One of the perks of my job is getting to interview people I’ve admired from a distance. Imagine my happiness yesterday when I talked with Dr. Charles Nelson, Professor of Pediatrics at Harvard Medical School, the Richard David Scott Chair in Pediatric Developmental Medicine Research at Boston Children’s Hospital, and one of the leading experts on how early childhood neglect, abuse, malnutrition, institutionalization, and prenatal environment affects children. Truly a great show!


We talked about many things including the effects of pre-natal exposure (drugs, alcohol and metals), institutionalization, malnutrition, and maternal stress on adopted children both as kids and as adults. He talked a lot about attachment and age at adoption. I so appreciated that he actually answered the questions and didn’t hedge his answers so much as to be useless.
Scientific Evidence for the Primal Wound Theory?
I’m still mulling over his thoughts on the primal wound theory. We received a question from an adult adoptee asking about the effect of removing a child from her birth mother, even when the child received good loving care. I extended this question to what has been called the primal wound theory by Nancy Verrier in her book by the same name. This theory holds that:
“severing the connection between the infant and biological mother [through adoption] causes a primal wound which often manifests in a sense of loss (depression), basic mistrust (anxiety), emotional and/or behavioral problems and difficulties in relationships with significant others… affect[ing] the adoptee’s sense of self, self-esteem and self-worth throughout life.”
Dr. Nelson said there is no scientific evidence to support this the primal wound theory that all adopted people carry a scar from being separated from biological parents. He said that countless people who’ve been adopted especially in first 2 year, but even beyond, are doing great, and “a theory that says just because they were separated from their birthmother leaves a permanent wound is just false on the face of it.” He then goes on to report on the evidence that would contradict such a theory.
Scientific vs. Clinical Evidence
I dug a little deeper because I’ve certainly heard from adopted adults that they believe many, and some would say all, adoptees experience feelings of anxiety, depression, and loss of self-worth, and they attribute these feelings to having been adopted regardless of the age at adoption. Dr. Nelson said it sounded like this primal wound theory was derived from clinical evidence not scientific evidence. Hummm, that’s something I’ve never thought about. I emailed him after the show and asked him to explain further. He said the following:
Clinical vs. Scientific: Freud was a case in point – he saw patients and developed a theory of human development. But, his theory was colored by who he saw as patients. His was a very biased sample, in two ways: those who approached him (not a cross section of the population by any means) and those he then selected as patients (neither a cross section of patients nor of the general population). Scientists, on the other hand, are more objective (or try to be) and draw from the general population.
Last difference: clinicians tend to use subjective measures when doing an evaluation, whereas scientists try and use objective measures. These can influence the results as well.
My friend The Adopted One, an adult adoptee, sent me an email right after the show. She also picked up on the distinction between scientific and clinical evidence. Her take is that scientific evidence is measurable and reproducible, while clinical evidence is neither.
The whole show was good. I liked that he specified the science vs clinical re the primal wound – science would have a hard time showing it, and what is intense for one will be minimal for another – there is always a bell curve in anything. My take is that there are some common feelings (why they have defined core issues) that resurface at many points in life – like any grief or loss. People get too caught up in the title.
Thoughts?
Image credit: ashley rose
I was delighted to read this article because it challenges the fatalistic view of adoption here’a a podcast to challenge it further https://thriving-adoptees.simplecast.com/episodes/primally-wounded
Thanks for reading and sharing an additional resource to consider. Looking forward to listening to it!
You’re welcome Tracy – please do let me know what you think. It’s a very personal pretty counter-cultural take. There’s a lot more resources including videos for both adoptees and adopters on my website http://www.thrivingadoptees.com looking forward to hearing your thoughts
I’ve recorded a podcast about the Primal Wound here https://thriving-adoptees.simplecast.com/episodes/primally-wounded
For me as an adoptee its real.
In my case there were multiple abandonment-s as a result of my adoptive mother dying and my adoptive father leaving my with a cousin to seek help for himself as it was the second death of a spouse for him.
There is a saying “as the sapling is bent so the tree grows”.
As to clinical vs scientific I think the lack of evidence can be easily explained by noting that even in a normal/biological probably dysfunctional families there can be equivalent traumas causing similar outcomes. ( 85% of families in Australia are defined as dysfunctional by psychologists! / Interestingly American Author & Pastor Norman Vincent Peale noted that by grade 4, 85% of children are “I can’t-s”).
