By Jennifer CarraherI am the daughter of an adoptee. My mother, adopted from an orphanage when she was nine months old, was raised by parents who were loving, protective, and kind people. They raised my mother, a second adopted son, and their third and only biological child in a pastoral, rural setting where the kids rode horses to their one-room schoolhouse, kicked around in the surrounding woods and pasture, and lived a pretty idyllic existence. When my mother was 18 years old, she became pregnant with me. In a whirlwind of impulsive action, she married my birth certificate father, moved 2,000 miles away from home, and six months later gave birth to me. By the end of the year, she had packed me up, returned to her parents, and essentially disappeared the man I believed to be my father. Within the next twelve months, she remarried, gained two more young children, and, four years later, she and my stepfather had a daughter of their own. Amidst this chaos, I immediately began to identify myself as an outsider in the family: a sensitive and insecure child, an interloper among the three children of a man with whom I lived but hardly knew. In just a few years, I was both born of and made into a fatherless child.

The psychological construct known as object relations theory has shown us the cruciality of early childhood relationships to identity formation; that is, the origins of the self emerge from exchanges between the infant and others. Originally theorized by Austrian psychoanalyst Melanie Klein, the essential idea is that the infant’s bond to the parents shapes future relationships. What this means is that the mother as a physical object is invested with emotional energy from the child, and the psycho-emotional impression of the mother—the internal object—comes to represent what the infant holds in her absence. If the object formation is disrupted early in life—as, I would argue, it is with virtually all adoptees and MPEs/ NPEs*—the failure to form these early relationships leads to problems later in the child’s life. Object relations theory also points out that situations in adult life are shaped by and mirror familial experiences during infancy.

My mother’s own adoption unquestionably caused for her a failure of identity formation leading to problems in later relationships. No doubt and with good reason, the sense of attachment and security that adoptees can, and likely do, feel carries over into adult relationships in all kinds of ways. The question is how this manifests itself. Adoption is not, by any means, the only way that this attachment disruption occurs. In fact, biological children may suffer the same disruption for a variety of reasons. The lack of attachment demonstrated by my mother in her adult relationships is not necessarily a reflection of her relationship with her adoptive parents, and not all adoptees develop in this same way. In our case, whatever the disruption my mother experienced as a child, whether the result of her late-infant adoption or some other barrier to her attachment, it severely affected her identity formation. This affected identity formation is where the intergenerational disruption of object formation can be seen most clearly.

I found out about my NPE status one year ago today. While reeling from the news for many months, I had not a single thought about my mother as a child—let alone as a daughter. I was too busy contemplating the questions, “Who is my father? Where has he been? Where can he be?” Over time, I began to ask myself questions about my mother’s own history, her fractured parental bonding as an adoptee, and how this object formation may have influenced her as a new mother in the NPE scenario. How does the attachment become so fragmented that the next generation could be subjected to suffering in this way?

The foundation of the relational object is one in which, as the infant grows, she naturally wants to consolidate the work of managing her most basic needs, which are described by Klein as drives; she does this by forming an attachment to an adequate caregiver who can contain these drives. For example, how the caregiver responds to the baby’s need to eat, comforts her if she cries, and meets her most fundamental needs. If these drives are met, then a good object relationship is developed. The caregiver, usually the parent, is the “good object.” To soothe herself, the infant eventually must be able to internalize that good object.

Conversely, if the caregiver cannot accommodate the infant’s drives, then the infant will experience the drives as being out of control and instead of developing a positive attachment to the mother or caregiver, the infant may develop a negative attachment. If the caregiver herself has inadequate object relations, if her drives have not been met and she is identified with a bad object (her absent parent), then it’s possible that in order to cope, the mother will project that identification onto the baby. This defense mechanism arises so that the mother may defend herself against unbearable feelings; it also works to defend the internal object against rage, which can destroy the internal object. The mother copes with the unbearable feelings and rage by externalizing those feelings. This is called projective identification. Because of this projection, the mother may begin to see the baby’s experience as the embodiment of her own bad object and perceived reality. For example, a mother may witness the baby crying uncontrollably and in that crying she will see the manifestation of the experience from which she has tried to distance herself. Because of this, her identification with a bad object is affirmed through her projection onto that child’s crying, and the child is left carrying that projected reality.

But how does this play out in the NPE experience? In my case, the object formation disruption seems to be about the attachment with the father. If the NPE’s mother is enacting her own loss of the father object by projecting it onto the baby, the NPE child may grow to identify herself with this negative experience. This means that the child suffers the mother’s perceived losses (fatherlessness in this case) because the mother’s own drives are disorganized. Instead of nurturing and helping the child to consolidate her needs, the mother continually and repeatedly projects chaos onto the child.

Because I was born to my young mother, perhaps in the midst of this object disruption, no doubt in part due to her experience as an adoptee, she exercised her projective identification on me. This allowed for an erasure of my father, or the man I understood to be my father—the exact experience she imagined for herself. She did this not only by removing me from my birth certificate father almost immediately after my birth, but also as I grew and developed, I was told in both explicit and subconscious ways that my step-father/father figure, with whom I had lived since the age of three, could not belong to me either. When I learned in my adult life that my biological father was someone else entirely, the projection further solidified.

It is not hard to envision that—because my mother was in an orphanage, was adopted, and expressed throughout her life massive levels of alienation—she continually saw herself as severed from her family, regardless of any external reality. Every detail of her experience as an adoptee could have triggered this alienation; for example, the birth of a biological son to her adoptive parents when she was 10 years old manifested as a catastrophic event for her. So many experiences of the adopted child can contribute to this perception of severance from the family.

All of these experiences, in turn, influenced how she saw me as a child. My mother was experiencing the absent father. By enacting a dramatized reality, she was able to facilitate her projective identification as a fatherless child onto me. She played this out by running from her own (adoptive) father, disappearing my biological father, and sticking my paternity on a non-father/stranger she almost immediately abandoned. In both subtle and overt ways, I was continually reminded that my step-father was not a legitimate parent either; he could never belong to me because I didn’t “come from” him. Ultimately, though, it was all a futile effort because the enactment and projection did nothing to contain her own distress. As an example of how this played out, when I discovered my biological paternity and asked her who she thought was suffering most in this situation, she simply replied, “Your father.” Like many other NPE mothers, there’s no ability for her to imagine the suffering of the child because she is so resigned to her own suffering.

