It’s ok to take a break – we are!

15th to 21st May is Mental Health Awareness Week 2023. This year the theme is Anxiety.

  • Fight or Flight – feelings of anxiety are our body’s innate response to stress or perceived danger. Anxiety can feel like unease, worry, or apprehension. This ‘fight or flight’ mechanism helps us react quickly to potential threats.
  • Physically, anxiety can show up in our bodies as a faster, irregular or more noticeable heartbeat, feeling lightheaded and dizzy, sweating, breathlessness, headaches, chest pains and loss of appetite.
  • Psychologically, anxiety can manifest as feeling tense or nervous, being unable to relax, fear, worrying, sleep problems, feeling tearful, concentration, obsessive thoughts or intrusive traumatic memories.
  • Anxiety can cover a wide spectrum – we can all feel a little anxious sometimes, for many reasons, but anxiety can become problematic if it persists for long periods of time, is overwhelming, or stops us from functioning in our daily lives.

And for us adoptees? Are we more prone to anxiety? I would say possibly, yes. We confront issues that the general population do not – we are faced with issues of identity, loss of genetic mirroring, our ancestry, our heritage. Some of us are displaced and removed from our culture, our country of origin, some of us discover late that we are adopted. Some of us are in harmful situations prior to adoption. Some of us face additional adversity in our adoptive families. We struggle to gain access to our birth and medical records/history, search and reunion is often problematic and fraught with complex emotions, and we can also be dealing with feelings of loss, grief, hopelessness, rejection to name but a few – and many of these issues and feelings can lead us to feel misunderstood, anxious, depressed and helpless.

There should be absolutely no shame in feeling any of the above. We are adoptees. We are SURVIVORS, and to claim and own any – even just one – of these issues and feelings is brave and courageous. 

Help and support

If you have or are feeling any of the above issues and either you want to know more about anxiety, here is a link to the Mental Health Awareness Week website where you can find further information.

If you feel like you need further support, you can contact the Samaritans or seek out other specialist mental health bodies or charities. Your GP can also help you. (It is good to know that anxiety can sometimes be a catch-all diagnosis for other underlying issues that many adoptees can suffer from – symptoms can present in a similar fashion.)

What about us?

This brings me to share with you that here at AAM, we are trying to be more aware of our own mental health. As a group of 7, we have been working very closely and intensely for a solid year now, spending a great deal of time, effort and emotional energy in brainstorming, campaigning, educating and advocating. We hit the ground running last May with our hefty response document to the JCHR Forced Adoption inquiry and we literally have not stopped. I mean, not for a day.

And none of us noticed. We showed up every day, and frequently every night. Adrenaline and excitement for our cause fuelled us. Things have been going great. We have had lots of media interest, we have been making great connections, meeting adoptees like yourselves and all has been good. Extremely busy and intense, but good!

But only this past week, we took a pause for breath. And we realised that we are all exhausted – every one of us. Emotionally, physically, mentally. So we are taking a well earned break. We are putting our own mental health first. We will be spending come much needed time with our families – whatever that means for us. We are going to try to indulge in some self care, simple pleasures, walks in nature, sitting quietly in the garden with a cup of tea. And we encourage you all to do the same.

We will be back, we promise you that! But we need this break.

In the meantime, take good care of yourselves, rest well, recharge and reinvigorate and we will see you soon.

All the best

AAM

PS Existing events will go ahead, see some of you there!

Adoptees and Therapy

What cannot be talked about cannot be put to rest.
And if it is not, the wounds will fester from generation to generation.

–Bruno Bettleheim

Bettleheim could easily be talking about adoptees –

  • Why is therapy for adoptees so scarce?
  • Why are adoptees unacknowledged?
  • Why does no one understand us?
  • How many people pay a therapist and still act as the educator?
  • Why is it when adoption is mentioned in therapy there is often an awkward silence?

I have asked myself these questions many times, with good reason: I am an adoptee and a therapist. 