Dr Nelson might do well to consider the “7 Up series by Michael Apted” & the Catholic saying used there “Give me a lad until 7 and I’ll give you the man”. And possibly give consideration to karma also, which according to psychologists many of us believe in, by virtue of the fact that we tend to think that poor people deserve what they get. Even science gives credibility to karma in accepting genetic heredity esp. of emotional traits up to 40% 🙂
Do any scientific comparisons exist, of institutionalized and naturally-mothered neonates? e.g. general health data, weight gain/loss, sleep patterns, time spent crying/ playing/ moving/ lying still – data from which inferences could be drawn.
This podcast will be of interest to you: Helping Childen Heal from Past Trauma and Loss. Additionally, check out our podcast on the TBRI model, which is evidence-based.
Thanks Tracy – will do!
Right on, adoptive parents, keep on discrediting and ignoring this theory. You know what you can’t discredit or ignore? The fact that the vast majority of adoptions are open now because that is what both natural parents and adoptees want. In fact, they have been fighting for it through the adoption reform movement since the 70s (which hopefully you have read about thoroughly). If blood relation doesn’t matter – if there is no connection between baby and mother – then why would this be the case? Your answers, I’m sure, will be amusing. Ain’t denial fun?
try making that comment again – perhaps without the anger and accusatory agenda…. It might be a good idea to NOT generalize your own experience to all other baby/mother relationships….
My adoption was open and I wish it hadn’t been! It was done for the benefit of my birth mother, not for me. Don’t generalize.
I am the birth mother of a 23 yr old daughter I adopted out in the 90s I am yet to read this book and feel I should have some councelling. I say this as I am in the process of putting everything into pospective before I even contemplate the steps at making contact with my daughter. I am so desperatley wanting to tell my side of the story to her but although she may reject any contact terrorfies me. I want to put this experience right. I have had an open adoption and her parents are encouraging ger to make contact they know I love her they have brought her up knowing she was adopted. And becaouse she has this knowledge I pray tge journey I am abt to embark on wilk be a positive one
Annette, I share your prayers! Please consider joining the Creating a Family Facebook Support Group (https://www.facebook.com/groups/40688106167/) We have many adoptees, both in reunion and not in reunion, in this group and I think it might be helpful for you to have their input. It’s a closed Facebook group so that only those in the group can see the posts.
Interesting idea. As someone who has never adopted a child or adopted out, I’ve never heard of this. It’s good to open my eyes up to something that may or may not be a problem for me one day.
I’ve encountered plenty of adoptees who don’t embrace the primal wound theory, but I’ve also observed (unscientifically) that adoptive parents seem more eager to dismiss the theory than adult adoptees. Whether it’s rooted in the science of early development or not, the fact remains that many adult adoptees find the language of the primal wound extremely useful. Many of us grew up with language that was given to us by our parents and others regarding adoption. In essence, we were frequently told how we should feel about adoption and rarely asked how we really did feel about it. As we enter adulthood, we struggle to reconcile the discrepancy and to find language that fits our experience. For many adoptees, discovery of Nancy Verrier’s work is a profound and life-changing experience. Finally, here is someone who understands! Finally, here is language that “fits.” The relief at being understood at last is tremendous. It may be tempting to dismiss this response as “confused” or “unscientific,” but I think that’s a mistake. Far better, in my opinion, is to ask what it is about Verrier’s work that makes it so appealing to adoptees. We can decide that the “wound” is more of a metaphorical expression than a scientifically proven theory, but it still expresses something that is profoundly “true” for many adoptees. I caution adoptive parents (and I am one, too, as well as an adoptee) against being too eager to declare “The primal wound is bunk!” In doing so, you may be closing yourself off to an important part of your child’s experience. And yes, it’s true that every adoptee processes differently & we can’t assume that _every_ adoptee will relate to primal wound language. And we certainly don’t need to impose primal wound language on a child, any more than we need to impose adoption-positive language. I think we do best as adoptive parents when try to let the adoptee define his or her own experience, as much as possible, while also understanding that adoptees express differently regarding adoption at different ages and stages.
Rebecca, you can’t see it, but I’m giving you a standing ovation. I too have observed that adoptive parents seem more eager to dismiss the theory than adult adoptees and that this language rings true for many. To dismiss their feelings for lack of “scientific proof” is meaningless. On the other hand to conclude that ALL adoptees feel a sense of anxiety, depression, and loss is over-reaching. For those for whom the language of the primal wound fits, more power to you. Ditto for those where the primal wound language feels alien. The universe of adopted people is big indeed with room for many differences.
The primary room theory is very real. Just look at the research. Good deal I’m adopted children and up with severe difficulties such as depression and attention deficit disorder. There is tons of research out there to show this is true. The Chi is telling the child they are adopted at the appropriate age and helping them to explore their own biological origins.
