Nikohl J. Allgood

Adoption as Relinquishment and How It Impacts Mental Health

by Nikohl J. Allgood


According to psychologists, adoptees are overrepresented in mental health treatment settings (Sunderland, 2010).  A study published in Pediatrics: Official Journal of the American Academy of Pediatrics found that an adoptee’s risk of a suicide attempt is four times greater than their non-adopted peers (Keyes, Malone, Sharma, & McGue, 2013, p.7). Adoptees also present at higher rates than non-adoptees with a number of psychological disorders including ADD, depression, and substance abuse disorder (Sunderland, 2010). This paper will explore the reasons behind this phenomenon and what can be done to reduce this risk.

Adoption as Trauma

Shareen Pine, an adoptee, describes adoption as a “traumatic, lifelong experience that is rarely recognized as one” (2015). Most people do not see adoption as a traumatic event, in fact the majority of us who have had little personal experience with adoption envision adoption as something out of a fairy tale. The problem with this way of thinking is it ignores the immense trauma and grief that accompanies every adoption. Paul Sunderland, a therapist specializing in treatment of addition and adoption issues, explains that every adoption begins with at least one relinquishment and every relinquishment in the early years of development causes trauma. He believes Developmental Post Traumatic Stress Disorder will soon be recognized as a subcategory of PTSD. To those who question whether adoption begins with trauma, Sunderland says, “Can we imagine, is there a bigger trauma than being separated from your mother, the one person you need at the beginning of life? I think not” (2010). Another respected doctor who has studied the effects of early trauma on mental health, Gabor Maté, explains that separation from the birth mother whose voice, body, heartbeat, and rhythms the newborn is used to can have a devastating effect on the infant’s nervous system. A baby needs a consistent caregiver. Many relinquished children move several times before being adopted. The fact that adoption is forgotten as a factor in emotional security amazes Maté (1999, p. 51).

Effects of the Trauma of Relinquishment on the Brain

Hormonal Imbalance

Most women who give their babies up for adoption live with a great deal of stress during the pregnancy. This stress causes her hormones to remain at abnormal levels, especially cortisol which is the stress hormone. Cortisol affects infants developing brains and nervous systems which puts all adoptees at a greater risk of psychological problems (Maté, 1999, pp. 51-52). In their book Reparenting the Child Who Hurts, Caroline Archer and Christine Gordon reiterate the impact cortisol has on the brain, specifically that it is known to affect the development of neurons during pregnancy and immediately following birth (2013, p. 23).

High levels of cortisol as well as adrenaline occur during any trauma, but in mother-infant bonding trauma, reduced levels of serotonin also occur. These irregular hormone levels make a huge impact on an infant’s brain chemicals and neurotransmitters. Infants are born with over 100 billion neurons. These neurons make connections based on experiences. Sunderland quoted famous neuropsychologist, Allan Schore, who observed, “Neurons that fire together, wire together” (Schore as cited in Sunderland, 2010). Relinquishment at birth feels life threatening; cortisol and adrenaline levels raise, neurons fire, and now the infant’s brain has made neurological connections between danger and abandonment. This causes the adoptee to experience real fear of any kind of separation or abandonment. An adoptee also experiences a strong need for attachment while at the same time fearing it, because the first important person in their life left, so they expect everyone will abandon them eventually as well (Sunderland, 2010).

Loss of Identity

Fear of Abandonment

The fear of abandonment can cause a child to live unconsciously on high alert. “There was a trauma, I’ve got to make sure it does not happen again” (Sunderland, 2010). Adoptees often internalize the belief that they caused the first abandonment and hope to somehow prevent another by pretending to be something they are not. Either by trying to mold themselves into what they think their adoptive family wished they were or by trying to be the good, perfect child. In both scenarios, the adoptee hides their hurts, fears, and struggles in an attempt to be accepted (Sunderland, 2010).