Another developmental psychological theorist and psychoanalyst, Donald Winnicott, theorized that the role of the father is to temper the ambivalence between the mother and the child. Ambivalence arises when the needs of the parent and the needs of the child are in conflict. Maternal ambivalence, specifically as theorized by Freud, is a universal maternal experience in which the feelings of love and hate for the child can exist side by side. When the father is absent, there is what Freud calls an ever-present “third” in the mother’s unconscious mind. For the NPE, the role of the father to modulate the mother-child relationship does not exist. This may be why so many of us have long-standing conflict with our mothers and spend years saying things like, of all of the children, I was always the outsider, or I never understood why I didn’t fit in, or asking why did she dislike me, what did I do wrong, and, eventually, why could I not have known my father? The answer to all of these questions lies quite simply in the projective identification of the mother onto her child: “If I can’t have a father, neither can you.”

While my mother may have subconsciously or otherwise attempted to make me into a fatherless child, I do not see myself that way. In fact, I don’t actually believe that my mother perceives me as without a father. She sees it only in herself, and she projects her own suffering as an internalized, fatherless child onto me. I have come to understand over the protracted and immensely heavy year since my misattributed parent discovery, that even as NPEs, even through all of our intuitions and suspicions, detachments and alienations growing up, we do have fathers. We should never diminish the significance of this fact because if we continue the pattern of projection of the fatherless child in our own lives, the cycle can never be broken. The gift of the NPE discovery is the acknowledgement of what has been lost to us, the chance to discover ourselves anew in order to protect our own children by offering them our solid and unwavering belief in their fathers. The only way to do this, I am afraid, is to begin to forgive our mothers.

*MPE/NPE: misattributed parentage experience/not parent expected or nonpaternity eventJennifer Carraher lives with her family in Sebastopol, California, where she’s an advanced practice public health nurse in the areas of women’s health and forensics. She’s also a medical sociologist who has worked extensively over the past 20 years in assisted reproductive technologies, kinship, and the social studies of science. Her current research is dedicated to promoting harm reduction as medical practice.   

Since her misattributed parent discovery in December 2020, she has established The Mendel Project, which will provide DNA testing and genetic support at no cost to patients in the hospital setting. She also continues to collect narratives from other adoptees, NPEs, and those affected by genetic surprises for the podcast Unfinished Truths. Find her at themendelgeneticproject@gmail.com & unfinishedtruths@gmail.com.

It’s not news to donor conceived individuals that they have feelings about the manner in which they were conceived—feelings that may never occur to, or be acknowledged by, others. According to a new study published in the Harvard Medical School Journal of Bioethics and discussed in a recent article in Psychology Today, not only do individuals experience significant distress upon learning they were donor conceived, but they also think about the means of their conception often.

The authors of the new study reviewed existing literature and recognized a dearth of research concerning how donor conceived people feel about learning of their status, about the ethics of assisted reproduction, how their sense of identity is affected, how they’ve coped, and more. Rennie Burke, Yvette Ollada Lavery, Gali Katznelson, Joshua North, and J. Wesley Boyd developed a survey about these issues and asked Dani Shapiro—who wrote about her own donor conception discovery in Inheritance: A Memoir of Genealogy, Paternity, and Love—to help them recruit respondents. The response rate was 96.6%, with 143 demographically diverse respondents, most from the United States, the majority of whom were conceived through anonymous sperm donation.

Among the findings:

• 86.5% believed they were entitled to non-identifying information about their donors
• 84.6% experienced a “shift in their ‘sense of self’” after learning they were donor conceived
• 48.5% sought psychological support
• 74.8% wished they knew more about their ethnicity
• 63.6% wanted to know more about their biological parents’ identities”

Highlights of the researchers’ conclusions are that increased attention to counseling is important, anonymous donation should be discouraged, donor medical history should be provided to offspring, and the full potential implications of DNA testing should be considered before individuals proceed.

J. Wesley Boyd, MD, PhD, shared his thoughts about the research.

What instigated the undertaking of this study? What inspired it and what was your goal?

For the last six years I taught a course in the master’s degree program in Bioethics at Harvard Medical School called Contemporary Books in Bioethics. The course was amazing because we had authors come and present a public lecture about their books and also speak just to the class members, who’d already read and discussed the books prior to the authors’ arrival. Two years ago, one of the books that we read was Inheritance by Dani Shapiro. Three pages into my first reading of that book and I was rapt. It might be the only book I’ve read cover to cover in a single sitting—I couldn’t put it down. I’d never given much thought at all to the issues in that book—and the whole topic of gamete donation—prior to reading Inheritance. Needless to say, it was great meeting Dani when she came to talk about her book. In the middle of her class presentation I asked her if there were large-scale studies about how donor conceived individuals felt about the nature of their conception and she said no. Right then and there in class I said, “Then I’m going to conduct a study” and I asked if any students wanted to participate and several raised their hands.

Could you summarize the most significant finding of the research?    

When individuals discover later in life that they were conceived through donor technologies it can be earth shattering. Many of the folks we surveyed were dismayed and had their sense of self turned on its head. Additionally, many of our respondents thought about the nature of their conception every single day—a finding that is astounding given that most of us never give our conception much thought if any. Many ended up seeking psychological counseling as a result of their altered sense of self. Also, many were troubled to learn that money had been exchanged surrounding their conception.

The study states that there’s been little consideration to whether donor conceived people “have suffered psychologically because of the discovery of their conception.” Was there a distinction drawn between suffering because of the discovery of their conception and suffering because of the fact of their conception? In other words, were individuals sorry to have learned about their status or troubled by the reality of having been donor conceived and having been unaware of it?

My impression of our results is that folks were troubled at not knowing about the nature of their conception and about the deception therein. It’s one thing to know early in life about the nature of your conception and incorporate that into your sense of self throughout your life and quite another to discover later in life that so many things that have been the bedrock of your psyche and stability are not what you thought. The former is quite likely just part of growing up, but the latter can upend any sense of stability and grounding for a person. In the latter scenario, foundational parts of yourself can be ripped away and you can end up wondering who you really are and also feeling like your previous life was a lie in many respects.