Thank You Dawn for acknowledging that “The universe of adopted people is big indeed with room for many differences”…. As an adoptive parent of 2 – one of whom seems quite moved by this theory, and another who sees it as a something written up by someone who had a bad adoption experience, I do think individuals bring their own selves to any “belief system”. I am so uncomfortable with the idea that one “theory explains all…” in fact, I would say that “The universe of ALL PEOPLE is big indeed with room for many differences”. Of course, my own experiences and background color my own view, and now matter what, I just want both my kids to be happy and comfortable in their lives…
I agree that the difference between scientific and clinical evidence is important to note. In fact, I believe that one of the shortcomings we have in the adoption community is over-reliance on clinical evidence. For example, we pull a great deal of information from panels and small groups of adult adoptees (think panels or authors) and then generalize their experiences to all adoptees without acknowledging that there is a huge population of adoptees who are not active in the adoption community who we never hear from that might have a completely different take on the same questions and situations.
Our organization tried to reach as many of these “silent” adult adoptees as possible through a survey that reached out to adopted people 18 years and older not only through adoption related avenues, but through common sites like Craigslist and Backpage to name a couple. You can read more about what they had to say about open adoption at Their insight and 281 voices helped shape our online course, Opening Up Open Adoption.
Katie, I think your point about over-reliance on clinical data in adoption was the point that Dr. Nelson was trying to make. I’m going now to read your survey!
I think the theory has taken on a life and meaning of its own far beyond the original book. In my opinion, it has become a tool or excuse to label adoptees as damaged unfortunately. I have heard potential adoptive parents simply scared to death by this idea – which I don’t believe was necessarily the intent of the original premise. I support that for some people her book was validating – and I don’t want to take away from the fact that it resonates with some adoptees. But, on the flip side I will tell you that I’ve personally been told that I was just unenlightened and repressing feelings if I didn’t feel wounded. And THAT is the issue I have with what the primal wound theory has become in the adoption world.
Exactly this! Although I have not read the book itself, I was introduced to it on reddit adoption forums by people who take it literally and think 100% of all adopted children are traumatized by definition, and they think it’s based in scientific fact. As an adopted child, I find this mentality incredibly alarming and the entire theory seems very self-defeating. Telling adopted children they are inherently traumatized seems like a strange, disempowering, and irresponsible message to send, especially if the evidence is solely anecdotal. I could also see this book having an negative impact on potential adoptive parents, scaring them away due to fear of having a f*cked up kid. The fact that the book has been out for over 50 years and no follow up studies have been done is a major red flag. If this book helps some adoptees, great, but to generalize this theory to *all* adoptees is dangerous and may do far more harm than good.
Thanks for this post and show, Dawn. As a pre-adoptive parent I was of course concerned when I first heard about the Primal Wound but I just can’t subscribe to the any theory that says any group of the population will react the same way to any given experience. Of course adoptees are affected by adoption, but there lives don’t have to be defined by it and they aren’t automatically doomed to live of a life full of anxiety and low self-esteem.
I wrote a post about my thoughts on this subject a few weeks ago:
I am a mom (by both birth and adoption) who was often the champion of respecting this theory, and those for whom it resonated, among my online and IRL adoption community of PAPs and APs (who were often quick to dismiss it) before I actually brought my son (by adoption) home. I felt it was important to just listen without reaction and try to learn from those for whom this theory held weight. I still do believe that. Mostly, I believe it’s important to listen and validate and not judge and not react (not always as easily done as said, of course) based on self-preservation or self-defense (this is important everywhere but extra important in adoption land, I think).
However, in *my personal experience* it’s hard to imagine that my son (through adoption) is affected by the primal wound. At 2.5-years old he is (and always has been) just the happiest little child you could ever meet. In fact, people (from his doctor to strangers in the supermarket) are constantly asking me, “Is he *always* this happy?!?” This kid just radiates joy. And he’s not old enough to be suffering from the “good adoptee syndrome” of always wanting to please for fear of being rejected. He has no understanding of his adoption status (though we are very open with him he’s just too young to grasp these concepts). So … I definitely think it’s incredibly important not to assume that ALL adoptees are suffering from this.
Just as much as “primal-wound-affected adoptees” want us to honor and respect their feelings, I believe some of them have some work to do in order to also honor and respect the feelings of adoptees who do not feel wounded. I wish that, just as I worked hard to accept the idea that my future child might suffer from this wound, some of them might work hard to accept that some adoptees do not feel wounded, and it’s not just because they “drank the coolaid” and are “in denial” or “young” or whatever other insulting reason I’ve seen given to dismiss the feelings of adoptees who aren’t angry or suffering or wounded or …
(Sorry, I’ve had some wine and seem addicted to parenthesis) 😉
{smile}
It’s also important not to convince yourself that your son does NOT or will not suffer any ill effects from being taken from his natural family. My parents would have said the same, especially when I was two and a half. They were wrong.
