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A Birth Mothers’ Shame in the Relinquishment of her Child

A Birth Mothers’ Shame in the Relinquishment of her Child

Definition of Shame

Bradshaw (2005) states that shame is not necessarily defined as an unhealthy emotion. He describes two types of shame, healthy shame and toxic dehumanising shame. Healthy shame is acquired by attaining intrinsic permission that he/she is human with limitations. It is the self-acceptance that mistakes are made and may continue to happen in a lifetime. Holding this type of shame produces room for human structure and boundaries, which in turn grounds a person and allows energy to be used more efficiently. It can develop the awareness and acceptance of the ‘self’ and human limitations. It gives room for change to make goals that are achievable and in our control. It is an inner emotional energy that amalgamates us rather than disseminates us.

Bradshaw (2005) states:

‘Shame as a healthy human emotion can be transformed into shame as a state of ‘being’. As a state of ‘being’, shame takes over one's whole identity. To have shame as an identity is to believe that one's ‘being’ is flawed and that one is defective as a human being. Once shame is transformed into an identity it becomes toxic and dehumanizing’ (P, 169). 

Toxic shame can create a false ‘self’ due to the fact that one may feel flawed. In turn, a person can then form an identity that covers-up the real ‘self’ in order to feel more human and belong. Miller (1986) describes this as the ‘soul murder’ of the true ‘self’. Bradshaw (2005) states that this destructive shame is the underling emotion to many psychological illnesses. Brown (2007) also states that ‘shame’ is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging. Women often experience shame when they are entangled in a web of layered conflicting and competing social community expectations. Shame creates feelings of fear, blame and disconnection.


How does ‘Shame’ presents in a client

 Kaufman (cited, Bradshaw, 2005) states:

‘Shame is the affect which is the source of many complex and disturbing inner states: depression, alienation, self-doubt, isolating loneliness, paranoid and schizoid phenomena, compulsive disorders, splitting of the self, perfectionism, a deep sense of inferiority, inadequacy or failure, the so-called borderline conditions and disorders of narcissism’(p,178).

Bradshaw (2005) describes unhealthy shame as a man on a horse that has no structure, direction, boundaries and goes around and around in all directions, not getting anywhere and wasting so much of his energy. He continues towards an addictive behaviour where he dares not ask for help, as this is perceived as a loss of power. This can be the same for a client who may have no boundary lines, as energy is lost and wasted running around and around after everyone. Saying ‘no’ to others is not an option for fear of losing the ‘false self’ in the belief of non- acceptance or in not belonging.

Brown (2007) states how shame can first react in the body before it even comes to the fore of our conscious minds. Research of fifty women reported how physical shame was described as a tightening in the stomach, a feeling like vomiting, shaking, a heating up in their faces and chests, dryness of mouth and finding it difficult to swallow.

Clients’ shame can be difficult to see in the therapeutic alliance. The reason can be that the ‘self’ has been so long being hidden or covered up, that it becomes an art form of habit (Lewis, 1971; Lindsay-Hartz, 1984). Morrison, (1989) & Wurmser, (1981) states that the defensive symptoms of clients’ ‘shame’ can be displayed in various ways such as humour, avoidance, intellectualization, projection or an acting out. This can be used by the client as a cover-up or diversion from acknowledging shame. Depending on the clients’ condition, shame can present in different ways. Research reports that a client suffering with depression can direct shame as inward aggression, where they may speak of feeling foolish, worthless or helpless (Lewis, 1971).

Then there is the client who may present as narcissistic where he/she projects aggression outwardly and this can also be towards the therapist. This can be due to the feelings of humiliation where even a slight challenging by the therapist can be taken as criticism (Lewis, 1971; Morrison, 1989). The countertransference reactions within the therapeutic process from these two clients can differ as to the condition presented (Brody, 1990; Colson, Allen, Coyne, Dexter, Jehl, Mayer, & Spohn, 1986).

