Intercountry adoption - emotional health

Adoption; intercountry; second; child; bonding; grief; change; birth; culture; travel; family; adopt ;

Contents

• What to expect at first
• Building new relationships
• Helping children manage change
• Acknowledging Birth Culture
• Coping with toddlers when the new baby arrives
• Issues for parents
• Resources
• References

Most children who have been adopted from another country do as well with loving parenting as any other children, but there are some issues and things to think about that are different from those of other children.

Adoption is a big step and can be even more confusing when you are adopting a child from another country.

What to expect at first

Older Child

• Your child may be very quiet as a lot of changes are happening, or he may be upset and cry a lot or have tantrums. Some tantrums can be to do with frustration because of difficulties with understanding and being understood.
• Your child may not smile much, be withdrawn, look confused and unresponsive to what is going on around her.
• These reactions are normal, the child needs time to become accustomed to all the changes.
• At the same time as gaining a new family who will love him, he is losing everything he is familiar with. He will grieve for this despite all your care. All this takes time. Take it slowly and don't try to do too much too soon.

Baby

• Your baby will be confused about all the changes and may not smile or laugh very much. (All babies cry a lot - it is how they tell you what they need!)
• It is also common for babies not to babble or babble less often during the early stages of coming into your care.
• The baby may not respond to your play, but remain a bit guarded depending on her age.
• Some cultures play with and cuddle babies more than others, so do not be surprised if your baby takes a while to respond to you. It just needs time for the baby to adjust to the change in care.

Building new relationships

Just like anyone else you have to learn to adjust to being a parent. There are many new things you will be learning about yourself and your baby.

• The "blues" that new mothers feel are not just caused by hormones. Most adoptive parents also have some "blues" due to the huge change and lack of sleep.
• In addition some people who do not understand may talk in ways that hurt you, eg talk about natural parents as if adoptive parents were not natural.
• Expect some ups and downs in your feelings for a while. It does not all fall into place straight away.
• You may be exhausted by the time you get your baby because of the emotional build-up and the journey.

Your Feelings

Few life changes have a greater impact on the rest of one's life than the arrival of your first child. The first days/weeks/months can be overwhelming for all parents. This period is stressful as you need to adjust to learning new skills, lack of sleep, having no routine, being cut off from social contacts and receiving conflicting advice from others.

During this time you may find your emotions are out of control. One moment you feel happy and excited, next moment teary and sad, then scared or irritable. Your feelings towards your child can often vary from feeling loving to then feeling frustrated or even resentful of the child's behaviour.

Things that help with this adjustment period are:

• to lower your expectations of yourself as a parent,
• give yourself permission to take time to cope with the whole process of becoming a parent.

You don't have to love a baby straight away to care for her well (many birth parents take time to develop love for their infants). Love often grows out of caring.

• Get practical and emotional support from family or friends during this settling in stage and allow yourself time out from caring for the child while your partner (or family/friends) take over the care (½hr to 1 or 2 hrs break can recharge you).

Helping your new baby or child to build new relationships

One of the most important things about helping your child or baby to settle in her new home and country is to keep as many of the familiar "anchors" as you can, while introducing your child to her new way of life.

Some suggestions to help with this include:

• Get as much information as possible from previous carers about the child's likes, dislikes, activities and routines (observe what is happening between the child and carer at handover as well)
  • foods and local ingredients (smells and taste)
  • going to bed patterns and rituals 
  • bathing
  • toys and play
  • music, sounds
  • language, mothering words
  • clothes
  • ways of being held, loved.
• Encourage the child to practise saying "mum" and "dad".
• Hang pictures of the child on the wall where she or he can see them.
• Involve the child in grandparent visits (take it slowly at first, too many new people will be confusing).
• Have ceremonies that welcome the child into the family and each year celebrate the occasion.
• Buy some new clothes to help get to know what the child likes.
• Talk about the family in ways that include the child.

Helping children manage change

Depending on the age of the child and what has happened to him before, there will be grief about losing the past (however bad it may have been). Even babies feel this. It was what is known.