It is every adoptee’s right to access therapy

As an adoptee, I know all too well how terribly hurtful it is to be misunderstood in therapy. There is an appalling lack of therapy suited to our needs and a lack of therapists who truly and precisely are able to understand our personal plight, adoption.

What happens to us before we are born?

Personally, and professionally, I believe the crux of many adoptees’ problems are present before birth – there is evidence to suggest the foetus in utero absorbs their mothers’ feelings. When we consider how our mothers felt, knowing the baby they were carrying would not be theirs, this theory is plausible. Birth itself may have been problematic–my mother suffered a severe anxiety attack during labour because she hadn’t been told what would happen to her body–emotions didn’t come in to it either!  

How are we affected if we are removed from our mothers as babies?

The bliss of being with our mothers and then an abrupt separation stunned, shocked and traumatised our tiny undeveloped brains, leaving our nervous system overloaded with cortisol and adrenaline, and our neuronal wiring in utter chaos. 

Stuck in time, in ‘baby’ trauma, the adult adoptee does not have an outlet to discharge their feelings and the trauma, now stored in their body, known as body memories. The actions, behaviours, feelings and cognition are often distorted, out of place, out of time and out of sync with the reality of the present – not surprising really, is it?

What does the NHS offer and why is it not suitable for adoptees?

The NHS counselling and psychotherapy services are wholly inadequate for adoptees. CBT and antidepressants are the usual treatments offered. This is totally unacceptable and shows the sheer naiveite of those who purport to help us.

CBT (cognitive behavioural therapy) and antidepressants are not suitable to treat trauma – the latter, though helpful for some are designed to stifle emotion, something we adoptees are used to! The former, CBT, should be introduced later, to help to rectify faulty beliefs and encourage a more positive attitude, for example. It usually lasts six weeks – six weeks was the usual time an adoptee spent with their mothers, another painful reminder of adoption’s legacy!   

I believe within the adult adoptee is a baby adoptee and, until the baby adoptee`s traumatic experiences have been acknowledged by an appropriate therapist, ideally another adoptee who has worked on themselves therapeutically, the baby adoptee is stuck – I call this ‘baby-work’. With CBT, the emphasis on cognition is not only missing the point but is of no use to an adoptee because our trauma began before we developed cognition. Until professionals, including therapists, are educated about adoption, nothing will change.    

The adult adoptee, thwarted once more because no one understands them, even in therapy, is exiled, marginalised, discriminated against, misunderstood and sometimes disbelieved because the therapist doesn’t even know what they are talking about! How is this humane or justifiable?

What can I do as a therapist?

My experience as a therapist with adoptees is not vast. Nevertheless, I refuse to reject a client because they are adopted. Instead, I chose humanity over bureaucracy, the truth over lies and the spoken word over the silence of adoption. Instead of rejecting the adoptee because, apparently, I am not ‘trained’ in adoption counselling, I may have been reprimanded.  I was not, because I kept quiet – another example of adoption’s secrecy, even today, therapists remain silent to protect the very officialdom that continues to twist its knife into adoptees.

This skewed imbalance within the therapeutic world, in my view, needs urgent attention. If not, the probability of breakdowns, heart attacks, anxiety, depression, personality disorders, cancer, hypertension, addictions etc remain our fate.

Furthermore, the inclusion of adoption into ACEs, the DSM – 5 and the WHO would give us the recognition we deserve.

The Department for Education is holding a consultation on removing the requirement for those who offer therapy to adult adoptees in England to be registered with Osfted (the schools inspector). You can view and take part in the consultation up to 20 March 2023.

Post written by a guest author who wishes to remain anonymous                                 

The Harsh Reality of Living Without any Medical History

I am an adoptee born in 1974 and adopted 8 weeks later. I speak from lived experience of inheriting a genetic condition, Ehlers Danlos Syndrome (EDS) from my first mother but only discovering this in my 40s.

I’m 49. When I look back at my life up to now, I can pinpoint times that I struggled with my health. Times that, if I had arrived in my adoptive family with a full medical history, would have been easier to manage, quicker to diagnose and come with a lot less worry. 