Previous studies suggested that failure to disclose to offspring their donor-conceived status was no more likely than disclosure to cause harm. Can you discuss how your study compared in that regard? 

If our findings diverge from any previous findings, I assume that is because of the ways in which we solicited research subjects. Our participants were often members of support groups (such as on Facebook) of donor conceived individuals who might have joined those groups precisely because they were struggling with their discovery about the method of their conception. As such, our participants almost certainly differ from individuals who were informed early in their lives about the nature of their conception and had been able to assimilate and process that information into their sense of self over a period of decades. Additionally, if there are people who discover later in life that they were donor conceived and did not have much of a problem with that discovery, they might not feel compelled to join support groups, so would not have been among those we sampled.

What if anything surprised you about the findings? 

I was not surprised by much, believe it or not. Perhaps the reason I wasn’t surprised by what we discovered is that I’d already read Inheritance and therefore had already grappled with the plethora of thoughts and emotions individuals might have upon discovering they are donor conceived.

The study states: “We believe that it is impossible to know where technology will be in another 50 years and, as such, believe that there cannot be truly informed consent today for anyone involved, either the gamete donors or potential parents who utilize these reproductive technologies.” Of course, who knows what may come, but do you have any thoughts about what issues might arise?  

I am no expert in genetics, but I mostly only have a vague sense about the nefarious ways in which genetic technologies might be used to make predictions about future potential for any single individual which might result in blocking pathways for those deemed unfit based on their DNA (not unlike what we see in the movie “Gattaca”). I could imagine things like cloning and creating more than one being from a single genome and having various identical beings committing nefarious acts, wreaking havoc and chaos. Also there might be certain genetic traits and dispositions that will be able to be amplified and magnified—a taste for power, sadism, or who knows what—beyond anyone’s ability to reign it in, creating evil on a scale that we can’t really imagine. Also, many individuals might be deemed unfit to be biological parents due to their genetic makeup.

The study concludes that great thought ought to go into the decision about whether to take a DNA test. Can you talk about the considerations and how individuals can be helped to make that decision? 

If someone tests their own DNA, in my opinion they ought to assume that their genome will end up in a database that is fully, completely discoverable. This availability will not only make you readily available to biological relatives, but to insurance companies, intelligence agencies, and police forces, to name just a few. I assume entities like NSA and the CIA are already looking at our genome in hopes of making predictions about predilection toward crime, espionage, etc.

The study also calls for testing companies to promote greater awareness about the potential harms of DNA testing. In what way would you like to see that awareness expressed? 

The ways I’d like to see it expressed are contrary to their profit motive, so I don’t expect much change in their marketing, but instead of the ads we currently see with people happily making discoveries about their ancestry, I’d like to see overt depiction of individuals who are shocked by what they find when they test their DNA.

Based on your study findings, what advice, if any, would you have for individuals who have learned that they were donor-conceived in order to help them better cope? 

I’d offer advice similar to that which I offer anyone who is suffering or in pain. I’d encourage them to seek whatever kind of support or counseling they might need to process their discovery—whether informal or professional—and to let them know that they are not alone. I think that latter point is why support groups can be so beneficial.

What are the greatest needs for future research, and what further research, if any, do you plan to carry out? 

My colleagues in medical ethics at Baylor College of Medicine are planning to conduct a larger, grant-funded study of folks who have done at home genetic testing and discovered that they are not biologically related to (some of) their first-degree relatives. Given their proposed sampling method, if it goes forward their study will be much larger and more generalizable.

What, if anything, stands in the way of research or makes research of this kind challenging? 

This research is challenging because many folks who find out late in life that they were conceived through donor technologies are hurting and their sense of self has been turned on its head. Given the levels of pain and suffering so many people have experienced, you have to tread very lightly in order to not exacerbate their pain in any way.J. Wesley Boyd, MD, PhD, is a professor of psychiatry and medical ethics at Baylor College of Medicine. He is also a faculty member in the Harvard Medical School Center for Bioethics. He obtained an MA in philosophy and a PhD in religion and culture, along with his medical degree, at UNC Chapel Hill. He’s taught extensively in the humanities, bioethics, human rights, and psychiatry. His areas of interest include social justice, access to care, human rights, asylum and immigration, humanistic aspects of medicine, physician health and well-being, the pharmaceutical industry, mass incarceration, and substance use. Visit his website at jwesleyboyd.com and follow on Twitter @JWesleyBoydMD @BCMEthics @HMSBioethics. BEFORE YOU GO…

Look on our home page for more articles and essays about NPEs, adoptees, and genetic genealogy.