You need to spend time building new attachments. Learning to deal with loss and change is part of the learning that all children (adopted or not) need to go through in order to cope with the many changes that everyone has throughout life, e.g. starting school, moving house, coping with a new baby, losing a pet, leaving school and so on...

Children react to loss in different ways depending on the age of the child and what has happened to them before. Some of the following may happen.

• If the child is under six months or so there is not likely to be grief in the sense that we understand it, but the baby may become disoriented in the early process of making sense of the world. Suddenly the world that he was starting to make sense of becomes topsy-turvy. Infants may react to this with distress, withdrawal or complete confusion.
• Children over six months who have had the opportunity to become attached to a carer will have some experience of learning to depend on someone, which will stand them in good stead. Although they will grieve they will also know about being cared for by trusted adults and this will be part of what they expect.
• Children who have never had the opportunity to relate to a trusted carer may find the process of developing a relationship more difficult and take more time to become attached to their new parents. They may seem OK at first, but later show their distress when they feel safer.
• It is possible your child may show some signs of stress for a while, such as:
  • regression - eg going back on toilet training or talking
  • withdrawal - eg not wanting to be played with
  • lack of affection for people - eg not wanting to be touched or held
  • indiscriminate affection - eg running to everyone as if no-one is special
  • distress and searching - eg sadness, looking for past carers
  • attention problems - eg running from one thing to another
  • not able to relax and settle at bedtime.

With patience and high quality parenting-type care, most adopted children, even with difficult starts, learn to belong happily to their adoptive families. If you are worried about this and especially if a child's problems continue over time, it is worth getting some help from a professional who is skilled in this area (e.g. in South Australia from CAMHS, or the Women's and Children's Hospital)

Some ideas for parents to help children with change

• Have one or two familiar carers to provide most of the care (eg mum and dad).
• Keep as many familiar foods, smells, possessions, clothes, routines as possible. Try to bring home something of the smell. You may be able to bring home the baby's old bunny rug with the known smells if you take a new one to exchange.
• Allow the child to make mistakes. For example, expect that he will not be toilet trained whatever you have been told and do not try toilet training until the child is more settled. There are likely to be just too many new things to learn at a time.
• Hold off separations for a while until your child can cope with them without being distressed eg avoid child care or leaving him with other people until later.
• Don't push too much physical affection if the child finds it difficult - try stroking the child with a soft toy at first.
• If the baby needs to be held a lot, try using a sling.
• Don't overdo the toys at first, try to keep things fairly simple.
• The child may need his or her cot or bed in your room for comfort. Many of these children are unused to sleeping alone. Try keeping a night-light on by the cot.
• Separation of any sort should not be used for discipline eg sending the child into time-out or to the bedroom.
• For sleep problems use methods which don't involve separation. Controlled crying/comforting is not suitable for young children, especially those who have separation difficulties.
• Be very trustworthy. Be where you say you will be when you say you will be there or before. Always say goodbye when you leave. Leave the child something of yours to mind while you are not there.
• Get music, tapes, rhymes in the child's language of origin, eg a tape of lullabies.
• Allow the child to cling - let him or her be the one who makes the decision that it is safe to move away.
• Say and show your love in as many ways as you can.

Remember that dealing with big life changes takes time. Your child may have ups and downs for many months before he feels he really belongs in his new family. This sense of belonging will grow out of the security and love that you offer.

Acknowledging birth culture

• Your child needs a balance between keeping her birth culture and becoming Australian.
• Some parents make too much of the differences so the child feels she doesn't belong.
• Others ignore the child's background and where she came from, so the child is cut off from her roots.
• Some put more energy and thought into the adoption than onto the child as a person. Children within the same culture are all different - get to know your child as the person she is.
• It will help your child if you to include cultural practices in your family life and some of her language if possible.
• If the child is talking when she is adopted, try to link her with someone who speaks her language at least for phone calls so she won't feel so strange.
• Celebrate special days such as adoption day and arrival day as well as birthdays.
• Try to make the mix of adoption and birth culture just part of your everyday life.

