Submission by Dr. G. A. Rickarby, MB, BS, FRANZCP,
Member of the Faculty of Child Psychiatry,
RANZCP, MANZAP, Consultant Psychiatrist
Point of View of this submission (as well, this section deals with an aspect of promotion of adoption used in taking of consents, and the sexual myths about mothers used during coercion to take consent)
The author graduated in medicine from Melbourne University in 1956. After commencing training in Psychiatry in London, I arrived in New South Wales in late 1971 to take up a position as Senior Medical Officer at Rydalmere Psychiatric Hospital in the first week. Of 1972 and, while in this position, to complete my training in Psychiatry in New South Wales where I became a Psychiatrist in 1974.
In 1976 I returned to practice Child Psychiatry as NSW Health Department’s Child Psychiatrist for Inner Western Suburbs of Sydney until I moved to Newcastle in 1978 for family reasons and took up the corresponding position there, still flying to Sydney one day a week to continue my Sydney responsibilities until I was able to be relieved in 1983.
I had a wider role in that I flew to Narooma monthly and later to Dubbo to conduct supervision and clinics. I was the first psychiatrist to be Consultant to The Adolescent Unit at Royal Alexandra Hospital for Children Camperdown.
In 1986 I became Child Psychiatrist for the Central Coast and was based at Gosford Hospital until 1989 when I went into semi retirement, still keeping Visiting Consultancies in Newcastle and Gosford. I am now in part-time Private Practice and sit on the Mental Health Review Tribunal where, because of an administrative change, I am again to be an employee of The New South Wales Health Department from 1st July this year.
I was sensitised to the problems of mothers who had lost babies to adoption early in my medical career when a young couple whose later children I delivered, spent much of their family resources (both money and emotions) searching for their first baby who had been adopted-out against their will during their teen years. Their grief was profound and drove their preoccupations and behaviour, particularly as they saved money for expensive private detectives who provided little help.
At Rydalmere I was concerned at the number of late adolescents and young adults who were requiring management for identity disorders and depression, and where there had been major dysfunction due to disturbances in an adoptive family.
In 1974 I was giving a lecture about preventable psychiatric morbidity to a large group of nurses about the possibility of using proven experienced parents as adoptive parents, when I received a hostile response. I was told that these babies were the “right” of those who could not have children of their own, and people who were not wholly behind this were a danger to the people who would never have another opportunity of having children.
From then on I took a much closer interest In the cultural prescriptions driving adoption practices in New South Wales, ironically at a stage when it was undergoing radical change due to the social renaissance that occurred after 1972.
Taking the Child Psychiatry role for the Inner Western Suburbs of Sydney Burwood, Strathfield, Drummoyne, Ashfield and Croydon in 1976, l was to find that adoptive families were a frequent source of referal. (I put the issue in here as it is pivotal to one illegal practice in the taking of consents of birth parents: that is to idealize adoptive families as necessary and desirable for babies, and to use such images repetitively in promoting adoption to the potential provider of the baby).
The long line of mentally ill, substance addicted, maritally divided couples (over both adoption and other issues), who hadn’t grieved their own or their mates sterility whom I saw in trouble during child rearing crises when they didn’t have the resources or will to see them through, disabused me of this notion very quickly. My colleagues and I wrote about this after waiting to take a future sample: Adoptive Families in Distress. (the heavily edited version).
I looked around at the adoptive families I knew socially, and there were similar themes occurring there too, partly because the adoptive family had no training in dealing with the inevitable identity disorder of the adoptive child, because, once the adoption was confirmed, they were left to do whatever they would, with no help or guidance about the special difficulties. The cultural myth was that it would be “just like having your own children”.
Adoptive parents were given misinformation, in that there was a cultural expectation that the baby would match the family because of a skilled selection of babies, and that affluence and religion based upbringing would override other difficulties.
Adoptive parents were given no help with hard testing behaviours in primary school age, with temperamental issues that might have been expected in the biological family, or differences in style of thinking and problem solving that were inate. They were not helped with their own grief, or their deeper feelings about bringing up somebody else’s child except for the myths around the “abandoning” mother implying to the child that he or she was was much better off with them.
Overall I have seen more adoptive parents for this variety of help than I have seen relinquishing mothers.
So not only were the young mothers subject to promotion of adoption, but the promotion was in a large number of instances an outright lie, and when there were capable people adopting, they had to deal with a child different in temperament and cognitive style from themselves through an intense identity crisis, not to mention the early damage to a baby who is born into a vacuum figuratively speaking, as there is no mother to hold and suckle, her noises have gone suddenly and there is no breast smell on which to imprint – many consider this separation as primarily damaging.
