I don’t remember a time in my life when I didn’t know about adoption. My best friend when I was growing up in Memphis, Tennessee was adopted. Susan and I were both only children; our fathers worked together. We are six months apart in age and have been in each other’s lives since before we could talk. We are sisters in all but biology and legality. For Susan, biological kinship was something she never knew until she gave birth to her children. I gained more insight into her experience when I became a mother by adopting.
My earliest understanding of adoption was through the narrative Susan’s parents provided. We were told that adoption was “special,” and that Susan had been “chosen.” Everything Susan was told about her adoption, she told me. We accepted the adoption narrative she’d been told, but got quickly shut down when we asked more specific questions—like, why Susan’s parents chose adoption. I once made the mistake of asking Susan’s mother if they chose adoption because they couldn’t have children of their own. This did not go over well and I never asked again. Susan was told she had German and Italian ancestry, which made sense to us, as Susan could not have looked more different from her adoptive parents, who were both born in Ireland.
At some point, Susan learned that her biological parents were from New Jersey and had the last name Schmidt. We were twelve years old when we figured out how to call New Jersey information and ask for phone listings for the name Schmidt.
The operator informed us there were hundreds of Schmidts in New Jersey. So, to the operator’s great irritation, we asked for five numbers at a time. We sat on Susan’s bed with the telephone between us. Too scared to make the first call, Susan looked at me and nodded. I dialed the first number.
“Um, hi,” I said when I heard a voice on the other end. “Did you or anyone in your family have a child born on July 8, 1968, that was adopted?”
The air was vibrating. Susan sat motionless, her eyes locked on mine. We were both terrified that her one of her parents might pick up the extension and figure out what we were up to. We knew good and well that our sleuthing would not be okay.
“Oh, okay. Thanks anyway.” I quickly hung up the phone and Susan motioned for me to try the next number.
We went on like that for hours, calling Schmidt after Schmidt with no luck, until we gave up and went to bed. I didn’t—couldn’t—understand what it was really like for Susan to know so little about her biological family. But that night when we went to bed my friend was quiet and clinging to “Goggy,” a stuffed animal that had been loved so fiercely for so long it mostly resembled a rock in a sock.
Susan was a precociously intelligent child, and what we used to call “high-strung.” She was given to panic attacks and had a deep need to be in control. Susan struggled in her teens with an eating disorder that required multiple hospitalizations. It was horrible watching my best friend, my sister, waste away.
That night of calling almost every Schmidt in New Jersey—and my lifelong friendship with Susan—has had a huge impact on me and my understanding of the loss, longing, and trauma inherent in adoption.
Today, as a licensed clinical social worker and psychotherapist, I am struck by how rarely my clients who are adult adoptees acknowledge the loss of their first family and the impact it has had on them throughout their lives. Many share what I characterize as restlessness. Part of them is always preoccupied with questions of belonging and identity. In graduate school, when I became acquainted with the Adverse Childhood Experiences (ACE) Study, it confirmed what I knew instinctively to be true: Adoption is a complex matrix of hope and fear, gain and loss, joy and sorrow. But the prevailing narrative of adoption often focuses, sometimes solely focuses, on the joyful and positive aspects. I have been witness to the sorrow and confusion in my oldest friend and in my clients who are adult adoptees. Adoption is complex and there is no way around that. Crafting a solely positive narrative doesn’t work. Adoption is both an adverse childhood experience —as it involves loss of parents—and the joyful creation of family.
In 1998, a CDC-Kaiser public health study began researching possible links between childhood trauma and adult physical and mental health outcomes. The initial study including more than 16,000 research participants.
The first wave of ACE research conclusively linked childhood trauma to poorer physical and mental health outcomes in adulthood. These outcomes are a result of the harmful impact of childhood trauma on the developing brains and immune systems of affected children.
The original ACE study included a survey consisting of 10 yes-or-no questions. Each question begins with “On or before your 18th birthday…” and they are designed to measure exposure to:
— Physical, sexual, and verbal abuse. Physical and emotional neglect.
A family member who is depressed or diagnosed with mental illness, addicted to alcohol or another substance, or in prison. Witnessing a mother being abused. Losing a parent due to separation, divorce, or other reasons.
Adding up the “yes” answers reveals an individual’s ACE score.
The results showed that most people in the United States have at least one ACE. One of the study’s most significant findings was a spike in poor long-term physical and mental health outcomes among people who have an ACE score of four or more. Instances of diabetes, chronic lung diseases, and myriad autoimmune diseases, mental illness including anxiety and depression, and experiences of violence, both as perpetrators and victims, were shown to be significantly higher for this group.
Subsequent surveys have expanded the list of ACEs to include many other experiences, including exposure to racism, gender discrimination, involvement with the foster care system, living in a war zone, living in an unsafe neighborhood, and losing a family member to deportation, among others. While the ACE roster does not explicitly include adoption, adoption is nevertheless captured under the question about the loss of a parent.