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Any surprise can be traumatic, but a DNA surprise raises one of life’s most fundamental questions: Who am I? Your very identity is made up of your memories, your shared stories, and experiences with family and friends. When you find out that something is not true, or not exactly true, it is a major shock to your emotional system.It is easy to tell yourself, “This is no big deal. I should be able to handle this.” But “handling something” is a process. And that process may involve feeling upset and expressing various emotions. Like any trauma, the emotional reactions can come in waves and when you least expect them. You and your family members both may minimize your experience by emphasizing you had good parents, you shouldn’t be upset, or even that you’re being selfish by looking for answers. I tell people that I don’t know what qualifies as an overreaction to news that changes your understanding of your world. Your reaction is not a sign of emotional weakness—it’s a sign that you are in touch with reality enough that you react when reality changes. I suggest you accept your reactions, your feelings, as being there. Accept that they are what you need to feel in the moment. There’s no need to try changing them—that doesn’t work anyway. You need to work through the process.There can be depression, with low mood and irritability, loss of appetite, difficulty sleeping, poor concentration, and an inability to focus on work. There might be anger. Part of what makes this kind of trauma so difficult is that you might think it’s not really that big of a deal—others have it worse. And it’s true, others have it worse. But trauma is not a contest—you can have all the emotions anyway. You are not weak.Yes. Sometimes you just can’t process everything at once and you will feel disoriented and unable to concentrate. The news can be so big that it’s like your circuits are overloaded.Yes. Research has shown for many years that stressful life events (both good stress and bad stress) have an impact on our health. It is important that you allow yourself to experience your emotions and not waste energy on fighting them. You might look at the Holmes-Rahe Stress Inventory.It’s important to accept our reactions as normal. The more we fight them or argue that there’s something wrong with us for reacting, the longer it will take to move forward, the longer it will take to heal. Journaling can be immensely helpful. Write down what you’re feeling, even if it seems extreme or overly dramatic. It isn’t. It’s the reality of what you are feeling in the moment. Meditation can be helpful, but if you can’t slow your mind down, that’s ok. Notice and accept that your mind is racing. If you’re able to exercise, that’s a great way of dealing with stress and clearing the mind. Reaching out to understanding friends is important. And there’s a large community online going through similar things. (Use the Resources tab on the Severance home page to find some of these.)I encourage people to move slowly in the process—think of yourself as writing a novel. What information do you need to make the characters more interesting, to make them sympathetic. Is there a way that you can make their behavior understandable? For example, a teenage girl that became pregnant in the past may not have been allowed much say in whether or not to keep the baby or put the child up for adoption. Going back even further in time, a single female may not have had the opportunity to earn a living wage and therefore couldn’t provide for a child. A father may not have known of a child’s existence. There are many more examples I can give. On the other hand, what you learn now becomes part of your story and, if you’re someone reading this, you’re likely the kind of person that wants to know your whole story. Being understanding and sympathetic toward others doesn’t mean you don’t have the right to experience your own emotions, though.

The most important thing is to take care of yourself. Ask yourself what you, yourself, need. Try to find a way to meet that need, but keep in mind you can’t control other people.

Therapy can be very helpful at any point in the process. A good therapist helps you reflect on who you are and who you want to be. Ultimately, you are the author of your story, no matter how many plot twists get added to that story. I would consider therapy necessary and would encourage you to seek help if you’re having symptoms of depression or trauma—low mood, irritability, sleep or appetite problems, inability to concentrate, relationship problems.Searching for answers can be all-consuming. We live in an age in which we can binge-watch on Netflix and learn the answer to a mystery on a television show within hours. When it comes to family mysteries, we have search engines, DNA, and genealogy services. There’s a lot we can learn quickly. But definitive answers can take a long time. Others may not understand our obsession—even others affected by the discovery of a family secret may not care like you do. It’s a very personal thing. It’s important to keep in mind that we can’t necessarily find answers quicker by working harder. As an example, I have spent two years searching for my grandfather’s birth parents. I found his likely father fairly quickly, but could find nothing on his mother. I gave up for a while and came back to the search and found I had earlier ruled out a group of people for some reason. This group has turned out to offer my best leads in my search. It’s important to take care of yourself. Meditate, exercise, sleep, stay in touch with your friends, get out of the house. All of these things will make your search more efficient. Taking care of yourself helps you think more clearly. All of these strategies are part of accepting our humanity, accepting that we don’t control how our bodies and minds react. This includes accepting that other people may be doing their best—we just don’t always know their stories, why they react the way they do. We need to take care of ourselves so we don’t lose ourselves in the process.Keep in mind that what you find in the search will trigger all kinds of emotions. You may find people who share DNA with you, but nothing else. A newfound relative may have no interest in a relationship, or on the other hand, may want more of your time and energy than you want to give. It’s a process, and you may not know what you want until you start finding answers to the secret, until you find these relatives. Don’t assume they’ll want the same things you do. Also, it’s important to keep asking yourself: “What is it I really want? What am I searching for? What values of mine will this search, and its possible answers, satisfy?”We are all ultimately seeking connection and belonging. Unfortunately, life is not clean. We don’t all fit into perfectly designed family trees. It’s estimated that 7% of Americans are adopted or in foster care. Add on top of that all the individuals who grew up in a “nuclear” family but were conceived outside of the marriage or through donors. That’s a huge percentage of us. It is important that we work to remove the stigma of this. We didn’t choose how we came into this world. It’s important that we not stigmatize ourselves. We are just as legitimate as anyone else.

We also need to keep in mind that we may be rejected by newfound biological parents. We need to keep our fantasies in check. These biological relatives are human beings, with strengths and with flaws, just like everyone else. Other people may not understand our need to search and they may have no desire to know the answers themselves. We need to accept that.

Greg Markway, PhD, is a clinical psychologist in St. Louis, Missouri. He became interested in genetic genealogy while searching for the roots of his grandfather, who came to Missouri from New York on an orphan train in 1896.

Read more about shock and trauma related to DNA surprises here and here, and return to the home page for more articles about genetic identity.

