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Season 1, Episode 8: Dr. Elsbeth Neil discusses the losses that children often experience in the context of adoption and the ways that continued contact with birth family & foster carers as well as policies around residential moves can mitigate or assist in coping with loss. Dr. Neil presents a number of helpful suggestions for adoptees and parents seeking to navigate open adoption.

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Dr. Emily Helder: Hello. I’m Dr. Emily Helder and I’m here with Dr. Beth Neil, and she’s a professor of social work at the University of East Anglia in England and her research interests focus on how adoption is experienced by adoptees and their kinship network, as well as contact among members of that kinship network. She, along with Mary Beek wrote a chapter in the Handbook of Adoption entitled, “Respecting children’s relationships and identities in adoption”. So thanks so much for being here, Beth.

Dr. Elsbeth Neil: Thank you for giving me the chance to talk about the chapter.

Dr. Emily Helder: Yeah. So one of the themes that the chapter begins with is this dual nature of adoption that it can be marked by belongingness trust, stability, and at the same time there’s an inherent loss. And I wondered if you could say more about how a focus on the adoptee’s perspective and their identity really helps understand this duality.

Dr. Elsbeth Neil: Okay. Well, I just think it’s really important that we do engage with these, both, both these aspects of adoption. You know, I think adopted children are often told they’re lucky, they’re special. They’re chosen, you know, you’re going to get a new family now. That, that narrative about everything you gain from adoption is also reflected in policy, you know, in England.

Adoption is really quite a favored option as a, as a permanency route for children and local authorities are encouraged to really consider it for children in care. And if you’re just thinking about everything that a child will gain, which you know, there’s a lot of evidence, children do gain a lot from adoption.

It obscures what children lose, lose their birth family that maybe, you know, all the memories or the family history, the lived experience of being in that birth family, the relationships, it’s the foster family as well. And then ultimately it it’s your identity. So I think there’s a lot of loss there as well.

And we have to engage with both sides of adoption to really have an ethical adoption system. You know, kids should not have to lose all of this in, in order to gain a new family. Essentially, our argument is you can have both. And if we change the adoption system, kids don’t have to lose so much.

Dr. Emily Helder: Can you say a little bit more too, about the different kinds of loss or grief, your chapter talks, for example, about disenfranchised grief.

And I don’t know that that’s a term that that everyone is familiar with.

Dr. Elsbeth Neil: Yeah. So I think there are multiple losses. So first of all, that there’s the loss of relationships. The people you’ve lived with, the people you’ve become attached to you, and that may be birth parents, it may be foster parents, but it’s wider than that.

It’s siblings, it’s grandparents, it’s pets. So there’s those real lived relationships that people lose. Then I think, you know, there is the loss of identity. So, you know, most people, when you introduce yourself to somebody, they say, Oh, tell me about yourself. We start to tell stories about ourselves. We might start, you know, where we were born or say something about the family we grew up in, or we, you know, we refer to where we have come from in terms of describing who we are now, and those stories about ourselves, we, you know, they’re not just our memories, they’re other people’s memories. Now, if you’ve lived for periods of your life, with families that you no longer live with and are not in touch with you lose those memories, nobody’s saying to you, Oh, do you remember the time? And I remember when you were a baby, you did this.

And on the day you were born and blah, blah, blah. So you’re losing actually your own life history when you’re moving from place to place. And there’s no continuity. You add onto that, adoptees in the U S for example, can still not access their birth certificates. That’s another layer of loss, just, that basic right to

know who you were when you were born. Kids lose connections with their culture, with their nationality, with their language when they’re moving across cultural groups. There’s the status loss of, you know, if you’re adopted the other kids at school are not really likely to say to you “oh, that’s great. You’re adopted.

That’s fantastic. I wish I was adopted.” So adopted kids often experience a lot of kind of bullying or microaggressions. They’re asked questions like, well, where are your “real family” and why didn’t they want you? And I think these losses are hidden by this narrative that adoption is a wonderful new start and you’re going to gain this lovely new family.