Meaning-making is vitally important to our attempt to understand adversity in our lives. It is through adversity that we experience resilience and develop character. As parents and supporters of fostered and adopted children, it is incumbent upon us to recognize that our children have experienced loss. This loss is an adverse childhood experience. Recognizing that loss need not detract from—in fact can deepen—the love or quality of parenting provided by adoptive parents.
Interestingly, the ACE Study has expanded its scope to include research about resilience. Preliminary findings indicate that having at least one consistent and supportive adult in a child’s life can make a profound difference in the long-term effects of higher ACE scores. Resilience research has also led to evidence-based interventions by clinicians, organizations, and communities that are integrating trauma-informed and resilience-building practices such as mindfulness training, cognitive behavioral therapy, and dialectical behavioral therapy.
Understanding that adoption is an adverse childhood experience requires a paradigm shift. It has been my practice, as an adoptive parent, to remind my son that adoption is both happy and sad. The happiest day of my life was certainly not the happiest day of his first mother’s life. As my son matures, he is more and more comfortable expressing sadness that he was placed for adoption. It’s my job to make sure he knows he never has to worry about getting in trouble or hurting my feelings for expressing difficult or sad feelings about his adoption, or for wanting to know his origin story and develop close relationships with his first family.
In her autobiography, Dust Tracks on a Road, Zora Neale Hurston wrote, “There is no greater agony than bearing an untold story inside of you.” Part of our job as parents of adopted children is to make sure they have access to all the elements of their story, so that they can make meaning in their lives. The onus is also on us to emotionally support and lead our children through what the poet Ranier Maria Rilke called “childhood’s dark abysses.” We are ultimately responsible for teaching our children how to look at the world dialectically, to understand that two seemingly opposite stories can be true. An adoptee can be “special” and “chosen” and simultaneously be left and let go.
Susan would not locate her first mother until she was in her late thirties. Their meeting did not mark the beginning of a close or satisfying relationship, but Susan has said that at least one of the big questions of her life was answered, which brought her some relief. Just last year, with the help of DNA testing, Susan was able to solve the mystery of her first father. Sadly, it was too late to meet him. However, through the process of searching, Susan found three brothers, and those relationships have enriched her life in myriad ways. She and I had spent our entire lives believing Susan was of Italian and German descent. She is indeed Italian on her maternal side, but it turns out she’s Irish on her paternal side…just like both of her adoptive parents.
Now in her fifties, Susan has a more complete familial health history. She has answers to questions she didn’t even know she had, having nearly died on several occasions due to a hereditary disorder of which she was unaware. But the years of unanswered questions about her first parents, along with additional childhood trauma and a likely inherited predisposition for anxiety, took a toll on Susan’s mental and physical health. Over time, and with the help of dedicated therapists, Susan learned to manage her anxiety. She continues to make sense and meaning with all the pieces of her life and story. Today, Susan is a successful professional researching human behavior and culture.
Susan is innately driven—not because of her traumatic experiences, but rather in spite of them. Her triumph lay in her determination to authentically frame her narrative in a way that serves her. She would be the first to say that it would have been much easier to accomplish this with access to her birth information, and permission and encouragement to express all of her feelings surrounding her adoption.
As adoptive parents, we can help our children make meaning of their lives by making all their birth information accessible, and by acknowledging and honoring the loss inherent in adoption. Learning about ACEs can be a key to understanding this reality.
For many adopted children, life begins with loss. It is no great leap to say that adoption is an ACE; it can be made worse by pretending it isn’t. A child never benefits when something hurts and they are told it doesn’t. Who really benefits from the story that adoption is only wonderful, never painful? We can only make genuine meaning from the truth.
Remember, most people in the United States have at least one ACE. As we work to support our children, we need to reflect honestly on our own adverse childhood experiences and look critically at how our own health and well-being has been affected. ACEs need not strike fear in our hearts, but rather serve as an opportunity to learn more about ourselves and those we love. The author and professor Andrew Solomon beautifully states, “banish the dragons and you banish the heroes…” We are all storytellers and meaning-makers, and we need heroes in our lives in order to become heroic ourselves. We understand ourselves and craft our character much more meaningfully through our adversity than our triumphs. It is how we develop empathy. And empathy is how we connect and, ultimately, love.
CDC ACE Study site
Wikipedia — Adverse Childhood Experiences Study
The 10 ACE Questions (and 14 resilience survey questions)
The Pair of ACEs: The Soil in Which We’re Rooted, the Branches on Which We Grow
ACE Study primer — KPJR Films, which came out with Paper Tigers in 2015 and Resilience in 2016, put together this five-minute overview of the ACE Study.
ACE Study video — Three-minute trailer for a four-hour CD of interviews with ACEs researchers produced by the Academy on Violence and Abuse.
How childhood trauma affects health across a lifetime (16-minute TED Talk by Dr. Nadine Burke Harris)
The Adverse Childhood Experiences Study – the largest public health study you never heard of – started in an obesity clinic
https://www.ted.com/talks/ andrew_solomon_how_the_worst_moments_in_our_lives_make_us_who_we_are (20 minute TED Talk by Andrew Solomon)
Counseling Missoula MT Eden Atwood LCSW Grief counseling and trauma therapy for children, adolescents, adults, and elderly.