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.
Image credit: ashley rose