A Birth Mothers’ Shame in adoption

Darcy (2014) states:

Just sitting with it; not fighting, not struggling, not suffering, the actual physical ache of our cells screaming in rebellion and remembering how much it just hurt to have our babies taken from our arms by any means… no matter of it was forced, or coerced, shamed or chosen… making you tired and jumpy all at once, short tempered, distracted, spinning thoughts from shallow to deep and back again with such a velocity that it literally can cause nausea’ (retrieved, 2015, March 21st)

She describes how emotionally and physically continuing after relinquishment of her child while forging the normality of life as a false sense of self as protection from the outside world. Inside she was holding on tight in holding back the dam of emotions that needed to be controlled to survive the shame knowing all the time that the tears would never stop and in the darkness of her pain that she may never be able to escape from the blackest place of her pain. Even the chance of reunion for some may be rejected for the fear of revisiting the heavy weighed shame and intense emotion that is constantly frozen as a life prison to oneself in time (retrieved, 2015, March 21st).

Parsons (2014)states:

‘If there is a real place called the birthmother Adoption Closet, what really died inside was the mother we were supposed to be before surrendering’ (retrieved, 2015, March 24th).  

She describes how it was the fear and shame that put her in the metaphor of the adoption closet, as it seemed at the time to be a better choice. Upon reflection, the reality was not as scary as the fear she held about the shame of how family, friends and neighbours would react. She had powerful thoughts of fear, where the birth father might think that she was trying to trap him. Also, the fear that she would resent her son if she kept him, however the bottom line was that as a mother she had no resentment for her son but rather an immense emotion of love.

She states how the closet was a safe place in the hidden pain from the world. At least there she knew what lurked in the shadows of the corners of the walls of the closet, compared to the power of her mind, the fear that what was outside these walls were the judgement of others in their opinion of her and she imagined hearing words being spoken or whispered like, she is ‘one of those women’.  In her choosing to come out of the closet there was people who loved and accepted and what came with it others in ignorance being insensitive and cruel yet she states a life of being free is a life worth living (retrieved, 2015, March 24th).

            Dusky (2013) describes the shame of telling her parents that she was pregnant and in avoidance to this she instead made up the story of moving away to go to college. The cultural shame of not being married, her decision to keep her daughter was not an option as this decision would result in telling her parents of the’ bad’ girl she was. The other part of her shame was in the giving up of her child that she hid from friends, lovers, health insurance examinations, work doctors. She chose to lie to family and society to protect the shame of her secret. She felt that it was just not the culture of the family but also that of the world too. She advises that in coming clean helped her clear some of the shame. When she was interviewed by a writer from the Cosmopolitan Magazine, she began to heal going towards writing her book ‘the birthmark’. She describes feeling not as alone with the support of the letters that reeled in from other birthmothers. Dusky (2013) notes Brown (2012) where she describes the three unhealthy strategies that are used for shame where we hid, keep secrets, people pleasing or we do the opposite by moving towards the shame by using aggression for the inner shame that is felt.

Brown (2007) reports that women struggled most with shame in the following areas: appearance, body, image, motherhood, family, parenting, money, work, mental and physical health, sex, aging, religion, being stereotyped, labelled, speaking out and surviving trauma.

Research of Birth Mothers’ Shame in Adoption

Free (2002) states that there has been little professional study around a birth mother’s trauma of secrecy, shame, sorrow and the culture of society’s negative attitude on the subject. She describes how the diminutive professional training given on adoption to accommodate a birth mother in healing her shame has been ignored. It is even the case where some therapists and societies belief that shaming is purposeful, as a preventive measure against unmarried pregnancies. This ignores the trauma of the need for birth mothers to heal and the continual existence of their lifelong pain.

Research also highlights that a birth mother within the adoption triad (birth mother, adoptive child and adoptee parents) are least studied or understood (Freundlich, 2002; Reitz & Watson, 1992; Zamostny, O’Brien, Baden, & Wiley, 2003). This may be the result that birthmothers are seen to remain in silence as the invisible parties of the triad. Research deems that this may be due to it being a choice for a birthmother in just getting on with it. For others, it may have been due to the cultural system of relinquishment, secrecy and confidentiality of historical legal requirements (Winkler, Brown, van Keppel, & Blanchard, 1988).