BEFORE YOU GO…

• Please leave a comment below and share your thoughts.
• Let us know what you want to see in Severance. Send a message to bkjax@icloud.com
• Tell us your stories. See guidelines at https://severancemag.com/submission-guidelines/
• If you’re an NPE, adoptee, or donor conceived person; a sibling of someone in one of these groups; or a helping professional (for example, a therapist or genetic genealogist) you’re welcome to join our private Facebook group at https://www.facebook.com/groups/402792990448461
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Joyful reunions have become a television staple. Less frequently told are the stories of the unsuccessful searches and unhappy reunions. Adoptees, donor-conceived people, and NPEs (not parent expected) risk being spurned when they reach out to biological family members, and rejection may cause significant distress. We asked Lisa Bahar, a licensed marriage and family therapist and licensed professional clinical counselor in Newport Beach, California, about how rejection may influence and interfere with interpersonal relationships, how individuals can help soothe themselves, and how therapy might help.Yes. If individuals ruminate and fixate on the thought of rejection, they may find they’re setting themselves for up interpersonal interactions that fall in line with their core belief that they are rejected and will be rejected. On the other hand, in a therapeutic environment or process, it may be a way to work through rejection and explore it for the purpose of gaining acceptance of self.It can produce general anxiety symptoms, depression, feelings of disconnect, and fear of intimacy.  Anxiety is a symptom of avoiding the discomfort of deep emotional pain that has not been worked through.Fear of getting hurt can set up you up for hurting others before they hurt you—a conflicted desire to get close, but then pushing away, rejecting other people’s love due to not feeling comfortable being loved. Sometimes it’s easier to be rejected. It’s known and familiar. A running theme in intimate relationships is looking to someone to accept you, and that may and most likely will turn into deep need, which can manifest in rage-like behavior when you’re left or not reassured that the person will return.Belonging would be about feeling accepted and willing to take a chance to make efforts to belong. It takes a lot of courage to work through the feelings of rejection. Learning how to let go of people is a significant step toward being accepted and belonging. Practicing that sense of freedom helps with interpersonal relationships and lets you create a connection that’s healthier and more fulfilling versus controlling, demanding, insisting, or guilting people into having you feel like you belong, which ironically sets up the cycle to be rejected.I would say try professional therapy relationships versus friends and family. It seems reasonable to turn to family and friends, however, starting with a therapist or maybe a trusted religion or spiritual practitioner may be a more effective alternative. Friends and family are well meaning, but they may not understand the depths of the disconnect that is at the core of the trauma of being rejected.Be willing to address it by noticing when you are feeling rejected. Set up a self-soothing kit that will calm your mind when you feel rejected, for example, warm clothing, soothing refreshment (not mood altering), sensory experiences that are comforting to the 5 senses to help you feel more connected to life. Creating a sensory experience might involve putting in your room flowers or a painting or work of art that’s pleasing to the eye, candles or atmospheric lighting, comforters that are attractive and warm, and bed linens that feel nice. It might mean having hot tea or another warm and soothing beverage for taste. For sound, it might mean playing music that’s calming, versus thoughtful or stimulating. Put together a list of books that will help you improve your feelings of acceptance, such as loving kindness or spiritual books. Learn about imagery so you can envision a place when you are feeling rejected. The comfort of a pet may help. If your pet appreciates being petted, you benefit and the pet does too. Practicing a loving kindness and compassion practice can help calm the mind. You remind yourself that you are safe, you are content, you are accepted. When practiced regularly, it trains the mind to accept yourself versus the negative negative self-talk. The mind is powerful and will accept what you tell it if you practice.Depending on the severity, most likely psychodynamic therapy will work with severe symptoms of abandonment. Object Relations and Gestalt therapies can be helpful. Psychodynamic therapy is a form of treatment that explores how an individual experiences symptoms of distress based on what is unconscious, and therapists work with clients to bring the unconsciousness into the conscious. This is important when working through jealousy due to the abandonment and the fear of rejection associated with this. This therapy focuses on childhood experiences as a way to understand current symptoms that are seemingly unhealthy. For example, a child rejected by his mother may set up an experience of rejection from others or even go so far as to reject his mate before she rejects him to avoid the discomfort of jealousy. And since many of these individuals have experienced trauma, EMDR and other trauma-informed therapies might also be helpful.I have had clients experience this. Rejection is a trauma and it deserves to be worked through. Therapy is essential, and the desire to find some kind of meaning from the experience would be the goal. Existential therapies can be helpful for this experience. Existential therapies look for meaning and purpose—why you are here. They also look at anxiety as an opportunity to be creative and face fears to create new experiences. Anxiety is seen as a launch to new beginnings.Learn to practice a willingness to turn your mind toward accepting that rejection is related to further acceptance of self. If you can love and accept yourself in whatever method you choose, then you will be equipped to deal with others who may reject you. The reality is, rejection is part of being in the world, and the key is not to try and avoid it, but rather to see it as an opportunity to explore parts of yourself you want to accept, change parts that don’t fit with your meaning and life purpose, and discover ways to be gentle with yourself when this inevitable experience occurs. Someone one told me, “If everyone likes you, you have a problem.”Lisa Bahar is licensed marriage and family therapist and licensed professional clinical counselor. She specializes in dialectical behavior therapy (DBT) and provides psychotherapy to individuals, couples, and families. She’s an adjunct faculty member at Pepperdine University’s Graduate School of Education and Psychology Master of Arts in Clinical Psychology program with an emphasis in Marriage and Family Therapy.

Read more about rejection here, and return to our home page for more articles on genetic identity issues.

By B.K. JacksonMost of the losses we experience in life require little explanation and are universally recognized and understood, such as the death of our loved ones. They were among us — and then they weren’t. We may have witnessed their transition from life to death, from breathing to not breathing. We may have seen their bodies lowered to the ground and have attended ceremonies acknowledging the gravity of our losses. We miss the dead, mourn for them, and are comforted by others who understand and may grieve with us. Over time, the sadness over their absence, while it may never evaporate, dissipates.

But some loss is less clear, even more distressing, and may last forever. Ambiguous loss is the traumatic loss of a person, a relationship, or even the desire for a relationship, for which there is no possibility of closure. The term may also pertain to a problem that can’t be solved or a situation that has no resolution. Pauline Boss, a family therapist, educator, and researcher who coined the term ambiguous loss in the late 1970s, describes it as a type “that has no validation and no body to bury. It’s a situation that leads to disenfranchised grief — grief that society doesn’t know what to do with or discriminates against.”

There are two types of ambiguous loss. One arises in situations where there is a physical presence but a lack of psychological presence, for example, when a loved one has dementia or is emotionally unavailable. The other type, conversely, emerges when there’s a psychological presence but a physical absence, such as when a death is presumed to have occurred but there’s no body, as was the case for many of the individuals with whom Boss has worked — loved ones of pilots missing in action in Vietnam, victims of 9/11 who were never identified, and individuals presumed dead after the catastrophic tsunami that struck Japan in 2011. The ambiguity is caused by a lack of information about the loss.

It’s this second type of ambiguous loss that’s commonly experienced by individuals who’ve been stripped of information about their genetic identities, whether as a result of adoption, donor conception, or other circumstances of misattributed parentage.

According to JaeRan Kim, PhD, MSW, assistant professor of social work at the University of Washington Tacoma, also falling under the umbrella of ambiguous losses are “any circumstances where what you think you understand about a relationship turns out to be unclear, misleading, or unknown.”  Adoptees who find out later in life they were adopted, for example, “often feel a sense of betrayal by their parents and may question everything about their relationship,” she says. “They may also experience the loss and uncertainty about their birth/first parents — who they were and what became of them.” The same is true for NPEs (non-parental events or not parent expected) and donor conceived people. Ambiguous loss, Kim adds, is also about the inability or failure of others to acknowledge that there’s sadness or grief over the loss.

