being a mother in the traditional sense of the word will need to be reworked and the therapist will help her modify the role to fit her current or soon to be family structure.

Utilizing techniques and theories such as Gestalt therapy and Object Relations Theory are great stepping stones to offering beneficial post adoption support to the adoptee, the adoptive parents, and to the birthparents.  It seems that there is much more than technique that needs to go on for this concept to be fully appreciated.  Psychoeducation for counselors, educators and birth and adoptive parents is key for post adoption support to be beneficial and fully understood by everyone involved and effected by this non-traditional family.  Utilizing adoption support groups can be a great way to help adopted children and adoptive parents alike realize that they are not alone in how they are feeling.  Finally birthmother and birthparent(s) rights need to be advocated for.  Many agencies imply that counseling and support is offered to birthparent(s), but strict standards should be enforced so that birthparent(s) receive the emotional support that they desperately need and are often afraid to seek during this difficult time.

References:

[1] Seligman, L., & Reichenberg, L. (2010). Theories of counseling and psychotherapy. Upper Saddle Ridge, NJ: Pearson.

[2] Wolff, J. (2000). Secret thoughts of an adoptive mother. Adoptive Families, Retrieved from http://www.adoptivefamilies.com/articles.php?aid=184