The impact of unexplained physical symptoms

As a child, I had double-jointed thumbs which I would contort into odd shapes to amuse my school friends. On the netball court, my weak ankles, flat feet and hyper-mobile joints led my feet to ‘collapse’ at times, giving me shooting pains. I just thought this was normal but when I was 13, with continual knee pain and bunions at such a young age, my mother took me to a podiatrist for gait analysis. I was given custom orthotics to put into my shoes to correct my fallen arches and over-pronation. 

At age 14, my teeth were crooked and I had a centre shift—my two front teeth were not central in my mouth. My dentist removed all 4 of my eye teeth to make more room, as my mouth was overcrowded. I had a fixed brace fitted top and bottom, metal rings moulded around all 4 molars and I had to wear elastic bands which stretched from my top to bottom brace – only to be removed when eating.

Pregnancy and childbirth—unexpected complications

Giving birth to my first child, pre-diagnosis, I had an emergency C-section because she was in undiagnosed breech position. I’m certain that she turned in the middle of the night after I was induced, due to having pre-eclampsia, and waiting for labour to start. I experienced awful pain and looking back, it might well have been that—EDS makes for very stretchy insides I later discovered. My episiotomy was very slow to heal, another facet of EDS which I just didn’t know at the time.

The effects of anaesthetics

When I gave birth to my second daughter, in Belgium, I had asked for an epidural. After her forceps delivery, the placenta would not arrive. That turned into a medical emergency as they discovered there and then that I had placenta acreta, where the placenta grows into the lining of the uterus and won’t come away on its own. I had to endure manual extraction, which was traumatic. And still painful, despite the epidural. I kept telling the medics “I can still feel!” I don’t think they believed me. Had they and I had prior knowledge of my EDS, we would all have been able to navigate round the fact that another feature of EDS is that we react differently to anaesthesia as our tissues are too stretchy to hold the anaesthetic and it doesn’t seem to stay where it is needed. When my daughters and I go to the dentist for any fillings or extractions, our dentist is now aware that she needs to give us more local anaesthetic and to give one with less adrenaline in, as that gives us the shakes. 

Our mental health: adoption is trauma

At university, I was diagnosed with clinical depression. I was treated with both counselling/talking therapy and antidepressants, but these didn’t really help. I didn’t even really feel comfortable with being diagnosed as ‘clinically depressed’ because deep down I intuited that something was just and has always been ‘off’/wrong… What was glossed over was the fact that I am adopted—not was, am—and being adopted has affected me lifelong. Even though in counselling sessions, I found myself mostly talking about my relationship with my adoptive mother and how difficult I found that growing up, my being adopted in and of itself was never addressed. Looking back, it was as if it simply was not even relevant – neither to my life, to the counsellor and certainly not to my mental health.

Adoption: the elephant in the treatment room

I do not believe that I was depressed, not clinically. I believe that I was traumatised. No pills could ever have helped me. I did not want to take pills. I wanted to be able to express, for the first time in my life, how I felt. I wanted to be heard. To be seen. To be validated. 

I found myself in the same situation many years later, after the birth of my first child. I felt elated to have started my own family, and I knew that I was not suffering from any kind of postnatal depression, but I went into the hospital to speak with one of the post-birth counsellors there as I just couldn’t shake the ‘lost’ feelings I was having.

Again, a hopeless exercise. I went once and I remember tears streaming down my face as I told the counsellor how disappointed I was that I had to have an emergency C section as my baby was breech – that I lost the chance to give birth naturally and to be able to see my baby being born, coming out of my body—so I knew she was really mine, and of me. I told her how important that was to me. She just sat there. She was not qualified to handle what I was telling her.

Where could I find support post-partum?

So I left the room, sat in my car in the hospital car park and cried. I didn’t know who to turn to next. So I stuffed all these feelings down and they didn’t resurface until a couple of years after the birth of my second daughter. 