At 2.5 years old?
Check back in when’s he’s in H.S.
LOL.
Right? Or better yet when he’s 40. And even though I’ve been reeling inside my whole life, everyone around me thinks I’m just fine. If only all of the adoptive parents could realize that the more they deny the effects of separating a child from its mother, the more harm they are causing to the child.
We brought our daughter home at 2.5 years and she was the most joyful child you ever met. A smile, hug, kiss for everyone. Every day was her birthday. Her exuberance filled up every room she was in. Joy, pure joy. Now she is a teenager and it has not been easy. Our once joyful child is struggling so much to find her identity, come to terms with being let go from a birth family that is still intact (even though dysfunctional) and her struggle to make peace with a birth mother she wept to find, but now cannot face for fear of secondary abandonment. Her birth mom loves her, grieves for her, begs for forgiveness, but our daughter cannot yet face her. She and her birth mom are swirling in absolute raw emotions-as are we, but we are the anchor for both of them. But yes, when our daughter was little she also was the most carefree joyful child you could ever imagine. No a care in the world. Now she carries the weight of her world on her shoulders. She’ll get through it. We are there for her.
He is only two. Most adoptees don’t have troubles until the teen years and then we hide them. We hide them because we don’t want to hurt you. Statistics say teen adoptees are more likely to commit suicide. Adoption organizations don’t want to lose their cash cows so they will continue to say adoptees aren’t traumatized. Check out the Facebook page Is Adoption Trauma to hear the voices of adult adoptees
Michelle, I’d also suggest that you consider our online community for voices of adult adoptees. http://ow.ly/OO2830ff3cb
Mani – What a lovely, thoughtful comment. Refreshing that someone can consider both sides!
As for the other commenters on here – Show me a teenager that *is* well adjusted XD They’re teenagers! It’s a tumultuous time. Everyone calm down and just let people be people, without projecting your own issues on to them.
As both an adoptee and an adoptive parent, I am happy to see that the “primal wound” theory is being challenged. I balk at any theory that says a certain experience will have a universal effect. Let’s allow every adoptee to determine for themselves if, and in what ways, their adoption has affected their lives. Without judgment, please.
If you have actually read the book, you would see that it never says there is a universal effect.
Thank you for this. I’ve always had trouble with the idea of a primal wound and it irratated me that if I didn’t feel it there was something wrong with me or I was in some type of major denial. It still doens’t describe me, but at least it kinda makes sense to me.
Allie Ferguson – great post! I of course have my own opinions about the PW theory, and I appreciated the distinction that was pointed out in Dawn’s post. As an adoptee, I bristle when someone tells me how I feel or decides to speak for the entire world of adoptees.
The concept that everyone in any group feels XXX is so terribly wrong and limiting in my opinion. Adopted persons (like everyone else) are individuals, with individual stories, each unique. I think it is damaging to assign feelings to an entire group of people, and I really dislike the attitude that sometimes comes along with it, that if an adoptee doesn’t feel this way, they are just unenlightened.
Brilliant distinction!
I used to read a great blog written by a psychologist who did scientific research. She had a number of posts that debunked the primal wound theory. Unfortunately, I think she changed feeds/hosts and I lost her.
Allison Boynton-Noyce wrote an excellent post on her blog about being offended by the notion that, just because she was adopted, that meant she was wounded.
I don’t buy the primal wound theory. If my kids someday read the book, and say “yes, this is how I/we feel” then I imagine I would read the book. However, I don’t think I’d buy into the primal wound theory. As Tao said, there are common feelings, but we don’t need to get caught up in the title.
As for the idea that “adoptees experience feelings of anxiety, depression, and loss of self-worth” – doesn’t everyone? DH wasn’t adopted or abused as a child, but has serious issues with depression and self-esteem.
Don’t worry, they’ll never discuss it with you.
Adoptees learn young not to tell adopters the truth.
Expecting otherwise is delusional on your part.
You are exactly right, Lisa. She’s not even willing to read the book before denying it. That shows that she is leaving little to no space for how they might feel and they will know it. We adoptees can feel the resistance of adoptive parents to exploring what we are thinking and feeling inside, so we just close up and don’t let them in. They don’t even have to read the damn book if they’d just listen to us.
You’re generalizing, just like the book does. I never had issues talking with my parents about my adoption, nor do I feel traumatized by my adoption. Please be kind, and don’t assume everyone has had the same experience that you have.