However, birthmothers have been known to be researched in the academic areas for professional counselling disciplines as to how best to serve these women. The findings are across countries such as Canada, Australia and the United States of American (Chippendale-Bakker & Foster, 1996). Research of a global population found that between one million to five million Americas are adopted which lead to the presumption that there is a figure of up to ten million of birth parents of adoptees raised in United States and other countries in America (Brodzinsky,1990)

Jacobs (1995)reports that in the mid-1960s findings from employees of an unmarried home in Sydney stated that they were aware of birth mother’s psychology and physiological effects of giving up a child. This included depression, excessive sleep to insomnia, lack of appetite to over eating, low self-esteem, personality disorders, feelings of rejection and regret for relinquishment of a child, they may also have attempted suicide. It is noted that female suicide rates in Australia in the 1950-1960s doubled from the 1900 which was at the time of birth mother’s adoption (Hassan 1995). Pannor, Baran, & Sorosky, (1978) reported that these psychological and physiological systems can be felt for a lifetime in mourning for a child given or taken away.

Silverman (1981) states that birth mothers in attempting to survive such trauma may replace the unspoken, hidden emotions and pain of secrecy and shame with the use of drugs or alcohol, which in turn can affect future chance of any intimate relationships and increase psychological issues.

A birth mothers’ decision to voluntarily relinquish her child is the most horrendous decision in her life (Winkler et al., 1988). The explosion of feelings of shame, desolation, pride, fear, grief, loss, terror can aid to the behaviour of hiding and not talking about their feelings as the ‘self’ can be seen as abnormal. However, in recent years’ adoption agencies, medical professionals that were chosen by the birth mothers allowed the women to face feelings and decisions in a compassionate and dignifying environment (Janus, 1997;Sobol & Daly, 1992). Barnardo’s in Ireland currently run support groups and support birth mothers in the healing of unveiling the shame and secrecy held. They also work with the birth mothers in the search for re-attachment with their child (O’ Morain, retrieved, 2015, March 13th). 

Multicultural findings

In relation to the multicultural finding of research, it was discovered that white women compared to women of colour which would include African, Mexican Filipino and American were less likely to relinquish their child towards adoption. Findings highlighted that this difference could be due to the cultural communities’ norm of the women of colour. The historical post slavery times in American where the survival legacy was to hold onto the family line could also be a factor in this. It is reported that women of colour go towards informal adoption where the child is kept with the extended family without any form of legality being involved (Sandven &Resnick, 1990).  Other explanations state that this could also be due to a birth mother’s stance at that time, for example of oppression or lack of privileges being available to her. However, there is also the question of whether a child of colour would have the option of being adopted that was not explored (Lee, 2003).

Recommended ways of working with a birth mothers’ shame

Zamostny, Wiley, Brien, Lee, & Baden, (2003) state that therapists in counselling who provide an integrative approach of developmental tasks and models, preventions approaches, adjustment life transitions of healthy coping skills and considering a client’s development in a multicultural approach can be beneficial in offering understanding and empathy to birth mothers.

Brown (2007) states that for a client to work towards shame resilience genuine empathy is the key. She describes two Petri dishes containing a women’s shame, where the environment of empathy dissipates ‘shame’ compared to a judgemental, critical environment that increases the destructive contamination of ‘shame’ more. Browns (2007) research of fifty women's shame highlighted strategies developed towards shame resilience. Knowing how to react to shame is an importance resilience tool. We often feel shame before we even think it and in recognising the shame triggers this then allows us to not act out or shut down. She recognised within her research that shame triggers are as individual as the women, their relationship and their cultures.

Following research of evidence as to what is required for birth mothers in counseling, Janus (1997) suggests that ‘adoption sensitive’ counseling approach as the most beneficial for birth mothers. Adoption-sensitive counseling is as follows:

$11.      Therapist need to be deflective practitioners in relation to their attitudes and belief around birth mothers, pregnancy, child birth and the rearing of a child and have knowledge of the sensitive issues around the ethical practices of adoption and professionally.

$12.      They need to access information on the social and cultural issues surrounding a birth mother and be conscious of this within the therapeutic process. They also need to consider and be sensitive to the multicultural aspects as to the range of types of adoptions.

$13.      A therapist needs to be aware of the political and economic aspects of adoption and the impact that this could have on a birth mother and her decision.

$14.      They need to be equipped with the resources of supports groups, adoption agencies, advocacy agencies that the client can be referred to. Also, the reading material that may facilitate in the healing process of a birth mother

$15.      Therapist need to allow the birth mother towards an experience of shame resilience and empowerment of strength to develop self-esteem and work towards a future with a plan that can encumber positive meaning and attainable outcomes to life.

