should applicants for adoptive parenthood be rejected? Should they
be informed by letter or in person? Should they be told candidly
about any disqualifying factors revealed during the home
study or should they be let off the hook more gently, by referring
to agency policies, baby shortages, or other equally impersonal
factors? There were a wide variety of answers to this question in
adoption practice, but it is fair to say that agency workers often
withheld details from couples when they thought these might be needlessly
destructive and hurtful. In the case described here, that is what
happened. In consultation with agency staff, psychiatrist Viola
Bernard suggested that greater honesty might have been a viable
course in this case, but only if it ultimately served a therapeutic
purpose. The excerpt is drawn from two separate documents: the case
summary and notes summarizing the staff seminar about the case.
This case is being presented as a springboard
for discussion around the handling of rejection. . . .
The question has been raised as to the validity of direct handling
with the client around reality factors in rejection rather than
the continued statement of the Agency’s limitations.
Mrs. S is 30 years of age, her husband 34, and they have been married
for 9½ years. They requested the adoption of a child under
a year of age. . . .
The problem here is one of spontaneous abortion. There have been
five altogether. The first occurred in 1940 and the second in 1945,
all ending around the third month. In 1948 there was a six month
pregnancy and delivery of a premature girl who lived for one hour
and one-half. In 1949 there was another five month pregnancy again
with the delivery of a premature girl who did not remain alive. . . .
They wrote to us initially two months after the last miscarriage.
They are presently using contraceptives and feel certain that they
do not want to go ahead with any more pregnancies. . . .
Both Mr. and Mrs. S. presented material in this area with great
pleasure and seemed always to want to center their discussions here.
It was difficult to separate their feelings around infertility because
of their stress of sexual denial made necessary by the miscarriages.
Both felt that their inability to have a child was something which
they should not be unhappy about but that their inability to have
intercourse during this time did present serious problems. Mrs.
S indicated to me that during the period when the doctor asked them
to abstain her husband found this so difficult that he had to sleep
in another bedroom. They had discussed this and decided that he
would attempt masturbation during this time but he was unable to
because he was “psychologically blocked”. She told me
with tears in her eyes that her one regret during all this time
that they were trying to have a child, was that she did not have
the courage to tell her husband that she would not object if he
had intercourse with another woman. She stated that she is the sexual
aggressor by her husband’s wish.
In supervisory conference it was decided to reject by letter. Immediately
following this Mrs. S called and asked to see me. I saw her three
days after the letter of rejection was sent. She was visibly upset
and indicated to me that since we were a casework agency, understanding
the dynamics of human relationship, that she felt that her rejection
here centered around problems within her husband and herself. She
at no time indicated hostility but pressed for reasons. . . .
* * *
This meeting was concerned with the handling of rejection. In general
it was felt that a worker can handle a reject directly only if she
has conviction about the validity of the basis for the reject and
about the need for direct handling. Sometimes the worker can be
more sure in her conclusions than about the way in which she arrived
at them and that makes it difficult to handle with the client. Some
of our uneasiness comes out of our self questioning, which is good
in the face of a problem of such complexity.
When rejection is handled directly we run into the possibility
of a personal showdown and there is a natural hesitation to come
face to face with the hostility of the client who has been rejected.
We are seeking to achieve a balance between the personal feelings
we have toward our clients and our objectivity which has to rest
on our professional thinking. This balance is extremely important
in handling rejection as well as in other aspects of the job. . . .
In discussing the S. case, Mrs. Goldart said that she had no doubt
about the validity of the rejection altho she was not certain about
the meaning of the material she got. Her thinking in rejection was
based on (1) the feeling in this couple that their reproductive
life was less important than their sexual life to the degree where
there was an imbalance, (2) that their relationship was so close
that the coming of a child might disturb it, and (3) their discussion
about children was so vague and unreal as to indicate unreadiness
on their part. Mrs. Goldart said that her conviction about rejection
came out of the material which they presented, rather than about
them as people, since she saw them as warmer and nicer than the
material would indicate.
In interpreting the material Dr. Bernard felt that in view of the
fact that habitual abortion represents habitual failure for a woman,
it could well be that this couple’s way of handling this problem
was to establish a closer sex connection. The material which Mrs.
S. gave us about the difficulty which abstinence created for them
and her concern about not having urged her husband to seek satisfaction
from other women rather than by masturbation, might be related to
the fact that in our culture children are taught to believe that
masturbation is wrong, and as adults we tend to look upon masturbation
as the less desirable outlet.
As regards the maturity of the S’s marital relationship,
they seem to be somewhat narcissistic people who find their own
idealized image in each other. If this is so it is valid to assume
that their relationship may be based on a complementary neurosis
which works for them both but which could be disturbed by the coming
of a child. This impression of rather narcissistic immature people
is borne out by their description of themselves as “model
children,” Mrs. S’s activities since their marriage—college,
part-time irregular employment, etc. As for the emphasis which Mrs.
S. put on their sex activity, it was Dr. Bernard’s opinion
that this would not necessarily militate against adoption, but could
be a reaction to a repressed feeling of failure of her feminine
potency, which is compensated for by her sex potency in another
area. . . .
Dr. Bernard thought that rejection without clarifying our reason
was an undefined threat, which left them only with the feeling that
they needed in a vague way to get psychiatric help to find out the
reason. A clear statement from us that we saw this togetherness
as a liability in relation to a child rather than an asset, giving
full recognition to how good that relationship is, could leave them
with the freedom to disagree, and to then project their feeling
on to us, rather than to turn it in on themselves. Dr. Bernard thought
this would leave them as undamaged as possible under the circumstances.