When, as well as the inherent misfit, the adoption was associated with frank psychiatric illness in the adoptive family at the time of adoption, or later sexual abuse, it was difficult for Child Health professionals not to become both distressed and angry. Once the Department of Community Services signed them off and The Department of Health was distracted from other duties caring for them.
The author wrote “Family Psychiatry and The Selection of Adoptive Parents” published in the Australian Journal of Social Work and it was used widely, but it was closing the gate after the horses. The Dept of Community Services (about 198O) started using me when they thought that refusals of adoptive parents might be challenged in Court (they hadn’t succeeded in stopping anybody determined before that). I was prepared to give evidence for them.
The people I met were mostly frankly mentally ill. (I heard the argument that the mentally ill, should not be discriminated against as far as adopting children was concerned)
It is important to discuss, at this stage another myth that was used cruelly against original mothers. In 1997 I was disgusted to hear it still promulgated on a television show by a social worker who had worked in Crown St Hospital during the single mother’s holocaust from 1966 to about 1973.
What she said was that the young mother could not readily go to Court to seek support from the father because a man taken there would have half a dozen others to say it could be them just as easily, or words to that effect. This was the myth that the young woman was prematurely sexualised, promiscuous and irresponsible. This myth was widespread and a source of creating a bad role for the pregnant single girl, particularly the teenager.
Having seen a large number of relinquishing mothers by the nineties, there were many instances of first intercourse, (some of it rape), some of seminal spills in the vulva, but most numerous were those of the first boy friend and profound ignorance about sex and contraception.
On the other hand the statistics will show that there was a virtual epidemic of sterility due to what was called Non-specific oophorosalpingitis (inflamation of the tubes and ovaries – and by non-specific they meant it wasn’t due to gonorrhoea or syphilis but was later found to be due to the Chlamydia organism spread venereally. The use of high dosage contraceptive pills (the original ones used in the sixties and early seventies) were also a significant cause of sterility when premature menopause occurred.
The tragedy for the original mothers was that they were younger, and this false myth about their sexuality used by those who wished to take their consent, was to render them more powerless, guilty or shamed, and as a frank lever to humiliate them. Their seeking secrecy for their sexual involvement made consent taking easier.
It is important that this section is not seen as an excuse for the flagrant flaunting of the 1965 Act by the behaviour and decisions of those empowered in institutions of public trust, or of cruel and unethical behaviour of Dickensian proportions visited upon young women in helpless circumstances.
Inability to have Children
As already indicated, there were particulars leading to a large number of couples who were unable to have children. Effects of early contraceptives and Chlamydia infections have been already mentioned. The public were not as ready to come forward to have any venereal infection treated, ectopic pregnancy was common, and there was an extraordinary rate of premature hystorectomy performed in Australia that astounded medical statisticians in other countries.
There were some causes in males such as infective disease of the genital tract which caused male sterility, again the the public would shun treatment, however there was little that could be done about mumps orchitis in childhood or adolescence. There were many instances where nothing could be found or where there were low sperm counts of unknown cause.
In the front line in managing adoptive families however, child psychiatry clinicians were aware of many couples who had marital and sexual difficulties, who led oppositional and divergent lives where the intercourse frequency was very low or absent. This type of ailing marriage where the couple were bound together in a hostile insecure situation is not to be confused with the unconsummated marriage which was also encountered. Here the couple often had a strong loving bond, but had difficulties related to having intercourse so well described in Michael Balint’s book Virgin Wives.
The Difference in Social Power
The group of people who wanted babies (other women’s) contained a large proportion from the middle class, as a result of both being employed, having property and other assets, as well as social affiliations and status.
In this culture respectability was highly valued. In dealing with adoption agencies after 1965, these couples often related to the agency with a strong public display of praise and gratitude, and the agencies would have photographs of happy adoptive families with cards, and a sense that they had personal ties with many adoptive families as a result.
Many agencies such as the Catholic hostel for unmarried mothers at Waitara had specially selected adoptive parents come to talk to the mothers about the benefits of adoption. Many such families adopted two to four children.
The relationship had a personal element to them and there was a sense of reciprocity experienced by the workers in agencies, antenatal hostels and maternity hospitals. The overall myth promulgated was “Isn’t it wonderful we can find such loving homes for the unwanted babies”. For those with an angry adolescent adoptee in psychotherapy, this was black humor indeed.
The Cultural Underrating of the Destructive and Often Irresolvable Effect of Grief.
The next cultural issue to be considered is important because unlike many of the others discussed, it is still a major issue in the 1990’s. That is the cultural underrating of the destructive and often irresolvable effects of grief.