So it’s disenfranchised. And I think particularly where the focus of adoptive parents is on incorporating the child into their family and loving the child as part of their family. But they’re not recognizing that the child has lost something as well. Then you can’t talk to the people that are closest to you about it.

So we know this from research with adult adoptees that people have all sorts of questions and feelings, but they feel like they don’t want to bring it up with their adopted mom and dad because they don’t want to hurt their feelings. Or they know it’s kind of a topic that they mustn’t address. So that’s what I mean really by disenfranchised grief, but it’s not really recognized by other people because of this narrative about adoption being, you know, this wonderful new start and the great new family.

So I think we need to engage with this loss and help adoptees with it.

Dr. Emily Helder: Yeah. And one of the things your chapter talks about in terms of mitigating loss, helping adoptees through that loss is the issue of contact and a lot of your work is in that area. So I wondered if you could say a bit about what you’re finding in your research about contact patterns between biological/first families and adoptive families and adoptees.

Dr. Elsbeth Neil: Okay. Yeah. So we’ve been doing research into this for over 20 years. And one, one study that we’ve carried out is a longitudinal study of children. And we checked in with adoptive families, adopted kids, birth families at three points in time. So we’ve seen this kind of group of kids grow up with various levels of openness in their adoption.

So some young people were having face to face meetings with birth family members as they grew up usually once or twice a year, three times maybe brothers and sisters as well. Other kids were just having letters back and forth between their adoptive parents and their birth parents. And I think we’ve seen in this study and others studies that we’ve carried out with birth and adoptive families, that first of all, there’s quite a lot of differences between these two types of contact. So we’ve seen where people are actually meeting up over time there’s quite a lot of opportunities to build empathy and understanding between adoptive parents and birth parents. You know, it’s a lot easier to understand somebody when you see them in the flesh, then just you get a letter from them.

Yeah. So there’s benefits in terms of the kind of empathy and relationship building between the adults, which then is beneficial for the child because these two aspects of their life become connected. And there’s an understanding it’s not just them in the middle and their adoptive parents don’t know anything about the birth family and vice versa.

So it’s about being part of a more extended kinship network as Hal Grotevant would say. Um, but also for the adopted young person themselves, I think the two main benefits they talk about from seeing parents and grandparents is actually knowing that they were cared about. Their families, still care about them, that they’re interested in them because they show up to these meetings and they, they can see how much they mean to their parents and grandparents and brothers and sisters.

So that helps deal with feelings of kind of “why me” and loss and rejection, but also for, you know, in England, most kids are adopted from the care system and they’ve been removed from their parents’ care because of concerns. So they can see for themselves, maybe the situations their parents are in, the problems their parents are struggling with, that meant, you know, it would have been really difficult for them to stay at home with their mom and dad.

So again, the kids who’ve grown up with this face to face contact, talked about that benefit as well. I can see that she couldn’t really have been a good mum to me at that point in time, but at least I know she cares about me and I know why I was adopted and I know who I am and where I come from. So I think these are the kind of benefits from the particularly the direct contact.

Now people could get the same benefits from letters, but it’s much trickier. And I think that’s interesting because I think professionals eschew, “Oh, letter contact that’s quite easy. It’s quite stable, no risks. Face to face contact oh that’s a bit tricky”. But imagine, you know, trying to write a letter to somebody that you’ve never met, or maybe only met once about something as intensely emotional as adoption.

And you put on top of that, the fact that a lot of birth parents, you know, are not used to writing letters, actually nobody’s used to writing them, but a lot of birth parents have maybe literacy problems, and they’ve got housing problems. They’ve got economic problems, they’ve got relationship problems. They’ve got a mental health problems, maybe drug and alcohol problems.

Just to be kind of organized and enough to actually get the letter and know where you have to go to get it and know what to do and who to send it to is a big challenge before you even get to that question of what can I say? What can I say to my child? So it’s an incredibly difficult thing that we ask people to do.

We have got a bit better over the years at supporting people doing it, but there’s still really, really big gaps in support for birth parents and adoptive parents to write these letters. So we’ve seen, you know, really high failure rate with indirect contact. By failure I mean, it actually just doesn’t happen.