Coping with older children when a new child arrives

A new child means big changes for all the family, but particularly an older child. The arrival of a new brother or sister is one of the most stressful events in a young child's life. No matter how carefully you prepare the older child for the change, he or she will feel more or less put out.

There are real changes for the child. Parents do have less time to spend with the older child and you are likely to have less patience with the older child than before the baby comes. See the topic Second baby for more about this important time in your child's life.

What you decide to do about this will vary from family to family. If your older child is under three or so, she will not understand much of what is happening. If the first child is older it will be helpful to involve her in the planning and to be aware that she may feel anxious about being "pushed out" of her special place in the family, and need lots of reassurance. Jealousy of the new arrival is to be expected and it usually takes some time for children to adjust to the new situation.

Travelling to get your second child

The following information is about helping your first child to feel as secure as possible during this new adventure. Remember, another change might remind your child of earlier changes and cause some emotional or behaviour problems for a while.

• Tell the child about the new arrival, but not too far in advance if he is still very young. A week or two is long enough for children under three to worry about something they can't fully understand.
• Make any changes to the bed or room a long time before the new arrival, so your older child does not think she is having to give something up for the new baby.
• The new arrival could arrive with a small gift for the older child.
• For an older child it will be helpful if the whole family goes if possible. This helps the older child to understand her own story, and the new child joins the family, not just a parent.
• If it is decided that the whole family needs to go, it is important that one parent is with the older child all the time so she does not have to cope alone with a strange place as well as new people.
• Leaving the older child home while parents go to get the new child will probably be stressful for the child as he may feel deserted by the people with whom he feels safest. If this is necessary he could be left in his own home with a well-known carer, eg grandparent. Telephone calls and postcards will help keep him in touch with his parents.
• If your older child loses some of he has recently learnt, such as toilet training, for a while, don't worry - this is very common when second children arrive in families. He will go forward again once he feels more secure.

Although your child may take some time to adjust to the new situation, he will, in the end have companionship and a brother or sister who will be there for him all his life. See also the topics Intercountry adoptions - travel and  Second baby.

Note: If parents adopt two or three children from the same family, or two or three children together, it can be very supportive for the children but can sometimes make parents feel left out. Children may "get together" and seem to be closer to each other than to the parents. This happens in all families, particularly when a child or children are in trouble. It is important to remind yourself that you are the person caring for all children and that their closeness is an asset to them rather than something to worry about. Spend time making an special relationship with each child in your family. If they "gang up" on you from time to time, try to ignore it, and not let it interfere with your discipline. Children will value you for fairness to all, even if, at the time they don't seem to.

Issues for parents

Coping with questions
Adoptive parents are often asked questions which seem rude or intrusive. It is worth thinking about how you will deal with these questions so they don't take you by surprise. Always answer questions with answers that you are happy for your children to hear. Put their interests first. Some possible answers are suggested below. Sometimes answering a question with a question about why the person asked will help you work out how you want to respond.

Questions do not always come from curious strangers but may include curiosity from friends or family members, etc. Think about to whom you tell what, because if your child's story is known by many people before he has a chance to understand it - it might be told to him by someone other than you, eg cousins hearing from their parents that a child's mother abandoned her or was raped or that she had other birth brothers and sisters etc - the cousins may retell this to the child at a later date.

Remember you can always ignore a hurtful question - or change the subject. This usually gives the questioner the message that you don't want to talk about it and gives you time to think about what you want to say.

Question "Is that child adopted?"
Answer "Yes" then move away or go on with what your were doing, or "Yes, isn't she/he beautiful?" or "Why do you ask?" - putting it back to the questioner, eg they may have an adopted child or perhaps they don't think the child looks like you - your answer can vary accordingly.

Question "You are very brave to take on a child from another country"
Answer "I guess all parents are brave, it's a big responsibility. Every child is his or her own person, wherever they come from"

Question "Where is she from?"
Answer Name the country and move off or ignore the question or say the suburb where you live.

Question "Why did you adopt?"
Answer "Why do you ask?".

Question "Why couldn't his real parents look after him?"-
Answer "My child's story belongs to him to tell".. (This is especially important if the child is there).