The cultural byte then was “They will soon get over it and be glad they are able to start their life over again afresh”. This was before the research of Madison and Raphael that showed tenfold morbidity for the bereaved, and before the comprehensive study by Singh et al of the effects of the Granville disaster and the contribution of Ms Buttrose to disseminate some of this knowledge to the general community.
The grief at loss of the baby has been compound, lifelong, full of sadness, anger and searching, and has involved much decompensation into depression and preoccupied distancing from relationships, or the person becomes an inured defence against such grief.
Nearly fifty percent were never to have another baby.
The practices of some of the hospitals around the birth were to aggravate the grief profoundly. The cultural myth was. “We have to stop her seeing the baby and give her sedative drugs – that will make it easier for her.”
Even superficial study shows these factors to be sticking points of aggravated grief. The only ones it was “made easier for” were those taking the baby.
Certainly a process like this was a response to the intuitive knowledge that the extant bond with the baby would be developing further and the resistance to signing the consent would be great indeed, despite the difference in power. This was all done before consent was taken, and in Crown St the young mother was subjected to large doses of barbiturate drugs until after the signing of consent.
One issue which could be easily obscured was the common law issues of informed consent. But at the time there was much focus on the signing of the consent. The thirty day period to revoke this was of such small moment to those administering adoption practices, that it was virtually ignored as a threat to adoption as it was easily deflected by such strategies with adult professional power as; “You don’t want to do that to your baby dear”; “You wouldn’t be able to cope dear”, and the variation of this, “We would have to take you to court because you are incompetent to care for your baby”, (Crown St used this before taking consents), “It’s too late the baby is gone”, or the variation of this is that the adoptive parents would be highly distressed.
Young mothers heavily brain-washed (and I use this term in full consideration of those practices which lead to the term becoming part of living english) hardly ever sought legal help, were readily bluffed into thinking these professionals were acting legally, and would have great difficulty in getting the correct papers to the Supreme Court as required.
It is salient that no mother went to the professionals office to say that she was ready to give consent. The professional went to her bedside and indicated it was time for the routine signing of the papers. This was described to me scores of times as being put in a manner that there was only one inevitable answer “Yes”.
However the procedure they would undergo before the fifth day of signing the consent to adoption had many aspects that should have required extraordinary attention to informed consent over and above any consent to medical or surgical procedures, some because they were part of the adoption production line (as at Crown st) and others because they were extraordinary departures from usual obstetric practice.
Such issues were the placing of screens to avoid them seeing the baby. Or pillows over the face, the immediate separation from the baby who was often taken outside to have the cord tied. (the mother ironically was the baby’s legal guardian), the administration of the drug Stilboestrol by injection (and later by mouth) to dry up the milk, and the use of powerful hypnotic drugs such as Sodium Pentobarbitone.
The capacity of these girls and young women was highly diminished during the crisis of labour, and the authoritive use of power by the professionals further diminished their capacity. Their volition to protect themselves was at a low ebb due to their dependent and extraordinary circumstances of birth, the immediate loss of their baby, and the drugs used on them. The information about what was being done and why, was often cursory, totally absent or misinformation. This was particularly salient in those who lost a baby to adoption when they went into labour with every intention of keeping their baby.
Isolation, Incarceration, Suggestion, Forced Labour, Repetitive Indoctrination, Humiliation, and Moral Coercion, including Social Role Subjugation.
It is more important to hear these issues directly from those who experienced them, but I include a brief account here, although the inquiry will spend considerable attention to hearing and evaluating evidence on this section.
It is pivotal in that without these ‘associated practices’ a great proportion of the babies would have been kept by their mothers. While rigid and harsh separation practices were used by many hospitals and services, many others used the ‘associated practices’ to secure their end – the taking of consent.
Superficially the living in a hostel, convent or other prenatal institution, was said to be preferred by the girls to ‘hide their shame’. However the practice allowed for the breaking of their usual first order social support, particularly their family and peer support. Here they had a new peer group in the same predicament. And their parents were replaced by a new group of ‘parents’ who would repetitively feed them bytes of the myths and use guilt and shame keys to bring them to a state of low self esteem.
Where this was superficially kind or warm, regression was promoted, and, as the Chinese and the North Koreans found in the fifties, this was the most effective form of mind changing possible. Where they were harsh there were attempts to please them in the only way possible – be ready to sign the consent, and it is the long term effects of those imprinted suggestions that are marring their lives twenty or thirty years later – particularly those who never had subsequent children, an outcome associated with going through this treatment.