Right. And, so, I think, you know, they argument we’re trying to put forward a lot more is if that’s the only option we need to support people a lot better with how to actually build some understanding and communication through letters. But let’s consider more the option of meeting up with continuing to see each other because it’s actually could be an easier way to communicate.

Dr. Emily Helder: Sure, sure. As, and one of the things that your chapter, I think nicely highlights is really respecting the child’s preferences and, and thoughts about that contact. And one of the things I was thinking practically is that, you know, across the developmental periods, I would imagine that children’s preferences and ideas and desires about that contact might change or at least be somewhat dynamic. And I wondered if you have given advice to adoptees or adoptive  families on how to honor their child’s preferences and choices while at the same time, recognizing that things may change.

Dr. Elsbeth Neil: Yeah. Um, I think it is a, you know, a lifelong challenge for adoptive families to meet the lifelong challenges of their adopted children and young people. So I think first of all, you know, a lot of adopted children, certainly in England are very, very young when they were adopted and they’re not old enough to, you know, articulate, oh, all these issues with identity and loss. So the task right at the beginning for the adoptive parent is one of putting themselves in the shoes of their adopted child and imagining them in the future. So really thinking, not about this, just baby or toddler or you know 5 year old, that they’re going to adopt, but imagining the 15 year old imagining the 25 year old imagining the 45 year old and thinking, what can I do now that is going to help them when they ask those questions later. So I think initially it’s about putting yourself in your child’s shoes and thinking about all the questions they might have about who they are, where they’ve come from and trying to get a communication going with the birth family from the get go.

So you can have got the resources to answer those questions. Then I think as children grow up. It’s, I mean, the main thing is to keep open the communication with the child, but there’s particular developmental stages I think where that’s, you know, parents maybe need to pay even more attention to that. So I think, you know, a lot of kids we’ve seen in our longitudinal research when they were very young, they didn’t have many questions about adoption.

They didn’t think very much about it. They just couldn’t remember being anywhere except in their adoptive family. And that was their life. Then just as David Brodzinsky has kind of described in his research there’s this big leap in understanding as kids get to about seven or eight and suddenly all sorts of questions and feelings start to pop up.

So I think that age is an age where parents need to be particularly alert to, you know, checking in with their child. Being open to answer children’s questions, but also not just waiting for the child to answer, but you know how, if you have this continual process of, of creating an open dialogue about adoption, then you know, parents have to start the conversation as well as be open to kids starting a conversation.

So, and that really goes up a notch, I think, around about seven, eight. Adolescence another time where we saw lots of different changing and growing feelings from young people in our longitudinal study. So it’s a time where again, kids’ interests may intensify their need for connection with the birth family may get stronger.

They may start to think, you know, initially kids in middle childhood are very concrete thinkers. So they might be thinking about the birth family member that they are having contact with, you know, the meetings with their mom or the letters with their grandmother or whatever, as they get into adolescence that might widen out and they say, “Oh, wow. Where’s my brothers and sisters, what are they doing now? And where’s my birth dad?” That’s a really big one for the kids in our study, because mostly they were having contact with people in their mom’s side of the family and their birth dad’s side of the family was, was left out. So a lot of kids didn’t even know who their dad was or how they could get hold of him or where he was, or did he ever think about them.

So all these kinds of questions were coming up for those teenagers. And it’s a time in the teenage years where I think parents. Yeah. They do have to expect and see as normal these questions and feelings, but it’s also a time where a lot else is going on for teenagers. You know, they’re feeling maybe more under pressure at school, in their peer group.

They have to think about exams. They have to think about jobs. They’re thinking about boyfriends, girlfriends. So it was also time we saw in the longitudinal study where young people often wanted to change their contact plans and some of them wanted to step back for a while from communicating with their birth family.