I was living in Belgium with my family at the time. My husband worked away seventy percent of the time and I was separated from family and friends. We spent five years in Belgium. I was struggling. I saw my GP, who diagnosed me with Generalised Anxiety Disorder (GAD) which might as well have been ‘I have no clue what is wrong with you so let’s call it a generic anxiety disorder and send you on your way with some antidepressants.’

Trying to take charge but the issues are still not recognised

The tablets made me spaced out and dizzy. So dizzy that I had an accident. I fell off my bike because my balance was so bad and my head so fuzzy, and hit my head on the kerb. I went to the hospital. I was okay, but I had had enough. I stopped taking those tablets and have never taken any again. I knew something was wrong. Not with my head, but with my life. I knew it was time to try to talk about how I felt, my adoption, my adoptive mother. All of it. 

I found a psychologist. We conducted our sessions in a hybrid of French and English. He listened. He let me cry. He held out tissues, but there just was no solution. I felt like he couldn’t fix me. Again, we focussed on my struggles with my adoptive mother, rather than the issues of being adopted and taken away from my mother as a baby. So I gave up.

EDS diagnosis and the consequences

A third attempt to try to sort myself out (and understand myself) arose from my Ehlers Danlos diagnosis in 2017. EDS is a genetic disorder where the structure of connective tissue & collagen is abnormal due to a gene mutation. This results in abnormally fragile and hyper-extensible tissues throughout the body which can lead to a range of multi-systemic symptoms and have a widespread effect on the body. Joints are hyper-mobile, or ‘loose’ and unstable, leading to overly tight muscles, joint pain and fatigue.

Looking to my first family for answers

As I was showing signs of Vascular EDS, which is often considered to be the most serious form, I had to see a geneticist to undergo genetic testing and ’counselling’ to ascertain which of the 13 types of EDS I had. I had to go through an extensive screening, with many questions about my family history. This was not only upsetting but very frightening.

Even though I am fortunate enough to be in reunion with both of my first parents, I was terrified not only for me, but for my children and, actually, for both of my first parents as I had obviously inherited this condition from one of them. I apologised profusely to my first parents when I emailed them a two-page document I had put together myself, asking about any possible conditions or early deaths in our ancestry from particular diseases or cancers. It was the only thing I could think of doing—to try to take control of my own health and protect that of my daughters.

Finally, some genetic testing—why do we not get this sooner?

The wait for my genetic screening results was fraught. I lost a lot of weight through worrying and this entire process brought many things to the surface for me about what adoptees have to endure without access to or knowledge of our genetic history and medical records. It is not only cruel to deny us access to these records, but it is also a danger to our health and that of our children and we often have to jump through several hoops to obtain these records.

My results came back negative for Vascular EDS, so a diagnosis of Hypermobile EDS was given.

Facing the intergenerational impact

A carrier of EDS has a 50% chance of passing it to their children, so without delay I had my daughters assessed in London to see if I had passed this on to them. They did indeed have the condition. I felt awful. That was all on me. My eldest daughter was 13 and my youngest 10 at the time.

The three of us have all seen a heart specialist, a podiatrist and several physiotherapists over the years to manage our EDS as best we can. Looking back, there were things I could have done which would have helped my girls, or afforded us to be better prepared for dealing with this. But I lacked the knowledge at the time.

Finally, some progress with mental health professionals

In order to manage this newly-diagnosed condition, I was referred to a clinical psychologist for Pain Management. We did discuss how to manage my pain, through pacing, prioritising, postponing, planning and delegating. However, certain traits were recognised by my therapist: my perfectionist tendencies, my need for routine and control of my environment, my people-pleasing and my system being on high alert/fight-flight for much of the time.

It was the first time that someone had suggested to me that I was not depressed, nor was I going mad, but that I was genuinely struggling. Again, we spoke about the difficult relationship with my over-protective, controlling adoptive mother, but not the maternal separation trauma. Mixed emotions followed—a combination of relief, anger and extreme sadness, to name but a few.