You will hear that some were restricted to the building without street clothes, some who worked in laundries and toilets, some were literally locked in during various phases of their pregnancy, and some had suggestions repeated in such a manner that that they doubted they would ever be a good mother for a child, or they would harm any other child they had or destroy the life of their partner.
These elements of damage were over and above the damage they were to suffer from the loss of their baby. Over forty per cent had no further children, and those of us seeing the children they did have later were aware that these associated practices were often the principal cause of family disfunction, even considering the mothers post traumatic fear of losing another child and crippling pathological grief decompensating to depression.
It was as if these factors were post-hypnotic suggestions of the most compulsive kind. Some were consciously mediated, but others acted through the unconscious, creating compulsive attitudes and behaviours only accessible to significant psychotherapy.
Those who became aware in their later life of the results of their development became angry as they realised the ramifications and sequalae of their treatment at this time. Saddest of all are those still in the humiliated state as they were at the time, but with a wall of defences that have become a false personality. In short instead of a person, there is Denial, Reaction Formation, Isolation of Feeling and the rationalisations satirised by Voltaire in his opus ‘Candide’. These are the tens of thousands out there who need any positive help the Inquiry might stimulate, even if only to stimulate their self esteem and fellowship with other victims.
Although these issues are less like the neon signs of Crown St. Malpractices, it could be one of the Inquiry’s valued tasks to further delineate such factors and their consequences.
Unethical and Unlawful Practices
While I personally consider that all the previous section of this report describes a linked series of unethical practices, there is a controversy about what is lawful and unlawful let alone what is unethical. I have reason to believe that the combined resources of the Parliamentary Inquiry will be better able to judge the element of the breaches of the law and ethic in both this material and in all the material presented to them.
However I must draw attention to some issues that may be over looked.
First – Crown Street.
One issue is the role of the medical staff, as without their prescription of scheduled drugs the whole pattern of abuse would be entirely different.
The commonly used offending drugs were Sodium Pentobarbital, Amytal, and Stilboestrol.
I studied a number of Crown St files and I also had the occasion to study Chelmsford files. The similarity was striking, the barbiturate drugs the same and in similar dosage (although not the same frequency to produce deep-sleep over a period of weeks). The senior Psychiatrists at Chelmsford and Crown St were the same. I was aware of the collusion between the two when I uncovered a letter by Dr Harry Bailey from microfiche kept at Paddington, ordering the abortion of twin foetuses (close to viability) of a Chelmsford patient by hystorotomy. This was duly carried out without the womans consent and she was wondering twenty years later whether her babies were still alive and with somebody else.
In this manner the Crown St files of relinquishing mother had more in common with Chelmsford files than they do with the files of other relinquishing mothers.
At Crown St drugs were also used for control in the ante-natal period, for many days usually, but sometimes drug control went on for many weeks. Chloral Hydrate, Sodium Pentobarbitone, Amatyl were all used. A 200mgrm dose of Sodium Pentobarbitone was given intramuscularly within some hours of the birth, this was often repeated during the first five days, but often backed up by oral doses of Pentobarbital or Amytal.
Those barbiturates were relatively quick acting, caused extreme sedation, stuperous states and delirium was frequent, sometimes due to withdrawal as much as intoxication.
Another issue at Crown Street was the issue of “clearing.” This referred to the step by step process leading up to signing consent, thus gaining permission for discharge from the secondary institution where the mother had been moved. The notion was the staff had to pay attention to the details of the process and make certain the consent was properly signed before the mother was allowed to literally return to an ordinary life outside of their power and imagined jurisdiction.
Threats of using The Child Welfare Act were used more for resistant consenters than on evidence that the baby would be “at risk.”
Apologists for Crown St point to the statistic that a significant proportion of single women kept their babies between 1965 and 1975. As babies being relinquished dropped to a single figure percentage of earlier years 1973 to 1975, ask to see the figures broken down year by year. As the younger the mother the greater the power imbalance, ask to have these statistics broken down by age.
It is important to note here that Crown St was not the only hospital to have a harsh regime and abusive practices, but it comes to notice frequently because of the weight of numbers of adoptions which occurred from there.
The Parliamentary Inquiry will hear of many senior professionals associated with the the above practices. Few of them will have been leaders and many will have gained employment with an institution where they had to quickly conform to institutional culture and practice.
It will be important to see past these these people to those who exerted leadership in full knowledge of the unethical and unlawful practices of the time, where the end: the provision of babies for adoption: justified the process necessary.
It will be important that their destructive role by such leadership be looked at whatever their affiliations. The senior Josephite nun who controlled the adoption of thousands of babies is one example, and another group who would generally be seen as untouchable in this respect is the Salvation Army.
