‘Something more than one phase of treatment’: Sunaya, an adopted adolescent patient who asked to return to therapy

ABSTRACT

This paper discusses my work with Sunaya, an adopted adolescent girl who asked to return for a second phase of therapy. This happened several months after her first phase of treatment had abruptly been brought to an end, due to unsolicited organisational changes. Sunaya’s search for identity was severely compromised by her having been abandoned at birth by her biological parents to a foreign orphanage, and subsequently being adopted at five months of age. In this second phase of therapy, I was struck by the extent to which Sunaya was now so suddenly driven to make sense of her origins in open discussion, managing to process and integrate the biological and adopted parts of herself in a way which had not seemed possible in our earlier work. This enabled her to make considered decisions about the next stages of her life post 18. I suggest that the original ending of Sunaya’s therapy, followed by our therapeutic reunion, represented in her mind a reunion with her biological parents; within the therapy Sunaya’s curiosity and ambivalence about such a reunion could be safely worked through. I link Sunaya’s request for ‘something more’ than one phase of treatment with Stern’s ideas about offering ‘something more’ to some of the most deprived patients in therapy. I further suggest that Henry’s ideas about some fostered and adopted children being ‘doubly deprived’ helped me understand Sunaya’s need for a ‘double dose’ of therapy, in order to redress how she had internalised multiple experiences of deprivation. This further helps us understand the need for looked after children to develop stronger attachments in multiple contexts.

KEYWORDS:

• Adoption
• child psychotherapy
• CAMHS
• adolescence
• double deprivation

Acknowledgement

I am grateful to Sunaya for consenting to the publishing of this material. Sunaya had already consented to the publication of her material for an earlier paper of mine about the possible unconscious underpinnings of adolescent overdose (Mirvis, 2018). In asking Sunaya a second time for her consent to publish material, I think she also gained a strong sense of her importance in my mind, and of the extent to which I was trying to make sense of her. This perhaps also deepened the alliance between us, in a way which facilitated further therapeutic development for Sunaya.

Disclosure statement

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

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Hillel Mirvis

Hillel Mirvis is a Senior Child & Adolescent Psychotherapist and Service Supervisor based at Dunstable CAMHS, having previously been at Barnet CAMHS (West) for ten years. Following qualification as a child psychotherapist at IPCAPA, he has been a Work Discussion Tutor on the Masters in the Psychodynamics of Human Development at the British Psychotherapy Foundation (BPF), and is currently a member of the Training Advisory Group (TAG) at IPCAPA. He has a particular interest in psychotherapy with adopted and fostered children and disturbed adolescents, and has published several papers in these areas.