$16.      Respect the individual as to the uniqueness of each story and the diversity of circumstances within life circumstances, avoid generalizing birth mothers as being the same.

Silverstein & Kaplan (1986) advises of a guide for a therapist in counselling any member of the triad group of adoption, this includes a birth mother. He states that a birth mother may cognitively emotionally repeatedly relive their adoption experiences in their indecisive behaviours in determination toward self-mastery. He advises that therapists in the counselling professional can help a birth mother in the guide of the seven core issues in adoption.

Silverstein & Kaplan (1986),

$11)      Loss: Ruminate about lost child. Initial loss merges with other life events; leads to social isolation; changes in body and self-image; relationship losses.

$12)      Rejection: Reject selves as irresponsible, unworthy because permit adoption; turn these feelings against self as deserving rejection; come to expect and causes rejection.

$13)      Guilt and Shame: Party to guilty secret; shame/guilt for placing child; judged by others; double bind: not OK to keep child and not OK to place

$14)      Identity: Child is part of identity goes on without knowledge; diminished sense of self & self-worth; may interfere with future parental desires.

$15)      Intimacy: Difficulty resolving issues with other birth parent may interfere with future relationships; intimacy may equate with loss.

$16)      Control: Relinquishment seen as out of control disjunctive event interrupts drive for self-actualization.

Personal Centred Counselling Approach with a Birth Mothers shame of adoption

The ‘Way of Being’ in PCC

Rogers (1947) ‘way of being’ relates first and foremost to the importance and value of the relationship with the client. It creates an environment of genuineness, caring, non-judgement and empathy. These core conditions are the very foundation of this humanistic approach of creating a warm alliance of unconditional positive regard in understanding the clients ‘internal frame of reference’. PCC approach is very much non-directive and focuses on the client’s present experiences from moment to moment with the therapeutic process (Corey, 2013).

The ‘Way of Understanding’ in PCC

Rogers explores a client’s ‘external locus of evaluation’, this is where a client takes on others’ beliefs and values as truth. A client can acquire this as his/her truth in a need for positive regard and conditional worth to belong. Psychological issues can be formed as a coping mechanism of the desired ‘self’ by creating a false ‘self’ to fit in and gain acceptance. In PCC, a therapist creates an environment of unconditional positive regard and empathy in exploring a client’s ‘internal locus of evaluation ‘of his/her truth of beliefs, values and gut feelings towards the development and growth of the desired ‘self’ (Thorne, 2006).

The Ways of intervening in PCC

For the client to be able to experience an alliance of PCC core conditions is of the utmost importance for growth and development. In this experience, a client can start to trust in his/her ‘internal locus of evaluation’ and feel acceptance and a heighten self-esteem. This can then be evidence that he/she can belong in unconditional positive regard. The client can then transfer this ‘way of being’ experienced in therapy into external relationships (Corey 2013).

Techniques Applied

Techniques that create a warm unconditional positive regard environment are open questions, active listening, reflection, summarising and clarification of the client’s feelings and experiences. There are no instruments used in assessing a client or techniques of probing a client rather it is in ‘being’ with a client is of the highest importance in PCC (Corey, 2013).

Contributions of PCC Approach to a Birth Mothers ‘shame’

The toxic shame of a birth mother as the whole ‘self’ is where the PCC approach can work with her on a journey of healing in exploring the ‘self’, self-concepts and in understanding the power of her inner resources towards development. In the ‘way of understanding’ can help to uncover the false toxic shame of the ‘self’ towards self-compassion, acceptance and growth. The heaviness of the secret can be unveiled in the conflict of the perceived ‘self’ towards the desired ‘self’ to be loved and belong. PCC can create a valuable space for a birth mother to share her feelings in the warmth, realness, sincerity, understanding, compassion, respect and non-judgement and own the direction of the therapy. This can be empowering with a sense of control where in previous experiences she may have had the belief of having no control. It can create a trusting and openness relationship where a birth mother can sense the therapists trust and belief in her towards growth and change. A birth mother can discover her own answers; this equips her with a belief in self-capacity for managing present/future problems (Corey, 2013). For a birth mothers ‘shame’ the most vital part of an effective and successful treatment is empathy (Watson, 2002).

