The influences of being an adopted person on the psychotherapeutic relationship from an object relations perspective: a modified systematic literature review with clinical illustrations
Hylton, Jennifer L.
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While there has been much debate about the inherent risks of adoption and the proposed psychosocial impacts, it is generally agreed that adoption places the adopted person at risk of some psychological sequelae and that adoption is a lifelong process. Furthermore, it has been reported that adoptees are overrepresented in mental health settings. It therefore behoves therapists to familiarise themselves with the implications of adoption for the therapeutic relationship. The purpose of this dissertation is twofold: firstly, to inform the non-adoptee psychotherapist who will be treating adopted people of the psychosocial impacts of adoption, and the consequences of these for the therapeutic relationship from an object relations perspective; secondly, to invite the adoptee therapist to consider the impacts of this status working with adoptee clients, particularly relating to issues of identification and over-identification. A systematic review of the relevant literature was conducted to answer the research question – what are the influences of being an adopted person on the therapeutic relationship? Additionally, clinical work with an adopted client was drawn on to illustrate the concepts being discussed. Finally, the author’s personal experience as an adopted person and client was periodically used to enhance the discussion. It was found that adoption is a significant experience of loss which is likely to impact on the person’s developing self representation, identity formation, attachment capacity, and object relations. The existence and degree of this impact then has consequences for the therapeutic relationship, most notably in terms of binary or hole-object transference, fears of abandonment by the therapist, adoption related fantasies, and counter transference fears of letting the client down. It is further proposed that while the therapist who is an adopted person is uniquely positioned to identify with some of the experience of the adoptee client, there are also unique risks to the relationship because of this shared experience. While no research was located in this area, it was speculated that responsibility lies with the therapist to do significant personal processing of adoption related issues to ensure that the benefits of identification to not become the disadvantages of over-identification.