Women who know I am interested in adoption have told me their experience when they nearly had their baby adopted out.
The outstanding theme of their stories is not that of professional advice about adoption alternatives, but one of being rescued by a senior relative or partner giving them support, or stubborn refusal to sign documents and of calling the bluff of those who tried to separate them from their baby.
I am not impressed for this reason either of the statistics of single women who kept their baby or the sophistry around the issue of alternatives for the single mother.
Nor have I had any account from an original mother from the late 60s to the early 70s relinquishment period of a professional directing her to consider one of these alternatives, only the relentless push toward adoption using a variety of promotional alternatives and the abusive tactics described in the earlier section.
I am aware that from about 1973/74 there was an emphasis on training of social workers and other allied professions to be comprehensive and professional about putting forward these alternatives, but even then they had to adapt to the institutions that employed them. The credit for these should go to the universities and not the institutions.
However this changed attitude and practice certainly contributed to the number dropping like a stone in this period, although changed mores and the Supporting Mothers Allowance were significant issues but so also was the drop in pressure as the invitro fertilisation program was succeeding.
The legal difficulties for mothers gaining recompense.
The vast majority of mothers who lost a child to adoption are not seeking recompense, but recognition of what was done to them and the recognition of the extent of their suffering. As their children have been brought up on myths of their mothers inadequacy, immorality and rejection of their babies, they need a firm clear statement to undo some of these attitudes.
However there are some who lost babies despite their determination to keep them. Those to whom such flagrant abuse has occurred require recompense as part of the process outlined in the previous sentence.
Their legal difficulties come about through failure to set aside The Statute of Limitations no matter how extensive the damage or blatant the abuse.
It would appear that their legal advisers have great difficulty in predicting legal outcomes, establishing negligent practice in a culture of abuse, or looking to common law failures of duty including the issue of informed consent and the abrogation of the right to use the thirty day period to revoke consent.
The failure of one case over issues of the adversary not being able to bring witnesses to balance their testimony over what should have been part of their case, left them with a sense of dismay, injustice and betrayal.
Recompense will be discussed further in the section on distress assistance.
Measures to assist persons experiencing distress due to adoption practices.
Distress is associated with the mothers grief, specific issues of damage, and problems about continuing their life despite this, and then in relating to their child as an adult and the complex feelings and stress which occur as they come to reunion (which many times is delayed or never happens) and then to relate to a young adult with very complex feelings about them often based on destructive misinformation, frequent identity damage with secondary self destructive behaviours, and learned testing behaviours then to be practiced on the mother who lost them.
Many mothers are very frightened of the child they will meet; so are the children, but those who have made it to being autonomous can handle it better and often constructively take the lead in the reunion situation.
Straightening the record.
In general mothers say they want help particularly in straightening the record, a full and compassionate account of their plight and the treatment to which they were subjected which is not fully communicated to their child. They want competent counselling from people who are not identified with the perpetrators.
Many are desperate for this and will travel hundreds of kilometres or even interstate for this. Special training for such counsellors would be required, although there are some among their number who have professional qualifications who may work through their own effects of loss to be able to help their peers.
Generally peer groups are very supportive but it is difficult for them to be organised, as in my experience, most groups are funded by individual savings from social security payments.
Those who have exposed themselves are aware of the high level of distress among the great majority who are frightened of rejection or social stigma and who are unable to come forward.
A variety of measures are required depending on the nature of the damage leading to distress and the type of distress associated with the individuals response to such damage. A list of the varieties of damage follows:
- Pathological Grief.
- Personality damage associated with the defences used against grief, against post traumatic stress phenomena and against depressive decompensation.
- Personality damage associated with the isolation of the birth experience and the loss of the baby, where this is a secret and there is no significant other to share the feelings and unresolved issues associated with the loss.
- Axis 1 Psychiatric Disorder
- Post Traumatic Stress Disorder.
- Major Depression
- Dissociative Disorder
- Panic Disorder (and other anxiety disorders)
- Situational Stress Disorder (often associated with reunion)
- Alcohol Dependent Disorder
- Prescription Drug Dependent Disorder
- There are other drug dependent disorders which are uncommon among these mothers.
- Personality damage associated with psychiatric illness as a sequel to loss of a baby to adoption.
- Personality damage associated with long term Pathological Grief.
- Aggravation and precipitation of a wide variety of physical illness which are related to stress.
- Disorder and incapacity in human relationships.
- Educational failure and poor employment status.
- Failure of bonding to other babies.
This list refers only to common reactions involving large numbers of mothers: The Inquiry will hear also of additional problems
(Continued in Part 2)
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