More important to consider for adoptees, says Kim, “is whether they have specific information about the adoption circumstances, the reasons for their relinquishment, and the knowledge that their birth/first families are okay, and if there’s been some sort of sense of peace about that loss. It’s also necessary to consider if the adoptive parents were open about including the birth/first parents and families in their lives, even if only in symbolic ways.” Ambiguous loss, she says, “is more difficult to manage if adoptees feel it is not safe to voice their thoughts and feelings about wanting to know more about the circumstances that led to their adoptions and if they are shamed or shut down if they question or mourn the loss of their birthparents.”

For adoptees and NPEs, the lack of information about their origins creates ambiguity when they can’t identify a birth parent, can’t locate a biological family member they have identified, or learn that a biological family member they’ve never met has died, shattering the dream that one day they will connect. In each case, there’s a loss of the promise of a relationship that doesn’t yet — and may never — exist. It’s heartbreaking in these cases of lack of information about genetic identity, Boss says, because there are multiple layers of loss and ambiguity. Individuals may feel shattered by the death of birthparents they’ve never met, feelings further complicated when they’ve been rejected or shamed by their birth or social families.

These losses, Boss writes in her 2000 book, “Ambiguous Loss: Learning to Live with Unresolved Grief,” are “always stressful and often tormenting.” They’re the most devastating and traumatizing of losses because sufferers must live with ambiguity that might stay with them throughout their lives. She illustrates her point, quoting from an old English nursery rhyme, with an example certain to resonate with anyone who grieves an absent parent:

As I was walking up the stair,

I met a man who was not there

He was not there again today

Oh, how I wish he’d go away

While some people have higher thresholds of tolerance than others for ambiguity, most people find it deeply disturbing and stress-inducing. It’s difficult to move forward when you don’t know for certain if the loss is permanent and when there are no rituals for mourning the loss. Those who’ve never experienced an ambiguous loss may not understand the depth of the pain or the level of stress it arouses.

Boss observes that among the many potential consequences people suffering ambiguous losses may experience are:

• a freezing of the grief process
• a sense of being stuck in limbo
• an inability to make sense of the situation or to make decisions
• depression, anxiety, and substance abuse
• feeling immobilized
• exhaustion, hopelessness, and helplessness.

These symptoms are similar to those of complicated grief but are the result of ambiguity, not death.If you’re struggling with an ambiguous loss, you may consider seeing a therapist. But, according to Boss, that’s not always helpful. Therapists, she explains — particularly psychologists and psychiatrists — often focus on inner psychiatric issues, but in the case of ambiguous loss, there are none. She characterizes ambiguous loss as a stress-based problem and uses a non-medical approach to distinguish it from a pathology. “It’s not like you have a mental illness such as schizophrenia or bipolar disorder. You don’t have to adjust to a disease that’s inside you,” she explains. “The pathology lies in the situation, not in your psyche. If you experience distress over an ambiguous loss, there’s nothing wrong with you, but there is something wrong with what happened to you,” she says. “The problem is that you’ve been dealt a card that was not your fault, and now you have to try to figure it out, but there may be no answer.”

That’s not to say that a therapist isn’t ever necessary or can’t help. If you need a high degree of control in your life, you might spend all your time digging and digging for answers and not living your life, Boss says. A therapist can help you change course, but you must choose one who understands that the problem lies in the context of the situation, not in the inner workings of your mind. Perhaps surprisingly, grief therapists might not be the best choice, because they’re trained to deal with loved ones who are dead — with the certainty of death. But you may not have that. Further, unless they’ve specifically been trained in this particular kind of loss, Boss says, therapists may try to put a timeline on your grief, but with ambiguous loss, “there is no timeline. It’s a forever thing.” Look for a family therapist or a social worker, she advises, because they’re trained to look systemically at your environment, at the context, and at what happened to you.

And don’t look for comfort in knowledge of the five stages of grief, Boss adds. It’s a concept that’s been widely misunderstood, taken out of its original context, and generally accepted even though there’s no evidence that it has merit. Society, and especially American society, loves the idea of these stages, she says, because they promise a way to get over it, to gain what she calls the myth of closure. “It’s an ugly word, closure. I don’t believe in it. It doesn’t exist, and why should it? It’s not needed.” The idea that we need to get over loss and move on is cruel, she says, because we now know that we need to learn to live with grief, even when there is a death.If your loss remains in your thoughts, that’s understandable, but it shouldn’t control your mind, Boss says, because then it becomes an obsession.

In her 2006 book, “Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss,” she lays out guidelines therapists can use to help individuals suffering ambiguous losses. But there are a number of things you can do on your own. Not that there’s a simple fix. Or even any fix. The solution is a matter of increasing your tolerance for, and comfort with, unanswered questions.

Once you acknowledge the losses and recognize they’re ambiguous, there are two key goals: learning to accept the ambiguities instead of struggling against them, and mitigating the stress the losses cause. The challenge is not to get over ambiguous loss, because that’s impossible, but to get used to it, to increase your resilience and learn to be able to live without knowing and move forward despite an ongoing mystery.

Accepting ambiguity, Boss admits, isn’t easy. “We live in a society that’s mastery-oriented. We want the answers, otherwise it’s as if we’ve failed. We have to fight that societal pressure for certainty, for answer to all questions.” She likes the idea that we’re a can-do society, but there are some questions that have no answers and may never have answers.

The way forward isn’t controlling and overcoming, it’s surrendering. “It’s sort of a mind game to live with unanswered questions, but it helps to lower the stress or anxiety associated with the ambiguity,” Boss says. One method she recommends is meditation. “It’s always good, but it’s especially helpful when you’re faced with questions you can’t find an answer to. It helps you lower the need to control and find answers.” Searching for certainty has a lot to do with a need for control and mastery, which often serves us well, but when there are no answers it’s self-defeating. “I think we have to consciously, mindfully, say, ‘I will not be able to find the answer to this,’ or maybe, ‘I found the answer and I don’t like it, but I have to be able to make that less important so it doesn’t control my life.’”