Cause they just felt overwhelmed with other stuff that was going on in their lives. Sure. But they wanted to keep that door open. So I think that’s a really important period where kids do want to step back where adoptive parents need to keep the communication going with the birth family for when young person’s ready to come back into that plan. So I think in the teenage years keep the communication open, going and be flexible and stuff. That’s when we really have to start allowing kids to take a bit more agency over what’s happening and listening to their views. The other time that the young people in our study, last time we saw them most of them were about 17, 18, 19, and they emphasized this move into adulthood as another really important stage because what a lot of kids in our study were experiencing were adoptive parents, or maybe professionals or other people in wider society saying to them, so what you’re going to do next?

So you’ve had these letters or you’ve had these meetings, you are an adult now, what are you going to do next? And they were saying, I don’t know, I’m not, I didn’t feel ready for it right now. I’ve got all this other stuff on, you know, I’m sitting my exams and I’m getting ready to go to college. You know, don’t leave it all up to me.

Right. So lots of kids said they would really welcome a conversation from maybe the professionals who’ve been supporting the contact or including with their birth family, with their adoptive parents to help them think through how they’re going to take forward these relationships into adulthood. So yeah, lots of different issues at different stages.

But I think the main thing is just to keep this as a topic that’s open, that’s on the agenda, that you’re undefended about that and you normalize it is perfectly okay for kids to ask all these questions and have these feelings.

Dr. Emily Helder: Yeah. That openness to communication is so valuable. Yeah. Yeah. Another way that you talk about mitigating experiences of loss or addressing loss beyond contact is thinking really carefully about the residential moves that kids are having.  So for example, from a foster carer to an adoptive home and there’s one section that I really thought was valuable because I think it highlights a common misunderstanding. And I, I think I’ll just read the quote from the chapter. You wrote “The secure attachment relationship with foster carers cannot be transferred to the adopters. It does provide a sound foundation from which the child will gradually take the risk of trusting in their new adoptive parents.” So could you say a little bit more about how understanding that idea of providing a foundation from which to take a risk, how that helps support children as they’re moving, you know, making those residential moves?

Dr. Elsbeth Neil: Yeah. So I think we, where we’re coming at with that sentence is something that we often hear in England, you know, that people often will minimize the impact on the child of moving from the foster home to the adoptive home. And they will often use the fact that the child has built a secure relationship with the attachment with the foster carer as a kind of argument.

“Well, we can move them quickly, quickly and easily. They’ve had a secure attachment, they’ll build another one.” And actually an attachment it’s not a quality of the child it’s a relationship, it’s about that foster carer and that child and the child is losing that they are losing their primary attachment figure when they are moved to their adoptive family.

And we have to recognize and work with that loss. So now obviously if a child has a secure attachment with their foster carer. What they gain is a secure state of mind with regard to relationships. So they’re going to be more likely to trust a new person. Yes. That, that bit’s true, but let’s not obscure the fact they are losing their primary attachment figure.

Now probably the most difficult time in your, in our whole lives to lose our primary attachment figure is between the age of six months and about four years. And that’s exactly in England when we are moving children to adoption. And what that practice looks like is these transitions are quite abrupt.

So you know, seven to 10 days, you know, at the start of that period you were living with your foster carer. You’ve maybe been there for since you were born in some cases, and as far as you’re concerned in your mind, you know, they are your primary attachment figures. Seven days later, you’re living with a new family and you don’t, you’re not seeing that foster care again.

So we’re really trying to get people to tune into actually how difficult these moves are for children. And we need to pay much more attention. And build in much greater overlap between these two family systems. So that that move is not so hard for the child. So I think when we recognize the, you know, the importance of the foster carer to the child, we then recognize the importance of the foster carer in assisting the child to move.

They’re going to be a really key person to encourage that child too explore the possibility of being in a new family start to play with their adoptive parents, start to let their adoptive parents care for them. The foster carer is really crucial there. And then after the child has moved, not disappearing, just forever after the moving day.

Being with the child on the moving day, coming around the next day, phoning them that evening and saying, how are you? You know? So we were trying to encourage people to, to, to recognize this loss and build in much greater overlap between the two families. So that, that, you know, it’s not just these losses in adoption.

It’s not just about recognizing them. It’s actually about kind of preventing them. So again, if foster carers can fade out more gradually and maybe not fade out totally, but still keep in touch at some level, because they’re not just an attachment figure to the child. They’re part of that child’s life story.