I wonder if anyone is conducting research in epigenetics on this and similar issues. The concept that one environment shapes us in one way (expressing one set of genes) but when removed or change that environment other genes can be activated, other biochemical pathways will be triggered and due to system resiliency and redundancy, those deficiencies can be overcome. Dr. Nelson touched on this but the field of epigenetics is in its infancy and there is SO much more to learn about nature/nurture. I suspect there is hardly anything hard wired when it comes to behavior with some genetic exceptions.
I’m not judging the book solely on the title. I’m judging the theory that “severing the connection between the infant and biological mother [through adoption] causes a primal wound which often manifests in a sense of loss (depression), basic mistrust (anxiety), emotional and/or behavioral problems and difficulties in relationships with significant others… affect[ing] the adoptee’s sense of self, self-esteem and self-worth throughout life.” I disagree with the entire premise.
Erin, Dangerous and disrespectful. I don’t think Dr. Nelson was denying its existence in individuals, he was addressing, as I understood him, its applications to the group. I think that was his point in making the distinction between clinical vs scientific evidence. I’d love to hear your thoughts. Have you had a chance to listen to his interview?
I have had some very interesting conversations about this theory with a group of adult adoptee family members and friends. In my non scientific own world, it just didn’t seem to resonate within that group. So my opinion is that the people who it doesn’t resonate with are the ones you probably rarely hear from.
I do not believe this theory. Many may not like my opinion on this, but I feel comfortable enough here to speak it. I believe this is a theory many use as a crutch. While I do believe some adoptees do have some difficulties with some things that might have stemmed from their adoption or the fact that they were adopted or do not know their roots, I do not believe the actual act of separation at birth is the cause of it. The characteristic and feelings that the ‘primal wound’ allegedly causes I have lived/live myself, and my biomom raised me although I was paternally adopted twice. I think far too often, people need someone or something to blame, and I believe the ‘primal wound’ is one of those things. This is my opinion and I respect those that differ from mine, and would appreciate the same in return.
Just because you have experienced some of the same issues that are effects of the primal wound do not mean that the primal wound doesn’t exist or cause those effects. I can have pain in my stomach from indigestion but that doesn’t mean that pain in my stomach might have been caused by an ulcer instead. It’s extremely dismissive if I come to you and say that my stomach hurts all the time and I think I have an ulcer and you say, “Well, everyone has stomach aches. I refuse to believe it’s from you have an ulcer because plenty of people who don’t have ulcers have stomach aches.”
Sue, like you, it is the universal application of this theory to all or most adoptees that I find troubling, but as someone said earlier, I’ve noticed that adoptive parents raise more objections to it than do adult adoptees, which has to give me pause. Your opinion as an adopted person carries more weight.
In case I wasn’t clear in my earlier comments, I in no way believe that the theory has no merit, the concept that it universally applies to all adoptees is the part that I reject.
I’m not an AP, Adoptee or even PAP (at this point). I also haven’t read the book though if my wife and I were to become adoptive parents one day, I’d definitely read it for my own general knowledge. So you all will have to take my opinion with a grain of salt.
It seems to me that this is impossible to prove one way or another from a scientific or even clinical study for that matter. First thing is that it’s not as if a new born or infant can communicate when they are separated from the woman who gave birth to them and whether they hurt or don’t hurt. Second it’s not as if as an adult an adoptee can remember what they were feeling when they were separated from their mother. It’s not a guarantee the baby feels a loss but it’s not out of the question either that they could experience a loss as a baby.
Whatever is reality will likely never be known. But I think it’s important for non adoptees especially those who are parenting adopted children to not dismiss it. When we dismiss it we make it seem like the adoptees who are experiencing it are crazy which is wrong. If anything we should be listening and learning from these adoptees.
The best thing IMO APs and BPs can do is prepare themselves that their child could experience this. And should also keep in mind if they don’t dismiss it and their child does experience it that it has nothing to do with them as parents. It doesn’t mean they are bad parents or did anything wrong. It was something that is out of their control.
You should read up on implicit memories and how trauma that occurs in our ore-verbal development affects the body because that is exactly what you are discussing here. I don’t “remember” learning how to walk, but my brain does. Everyday when I get out of bed, my legs carry me to where I want to go. Being able to recall the event doesn’t mean that you/your brain don’t remember it.
Erin, I agree.
Dawn Davenport, I haven’t had a chance to listen to the interview, so I wasn’t responding to him. I guess I think it doesn’t really matter if physiologically, the hurt was caused by separation from biological mother or something else, it’s the person’s experience, so you have to start there.