Limitations to PCC approach

In relation to a birth mother’s crisis of shame PCC could lack the directive approach that a birth mother may seek. The therapist in using a reflective response to the birth mother could leave her feeling that the therapy is a waste of time as she may require information on what to do in the crisis (Corey, 2013). PCC has been criticised for the ‘way of being’ lacking strategies for clients who had certain mental disorders. A birth mother of shame who develops psychological mental disorder due to the toxic shame of the ‘self’ may not benefit from this approach (Corey, 2013).

The application and contributions of PCC in a Multicultural setting

PCC includes people from diverse cultural backgrounds and community (Corey, 2013)In relation to the effects of PCC in cultural diversity.

            Cain (1987) states: ‘Our international family consists of millions of persons worldwide whose lives have been affected by Carl Roger’s writings and personal efforts as well as his many colleagues who have brought his and their own innovative thinking and programs to many corners of the earth ‘(P.149).

He also reports that the core conditions of PCC in its understanding principles complements all culture (Cain, 2008, 2010).Watson (2002) states that PCC approach where the client is the expert and the therapist does not assume a client inner frame of reference but rather explores to understand and gain clarity in a non-judgemental way aids in the clients’ growth and acceptance of the clients perceived reality.

Limitations of PCC in a Multicultural setting

It can be very difficult for a client to be in the environment or comfortable to receive the core conditions of empathy as this may be something a client may not have experienced before or feel that they deserve as some cultures may be averse to this type of communication (Bohart & Greenberg, 1997). For a birth mother who may have the need for depending on the therapist for answers and to take over a structure may be difficult and find this a very laid back approach of the therapist that may result in the relationship not forming therefore the treatment to be unsuccessful (Corey, 2013). Another limitation can be if the therapist has no knowledge of the system of adoption and is not familiar with the adoption sensitive approach (Janus, 1997).

Choice Theory/Reality Therapy Approach with a Birth Mothers’ shame of adoption

The ‘Way of being’ in CT/RT

CT/RT is a directive approach; the therapist is the teacher, mentor who creates a warm, supportive, non-critical yet challenging environment (Corey, 2013). A therapist trusts in a client’s power to choose, plan goals and act in the doing of decisions towards change (Glasser, 1975).

The ‘Way of understanding’ in CT/RT

Glasser states that all behaviour is purposeful towards satisfying a driven genetic need. He states the five genetic needs as:1) Survival,2) Love and belonging, 3) Freedom,4) Fun and  5) Power (Corey, 2013). He explores the mental pictures of a client ‘s ‘Quality World, his/her beliefs, values, fantasies and perception of what it should be like. He advises that the inner ‘Quality World’ not matching the reality of the external ‘Quality World ‘of circumstances can cause the conflict of the client’s unhappiness (Wubbolding, 1988).

The Ways of intervening in CT/RT

Glasser (Corey, 2013) explores ‘Total Behaviour’ which is a holistic approach of a client’s feelings, thoughts, physiology and actions (behaviours). He states that change can occur of all four areas by focusing on changing only one area either the thinking or behaviour. He advises that to concentrate too much on the feelings especially negative feelings will only increase the negativity (Corey, 2013).

Techniques applied

Is an active listening, open question, reflective summaries of feelings and experiences. It is based on ‘seven caring habits’ of listening, supporting, encouraging, befriending, trusting, accepting and negotiating differences. Glasser (1998) states, that the ‘seven deadly habits’ of criticising, blaming, complaining, nagging, threatening, punishing and bribing or rewarding for external control are never part of this therapeutic alliance and process.

Contributions of CT/RT for a Birth Mother ‘shame’

CT/RT can empower a birth mother in exploring her basic needs and in taking back her personal control on identifying options and choices towards change in the self-growth of the ‘desired self’ away from a past life of the of toxic shame of the ‘false self’. It can explore the psychological conflict of her perceived inner ‘quality world ‘compared her external ‘quality world.’ It can equip a birth mother in self-evaluating what current behaviours are not satisfying her basic needs and enhance a need for change and the steps required to acquire the change and the actions that need to be taken (Dilman, 1988). A birth mother who has a core belief of hopelessness, worthlessness can regain a sense of power in the ownership of choices and implementation of new behaviours, which in turn can enhance a birth mother’s belief in the hope of resolving any psychological issues (Corey, 2013).