You know, they got those memories of their early life, you know, maybe their first day at nursery school, their first tooth, the first word they said. They’ve got all those memories, which is another reason to keep that connection going at some level over the years. So that’s what that piece of work is around. Yeah.

Dr. Emily Helder: Helping continue to construct those personal narratives.

Dr. Elsbeth Neil: Yes. Yeah,

Dr. Emily Helder: At the end of your chapter, you and Mary really nicely outline a lot of the practice and policy things that you’ve just mentioned around moves. And then the other thing that you talk a bit about is the the secure base model that, that you’ve outlined. And I wondered if you could talk especially about that secure base model and how that both helps adoptive parents, you know, in, in their development of that attachment, but really what benefits you’re seeing for the adoptee when people think about that, that particular model.

Dr. Elsbeth Neil: Okay. Yes. Well, the secure base model it’s, it’s a model that’s been developed by my colleague, Mary Beek and Gillian Schofield that’s come out of our research with, with children in care. And it’s essentially an attachment theory based model. So, you’ll see, in the chapter we’ve got a star with five interconnecting dimensions and four of those dimensions are, you know, really, the same as Mary Ainsworth dimensions about what, what, what do we know it is that parents and caregivers do that help children build a secure attachment relationship.

From Mary and Gillian’s work with  children in care  they’ve added this fifth dimension about family membership. Now, I think what we really trying to argue in this chapter, that it is that they all these issues for adoptive people about loss, about identity, about separation. They’re not a separate issue to this issue of building a secure attachment relationship in the adoptive family. Now, I think often, particularly maybe in the minds of prospective adoptive parents, they can seem to be in opposition. You know, adoptive parents are very, feel they have so much love to give and they can’t wait to make this child part of their family just, you know, love them and somehow thinking about the families that the child has lost and the identity challenges of the child is a challenge to their security in the adoptive family.

And I think what we want to say is, no, it’s not. The more you can recognize these issues that adoptees have and support your children with these issues the closer you’re going to get as a family. These are not opposing things. So, for example, the dimension of sensitivity is really important in not just in terms of, in dealing with these adoption related issues to listen, to attend to what your child’s feeling. What they’re saying, what they’re not saying when they’ve gone quiet. Using, this, your empathic capacity to try and understand how they might be feeling as an adopted person  is not, you know, that’s something, I think that  going to bring you closer to your child if you’re alongside your child, as they try and manage these issues.

So I think we’re trying to tease out how actually adopted parents really engaging with these issues with their adoptive kids is all part of their family building as well. And children feeling they belong. So I think sometimes what drives a wedge between adoptive parents and children is where kids feel they can’t ask any questions. They can’t bring this up. They’ve got to go and look for their birth family in secret. They don’t want their mom and dad to know that they’re looking on Facebook or wherever that’s what can drive a wedge when you haven’t got that openness. So we’re trying to help people think this, these are not in opposition, the child being in your family and the child being part of another family.

It’s the same thing about helping them develop as an individual and to be a secure person.

Dr. Emily Helder: Yeah. Yeah. All wrapped up in that stability and trust and permanence.

Dr. Elsbeth Neil: And cooperating, you know, is another dimension. So what we were talking about earlier about the different needs and feelings that kids might have at different developmental stages, I think, you know, as children get older, parents have to allow them more and more input into the decision making around contact. When they’re babies, the parents have got to do it for them. You know, they’ve got to cooperate with them and say, well, what do you think about this? And what do you want to do next? And how can we help you with this now that you’re 18?

What role would you like us to play? So I think those two dimensions really fit, not just with helping the child feel part of the adoptive family but helping them manage their membership of multiple families and all these identity challenges.

Dr. Emily Helder: Yes. Yes. Well, thank you so much, Beth. I feel like your work is so practical and applied and helpful for families and adoptees navigating this process.

So thanks for writing the chapter. Thanks to Mary too. And for taking some time to talk with me about it.

Dr. Elsbeth Neil: Yeah. Thank you very much, Emily.

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