No Pre-trauma Personality

Adoptees have no remembrance of their identity before their trauma of relinquishment. Due to this, they begin to believe they are the person they adapted into. Most people who experience a traumatic event can remember a time before the trauma. That knowledge can help them get back to the person they were before the event occurred. When trauma happens at the start of life, there is no pre-trauma life to remember (Sunderland, 2010). There is nothing to measure their current self against. It is difficult to become the person you would have been without the trauma when you have no idea who that person might have been.

Lack of History

A loss of identity can also stem from a lack of personal history. Most individuals look to their families or their culture to help them connect to the world – to help them form a sense of who they are. Frequently, adoptees have little or no knowledge of their beginnings. Pine asks, “Can you imagine being the only person in the world you know you’re related to?” She says this led to internal questioning she kept secret out of fear and insecurity (Pine, 2015). This kind of questioning does nothing to alleviate the pain. Questions asked silently can never be answered and will lead to further feelings of frustration and isolation as more questions arise.

Recovery from the Trauma of Relinquishment

Thankfully, experts agree, healing of developmental trauma is possible at any age though will prove more effective the earlier the process is begun (Archer & Gordon, 2013).


Creating a Healing Environment for Adoptees

Counseling for adoptive parents. When possible, prospective adoptive couples should seek counseling prior to adopting. Counseling will help them deal with any grief caused by being unable to conceive a child. It will also help to ensure they are not unintentionally attempting to fill the gap of a biological child with an adoptee. It is impossible for an adoptee to become someone they can never be in order to heal a wound in their adoptive parents, and this only contributes to further loss of identity for the adoptee (Sunderland, 2010).  After healing the wounds of their own grief, a couple is in a much better position to help their adopted child heal as well.

Investigate the adoptee’s history. When going through the adoption process, the adoptive parents should gather as much information about the child’s natural family as possible. This will ensure they are fully equipped to help their child explore their history when the time comes.

Be honest and open about the adoption. Acknowledge their loss, grief, anger, and pain. Allow them to share their feelings openly. Archer and Gordon put it well when they observe, “It may be painful for us and our children to think about past hurts, but this in no way equals the pain of bearing them in isolation” (2013, p. 215). They need to know it is acceptable to share their feelings about their birth parents without feeling disloyal. When a child is able to talk about the trauma in their past, it begins to lose its power (Archer & Gordon, 2013, p. 78).

Provide reassurance and acceptance. Give adoptees permission to be themselves and to make mistakes. Let them know they are not expected to be perfect; no one is perfect. Take steps to get to know who they really are and accept every part of them. Reassure them they are loved and accepted for who they are, not what they do or who they pretend to be.

Find friends, mentors, and counselors uniquely able to help. Look for people who have similar backgrounds either culturally, if necessary, or as a fellow adoptee. Enlist the help of people who can connect with the adoptee in ways the adoptive parents are not able to and celebrate those connections. This will not only help with the adoptee developing their own identity; it also gives them the opportunity to make new, safe attachments.


Although the trauma of relinquishment presents adoptive families with a unique set of struggles, adoption provides a child who has been relinquished with a family to love them. When adoptive parents proactively address the issues facing their children, they provide an environment where the adoptee can begin to heal. The correlation between mental illness and adoption remains largely unstudied. More research is needed to determine how differing approaches to healing affect an adoptee’s mental health long term. Until then, acknowledging the trauma of relinquishment and being aware of the elevated risk of mental illness in adoptees bring the first steps toward healing.


Archer, C., & Gordon, C. A. (2013). Reparenting the child who hurts: A guide to healing developmental trauma and attachments. London: Jessica Kingsley.

Keyes, M., Malone, S., Sharma, W., & McGue M. (2013). Risk of suicide attempt in adopted and nonadopted offspring. Pediatrics: Official Journal of the American Academy of Pediatrics. 132(4), 1-8. Retrieved from

Maté, G. (1999). Scattered: How attention deficit disorder originates and what you can do about it. New York: Penguin.

Pine, S. (2015, January 9). Please don’t tell me I was lucky to be adopted. Washington Post. Retrieved from

Sunderland, P. (2010, November 9). Adoption and addiction ‘remembered not recalled’. Lecture. Retrieved from

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