Part of the solution is deciding to accept the ambiguity using both/and thinking, which Boss describes as holding two opposing ideas in one’s mind at the same time. It’s a way of acknowledging that there may be more than one way to look at something, and though the views may be contradictory, they are both true. A woman who was abandoned by her mother, for example, might say, “I both will never know my mother, and I have loving mother figures in my life.” Another example, Boss says, is, “I am both sad about my lost hopes and dreams, and happy about some new ones.”

In large part it’s a matter of “learning to live in the now, of acknowledging and recognizing for yourself that there’s a part of your past that you’ll never claim, and although that’s not okay, it’s something you can live with,” according to Kathleen R. Gilbert, PhD, professor emerita in the Department of Applied Health Science, Indiana University School of Public Health-Bloomington and an Association for Death Education and Counseling Fellow in Thanatology (FT).

If you’re in the grip of an ambiguous loss, these coping strategies may sound either far too difficult or much too simplistic, too paradoxical. It might be hard to hear that the solution to ambiguity is acceptance. But, as the experts indicate, there’s no way to create certainty in an inherently and invariably ambiguous situation. Continuing to obsessively question and wonder about things that can’t be known, says Gilbert, “trying and trying to find answers when there are none is like a fool’s errand.” It’s frustrating to hear, she admits, that the answer may be “mindfulness, centering, accepting, and giving yourself permission to be okay in this present moment with where you are and what you know.”  It may make you want to throw up your hands and scream, she says, but the only way to ease the suffering is to learn to react differently.

It’s also helpful to find creative outlets, both to reduce stress and help make meaning when meaning is difficult to grasp. Boss recommends arts-related activities and storytelling. Journaling and creative writing are extremely helpful, she says, as are painting and physical activity. “Movement is exceedingly important to work out stress. It’s a Western idea that you need to sit in a chair and face a therapist. It’s not always the best thing to do.” Sitting in a therapist’s office, for people who have been traumatized, may be less useful than if the therapist would go for a walk with them. You can explore these activities on your own or look for an arts, music, or movement therapist to guide you.

These activities, says Gilbert, may be among the ways you can make meaning when there seems to be no meaning, to make sense when things don’t seem to make sense. It’s about coming up with an explanation you can live with. “It’s not about a broader, deeper, more philosophical meaning — that’s what a lot of people think when they use the term meaning.” Instead, she says, “You’re looking for something that can help calm you and let you live your life in the world with the information you have. The question is, how can you reframe everything in a way that makes sense to you and that lets you go forward?”

Talking to other people who’ve had a similar experience is helpful as well, says Gilbert, “not necessarily to look for advice or direction, but just to toss around ideas and hear what other people have done, how they’ve made sense of things, and how they’ve functioned.” And in return, being able to help others is another way of making meaning.

Grieving, Gilbert concludes, “is really an external expression of an internal process of trying to get to be where you can live with the reality you’re in now.” When you boil it down, Boss agrees, adapting to ambiguous losses comes down to this: “We can’t always have what we want, and we can learn to live with that. Hopefully you get 90% of what you want, and I think we can adjust our coping style and build our resistance to live with even that 10% we can’t have.”

By B.K. JacksonWhen Julie Lopez was born, she was removed from her first mother and taken to an orphanage, where she lived without a primary caregiver for two months until she was adopted. She had a good upbringing in a loving home, yet for much of her life was troubled by puzzling symptoms. At one point, for example, she experienced dizzy spells and disorientation that made her feel “as if time moved out of space.” She went to a neurologist who prescribed medication for what he believed to be extra electrical activity in her brain. “My life was pretty great, so some of the symptoms I had were inexplicable to me.”

It’s a phenomenon she believes is common among people who believe their early lives were essentially carefree. After working with a therapist skilled in brain-based therapies, she came to know that some of her symptoms were triggered by behavior-influencing codes stored in her implicit memory — the memory that can’t be consciously accessed. As a result of that therapy, the symptoms dissipated. Lopez attributes much of her own personal therapeutic success to those early experiences with brain-based work.

Cracking those codes is the subject of her new book, “Live Empowered!: Rewire Your Brain’s Implicit Memory to Thrive in Business, Love and Life.” There, she explores how these memories, which normally help people function efficiently, can become tripwires, setting off cascades of negative emotions and destructive symptoms.How can you be affected by experiences about which you have no memory or that happened before you were able to understand and express them through language?

It all begins in the hippocampus, a part of the limbic system, which controls the autonomic nervous system. It’s the part of the brain “responsible for coding and putting date and time stamps on our explicit memory — the memory we can consciously recall,” says Lopez. There are four circumstances during which information is stored in implicit memory.

1. When an individual is in the first three years of life, before the hippocampus is fully developed
2. Following a physical brain injury that damages the hippocampus
3. When stress levels are high, cortisol levels rise, and the hippocampus shuts off
4. When bodies dissociate from the experience of extreme trauma and the hippocampus similarly shutters.

Implicit memory, says Lopez — founder of the Viva Center, a Washington, DC community of therapists specializing in brain- and body-based therapies and a trauma-informed approach to healing — is a concept developed in the early 1900s by a number of scientists in different disciplines to explain how our systems hold data that we don’t consciously remember.

Every human, says Lopez, has implicit memory, which she describes as a hidden control panel in the brain — not one you can consciously direct, yet which holds all the data that informs how we live. “Everything stored in implicit memory is there to help us in our most primary function, which is to survive and to excel.” Although we can’t directly tap into this vast reservoir of experiential data, it nonetheless influences our behavior and wellbeing, both positively and negatively.

