It’s not my fault, it’s yours: shame, loss, and the ego ideal in work with adoptive couples

ABSTRACT

Work with adoptive parents can be complex due to the multiple experiences of loss often carried by the adopted children and by the adoptive parental couple. This paper explores some of the emotional states and dynamics these experiences of loss give rise to, with a specific focus on the parental couple relationship. The case is made for the efficacy of psychotherapy with the couple, the difficulties of managing losses which can generate feelings of shame, and the projective use of blame within the couple and family as a way of evacuating unbearable emotional states. The concept of ego ideal is reviewed, and the need for adoptive couples to relinquish and mourn what is conceptualised as a shared ego ideal. The creation of a more realistic ego ideal is described as a particular aspect of the process of moving from the couple imagining themselves as birth parents, to their aspirations as an adoptive couple. Clinical material is used to illustrate how shame may manifest itself in an adopted child in psychotherapy, and in work with adoptive couples. The inevitably painful nature of mourning, and work with a couple struggling with this, is described.

KEYWORDS:

• adoption
• adoptive parents
• shame
• loss
• ego ideal
• couple psychoanalytic psychotherapy

Acknowledgements

My thanks to Mary Morgan and Margaret Rustin for their helpful comments on an earlier version of this paper, and to Maria Papadima and Rachel Acheson for their sound editorial guidance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. For confidentiality reasons, I have used anonymised, disguised, and composite clinical material and family settings, and I have also included some material where informed consent by specific parents has been sought and agreed upon. The composite clinical vignettes are from a variety of clinical contexts in which I’ve worked with adoptive couples over many years. I have encountered multiple versions of the family and couple situations described, so while each family is unique, there can be many similar features and dynamics. In drawing on my clinical experience in this way, I have endeavoured to stay faithful to the emotional quality and nuances of the communications, experiences, and dynamics involved.

2. In the case of same sex couples, although their sexual coupling per se doesn’t carry the possibility of conceiving a baby, I would argue that their sexual intimacy and relationship can be the ground upon which their shared aspiration grows.

Additional information

Notes on contributors

Simon Cregeen

Simon Cregeen works independently as a child and adolescent psychotherapist and couple psychoanalytic psychotherapist. For many years he was Head of Child and Adolescent Psychotherapy in Manchester and Salford NHS CAMHS and taught on the clinical training at NSCAP. He teaches and supervises and has published in the Journal of Child Psychotherapy and elsewhere. He was involved with the IMPACT adolescent depression RCT and is a co-author of Short-term psychoanalytic psychotherapy with adolescents with depression: A treatment manual (2016). He is a Trustee of Manchester Psychoanalytic Development Trust.