Question "Are you her real mum?"
Answer "Yes".

Question "Can't you have your own children?"
Answer "Why do you ask?" or "That's something personal, I don't want to discuss" or "This is my own child".

Question "Isn't she lucky?" or "Aren't you wonderful?"
Answer "We are the lucky ones".

Question. "Are they brother and sister?"
Answer "Yes".

Question "Did you get any background information about his real parents?"
Answer "Why do you ask?" or "That is personal information I don't want to share". Answer in general terms not specific to your child e.g. "Many children who are adopted are born out of marriage and in some cultures this is difficult" or "Many women do not have real choices due to poverty or cultural attitudes to single mothers and their children."

If you don't get the child you expected

All parents have in their minds some ideal of what they want their child to be like, whether they are birth parents or adoptive parents. 

• You may have fallen in love with a photograph and the real child is very different.
• Often it is to do with the sex of the child.
• Sometimes it is to do with getting a baby who is more unsettled than parents expected or a child who has some kind of disability.

In any case there can be a sense of disappointment. You did not get what you hoped for. Very few children are exactly what their parents hoped for, because they are real people and bring real needs and characteristics that are uniquely their own.

Most parents can work through their disappointment in time, as they start to get to know the new little person they have in their family for him or herself. Sometimes if the child has a major disability, the grief can last a very long time and be re-awakened every time a new stage of development presents problems.

If your feelings are not resolved it can cause difficulties both for you and your child or children.

• It can affect the way you build a relationship with your child and affect other children in the family as well.
• Also parents sometimes find ways to blame themselves or each other.
• It can sometimes lead to depression.
• A child who is not really wanted often senses this.

It is important to be able to come to terms with your feelings.

• It is important not to hide feelings of disappointment or shame of not having your dream realised. This shame is often so painful it is too difficult to admit even to your closest person.
• You need to recognise this disappointment is because of a mismatch between the picture in your head and reality.
• Discovering the reality can be an adventure, but only if you find someone understanding to tell.
• If you are disappointed you are not abnormal - it is very normal to feel this, especially if your child is very different in some way from what you expected. After all the child who lived in your head has probably been in your imagination for months or years - the new person (the real one) takes some getting used to.
• If this does not happen and the disappointment and grief keep on, you need to seek help from a counsellor who can help you to understand your feelings - both for your own sake and for the sake of your children.

Here are some other feelings you may have

While getting a new baby or child into your family is a very exciting and joyous happening there are some worries which many adoptive parents have, which it are good to have out in the open and talk through with someone who understands and cares.

• You may feel distressed or worried about all the formalities involved with adoption.
• You may feel after all this that you have to be perfect and find it difficult to ask for help.
• You may still be feeling sad about not being able to give birth to a baby.
• You may feel cross about the questions people ask you about your child and about why you are adopting.
• You may meet people who make you feel that you shouldn't be adopting.
• There can be problems with other members of the family such as grandparents.

Resources

South Australia

Department of Families and Communities Adoption and Family Information Service (AFIS)
Phone 8207 0060
http://www.dfc.sa.gov.au/pub/default.aspx?tabid=199

World Families Australia 8363 4111

References

Focus groups with parents from the Australian Aiding Children Adoption Agency (AACAA)

Brook, D and Barth R, "Adult transracial and inracial adoptions: effects of race, gender, adoptive family structure and placement history on adjustment outcomes", in American Journal of Orthopsychiatry 69(1), January 1999.

Hughes, Daniel A. "Adopting children with attachment problems" in Child Welfare LXXVIII Sept/Oct 1999 p541-560.

McDonald Thomas et al "The postadoption experience: child, parent, and family predictors of family adjustment to adoption" in Child Welfare, Vol LXXX (1) Jan/Feb 2001 p 71.

Zeanah, Charles "Disturbances of attachment in young children adopted from institutions" in Developmental and Behavioral Pediatrics 21 (3) 20000 p230.

Zeanah, Charles H. "Disturbances of attachment in young children adopted from institutions" in Developmental and Behavioral Pediatrics, 21(3) June 2000. P230-236.

The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.