Suppose, for example, there had been a time you felt unsafe during your infancy and that period of danger coincided with a terrible windstorm. Those experiences were encoded in your implicit memory. Now, when a strong wind blows, you may feel your heart rate rise, your palms sweat, and your breath quicken — reactions that may make you afraid of going outside. You don’t remember the inciting event or the windstorm. All you know is that when the wind kicks up, it stirs strong emotions. Or perhaps you were terribly frightened in infancy by a man with a big bushy moustache. Even now, without knowing why, you may recoil from anyone with similar facial hair. These implicit memories can be triggered by any sensory information — a scent, a color, a sound, or anything felt or observed.Infants and babies taken from their birthmothers tend to perceive that severance as a danger, a threat to their well-being. The physical sensations associated with being removed from their mothers and the consequent feelings of being unsafe are stored in the body and the mind as implicit memories — remnants of trauma that remain and can cause distress throughout life. But because individuals don’t understand these as memories — that is, as narratives they can express — they may not identify their experiences as traumatic or link their distress symptoms to these early preverbal experiences.

The loss of a primary care person, Lopez explains, is significant, and deprives a child of mirroring (when a parent reflects a baby’s emotions as expressed by voice or expression) and attunement (a sense of safety that develops when parents are responsive to an infant’s needs). Often, those who didn’t have those primal experiences have symptoms of anxiety related to friendships and intimate relationships. “That struggle can look like any part of the classic symptoms for PTSD,” says Lopez. “It doesn’t mean they meet the diagnostic criteria, but they’ll exhibit avoidance of things associated with vulnerability in relationships.” Other symptoms may include flashbacks, nightmares, dissociation (a sense of separation or disconnection from oneself), anxiety, and depression. They may rely on coping strategies to avoid having to be close, such as excessive drug or alcohol use or other types of behavioral addictions that help them avoid what they see as threatening.

“There may be codes that are put in our brains that tell us the way to get through life is not to attach to people, because when you really attach, you get hurt,” says Lopez. Many people who’ve had great losses in their lives or in relationships, she adds, have had those types of codes embedded without being consciously aware of it. She’s worked with clients who say they want a relationship, yet their behavior tells a different story because of those codes. Thus, for reasons they can’t understand, adoptees may fear being abandoned, be unable or afraid to securely attach to others, or find it difficult to trust people.

Similarly, those who were not raised by their genetic parents, even though they may not have been aware of that fact until adulthood — NPEs (non-paternal events or not parent expected), donor conceived people, late-discovery adoptees — also are likely to have been imprinted with memories about which they have no conscious awareness and which may cause dis-ease. They may react in ways they don’t understand to people, places, sights, sounds, smells, or other sensations associated with childhood experiences.

NPEs and others also may have stored sensory data from subtle or outright signals they observed that indicated they didn’t belong, were unwanted, or were a source of conflict between their parents — sensations that may stimulate feelings of disconnect, alienation, and inauthenticity. “When a child grows up without genetic mirroring and in situations in which there is deception — when the parents are actually sitting on a secret — the child picks up on data energetically, in a nonverbal way, and those pieces of information can be stored in implicit memory,” says Lopez.

Furthermore, she adds, “There are some physical and visceral experiences that go along with being disconnected from people that you’re related to.” Although in her practice she most often sees clients with expressions of anxiety, others may present with feelings of hopelessness and despair. There may be uncomfortable bodily sensations and symptoms such as those associated with obsessive-compulsive disorder, “where they have a compulsive drive to put things where they belong or keep things in order or a difficulty handling stress either personally or professionally. They may have overly controlling behavior because it feels scary to loosen the reins on relationships.”

They don’t grasp that they’re being triggered by unconscious memories. It’s as if they’re being sent signals that they can’t  see, hear, or understand. So the feelings their memories engender may seem to make no sense and to be incongruous to the situations in which they arise. And when symptoms occur, clients have no reason to suspect they’re linked to past experiences. But, says Lopez, symptoms are always telling a story. The question, she adds, isn’t what’s wrong with you, but what happened to you? When they don’t know the answer — when they’re unable to peg their symptoms to something in their past that was destructive — they may feel there’s something wrong with them, that they’re broken or defective.Lopez is dedicated to changing these destructive patterns and helping individuals realize that symptoms occur for a reason. Since traditional talk therapies are typically ineffective for treating issues arising from memories for which one has no words, she sees it as her mission to help people use more pinpointed techniques that have been advancing in the last 30 years. In “Live Empowered!” she describes three brain-based therapies — Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, and Neurofeedback — through which therapists can access the mind’s hidden control panel, explore the root causes of obstacles, and reprogram responses and behaviors.

Developed by clinical psychologist Francine Shapiro to mitigate symptoms linked to traumatic memories, EMDR is an evidence-based therapeutic method that relies on bilateral brain stimulation, whether through eye movements, sound, or touch, to target and process memories stored in the nervous system and manage maladaptive behaviors that stem from them.

David Grand, PhD, who discovered Brainspotting, describes a brain spot as a “a point in visual space that a client has a strong reaction to.” With his technique, a therapist uses a pointer to guide clients’ eye movements across their fields of vision to help identify those points, which, Lopez writes, “hold an active memory (explicit and implicit) tied to an undesired symptom or corresponding to the neural pathway you want to modify.” Brainspotting helps them process and let go of the stored emotions.

Neurofeedback, or electroencephalogram biofeedback, is a therapeutic strategy that that tracks brainwave activity and teaches clients to modify their brainwaves. When those modifications move in a direction that influences the brain to function more efficiently, clients receive visual, auditory, or other types of feedback that reinforce their efforts.

Each of these techniques is effective due to neuroplasticity — the brain’s ability to adapt, reorganize, and form new neural connections. These aren’t the only approaches to accessing implicit memory and treating trauma. Other approaches falling under the umbrella of somatic therapy are used by some therapists to target the encoded memories through the body rather than the mind. And therapists can use many additional nonverbal approaches outlined in “Live Empowered!” to decode implicit memory.

Working with implicit memory, Lopez observes, is a great opportunity to clear troubles or roadblocks that might otherwise impede individuals for the rest of their lives. “It’s about changing the codes that are driving what’s going on now so that people can live more productive lives, be successful, and feel good about themselves.”

Check back for more in-depth explorations of these individual brain-based therapies as well as somatic therapies that may also be helpful for problems arising from trauma stored in implicit memory.In addition to reading her book, you can learn more about Lopez and the techniques she uses at her website and in this episode of the Adoptees On podcast.