In 2022, aged 48, I finally found an adoption-competent therapist. A therapist who specialises in family therapy, but who also happens to be an adoptee. She understands my primary trauma and my feelings around being an adoptee plus the secondary trauma of having an adoptive mother who could not give me what I needed. Who in fact made my initial trauma worse.

What can we learn from my story and what needs to happen for adoptees?

We must have access to our medical history and our trauma must be validated, understood and treated by adoption-competent therapists because, for some adoptees, not only our health but our very lives may be at stake.

Finally Being Diagnosed with Complex PTSD

When I was a teenager my mother told me I was not her biological daughter. I had been fostered but she refused to tell me who I was and where I came from. Social services knew I had been deceived throughout my childhood but they did not tell me the truth.

I felt sad and lonely as a child, something was missing. I had to wait several months for my adoption order before I found out who my biological parents were and the circumstances surrounding my birth. I did not receive support from any professionals to help me process this discovery.  

Anxiety and depression

As I grew into a young adult I visited the GP because I suffered from severe anxiety and depression but instead of taking my childhood into account, I was given a prescription for antidepressants which only numbed me so I stopped taking them.

I felt a deep sense of loss and shame inside my body. I also felt fear. I was not safe. I couldn’t express it but professional services continued to ignore the traumatic childhood events surrounding my adoption. I struggled to form relationships and I felt immense grief. I had flashbacks, nightmares, stomach pains and migraines.

Normal decisions became difficult and overwhelming, I was constantly hypervigilant. I couldn’t regulate my emotions, I found it impossible to breathe deeply or calm myself. Self-loathing affected every part of my life and relationships. I was flawed, unlovable and unacceptable. I questioned my value and my worth. I was living on autopilot, unable to make rational decisions or enjoy my youth and I would react to everything. 

Pregnancy

Life events and experiences triggered these emotions inside my body constantly. During my first pregnancy, I had only recently been reunited with my birth mother when she died. The grief and pain interrupted my bonding with my child. I believed I wasn’t going to be a good enough mother and I shouldn’t be in this world. 

Left untreated I developed severe postnatal depression and was given another prescription for antidepressants but still no recognition of the cause. It took two years and a breakdown for a sympathetic GP to tell me I needed counselling.

Cognitive behavioural therapy (CBT)

I was placed on a year-long NHS waiting list and given CBT. I was told it was my thoughts that were detrimental to me not my experiences. So I internalised more shame.

The CBT didn’t work; I knew it was much deeper than changing my thought patterns but CBT and IAPT counselling was all I was offered by the NHS for another twenty years. I couldn’t afford private therapy.  

Finally being heard

As a middle-aged woman, I made a desperate visit to yet another GP. I was feeling hopeless, guilty, and shameful. I had severe uncontrollable mood swings. I isolated myself as a coping mechanism and had dissociative thoughts. I sat in that surgery and I told her all that I had been through in my life as the tears streamed down my face. She finally heard me and I was referred.

Several months later I had a consultation with secondary mental health services. Six months after that I was assessed by two clinical psychologists and asked a series of questions about my life experiences. I was left in the room for the team to discuss my answers.

When they returned they sat down and told me I had Complex PTSD. I didn’t even know what it was! Suddenly my whole life made sense and I cried from the relief in my body as the clinical psychologist apologised on behalf of the NHS for my suffering all these years. 

Still waiting to see a therapist

That diagnosis was in October 2021 and I am still waiting for my trauma therapy because apparently there is a shortage of trained therapists and a long waiting list.

My advice to any adoptee

My advice to any adoptee who is struggling with similar symptoms is to visit your GP and insist on a referral and get a second opinion from another GP if you are dismissed.

The important first step for any adoptee who cannot for financial reasons access private therapy is to get a referral to the right services.

There is post-adoption support through your local authority for adult adoptees as well as six free counselling sessions via PAC if you live in a subscribing borough – but many councils do not offer this. Some charities offer therapy and will assess you for a reduced fee if you are on a low income.

You deserve all the help you can get and you are not alone.