  Limitations to this approach of CT/RT in relation to birth mothers shame

Marmot (1999) states that CT/RT idea that psychological issues such as mental disorders and depression are chosen by the client to repress anger, seek attention or avoid change is irresponsible, as no research is there to back it up. For a birth mother this could be hard to digest that in the shame of her decision is in her choosing the effects of her choice. Glasser does not consider any of the environmental factors that could have influenced her decision. This may come across as a very cold approach in her psychological experience of shame could lead to further increased feelings of guilt and toxic shame (Corey, 2013). Another limitation for a birth mother is where CT/RT does not explore the past so therefore not exploring any repressed emotions of the past trauma in the relinquishment of her child. He also does not explore dreams and the value this may give to a client in gaining insight into unconscious emotions and thoughts that may be hidden yet presenting in current behaviours (Corey, 2013). Glasser in his approach of CT/RT perceives it as a simple approach that does not require a need for a therapist supervision, which in turn could leave room for a trainee or inexperienced therapist to impress judgement in the therapeutic process, this would be damaging. Also, where the therapist may try to fix the clients problem instead of trusting in the client’s power of them being the expert (Wubbolding, 2008). As much as a birth mother at the early stage may look to the therapist for answers this would not empower in the self-actualising of the damaged ‘self’ and again the conditions of worth would not be internalised but rather dependent on external for self-worth. Glasser does not entertain any form of client transference, which in turn could lack the insight for a birth mother to explore her perception and reactions to outside relationships that may be influencing in a destructive manner (Corey, 2013).

The application and contributions of CT/RT in a Multicultural setting

            Glasser (1998) states that in working with a diversity of clients with cultural backgrounds the approach of CT/RT which includes the five-genetic basic driven needs and the theory that all underlining psychological difficulties of unhappiness are due to a relationship can be successful in the therapeutic process. Wubbolding (2011a, 2011b) is also in agreement with Glasser for the reasons that we all no matter what cultural background need to make choices and take personal responsibility to meet and satisfy ones driven need in life. However, he does suggest that for some cultures that a therapist may need to be educated especially where sensitivity is required for the implementation of plan towards change. In relation to birth mother it is highlighted the need for sensitivity in the example of the adoption sensitive approach and the need for a therapist to be educated in this specialised area. One of CT/RT approach is in the strength of providing information or educating the client for them to be equipped in making behavioural changes to meet with a desired need. (Corey, 2013) An educated therapist in the area of adoption and all the surrounding factors can influence a birth mother towards growth and healing. Information that can be given where a birth mother may not be aware of can empower her towards option of choice and a plan for change. When working with a birth mother a CT/RT therapist needs to be softer in his/her approach when asking direct questions especially when working with the Japanese, within this culture the belief of direct questioning implies a lack and a client of this culture may find this insensitive and view the therapist as interfering and disrespectful (Wubbolding, 2000).

Limitations of CT/RT in a Multicultural setting of a birth mothers shame in adoption

Wubbolding (2008) advises that CT/RT focuses on the clients' choices in empowering them towards what is only in their control to change. However, therapists can make the mistake with a birth mother of not considering her environmental issues such as the social injustices, discrimination, and oppression. A birth mother from certain family, social culture may still be living in a limited environment of options to choices in certain areas and this need to be considered by the therapist (Corey, 2013).

Conclusions and Findings

An Integrative Approach to counsel a Birth Mother of Adoption

Brown (2007)and Watson (2002) suggest that it is genuine empathy that dissipated shame which coincides with a PCC approach. Bradshaw (2005) advises how toxic shame can destroy the ‘self’ and in PCC ‘way of understanding’ in exploring the false ‘self’ and ‘external locus of evaluation’ can aid a birth mother towards the growth of the desired ‘self’ in developing and trusting in her ‘internal locus of evaluation’.

CT/RT approach can give the power and control back to a birth mother and in her choosing different behaviour towards satisfying her basic needs. In the ‘total behaviour’ of being in the driver’s seat of taking personal responsibility towards change of meeting, accepting or changing her ‘quality world’ pictures to resolve the conflict of unhappiness experienced. Brown (2007) suggests how women reported growth against ‘shame’ by creating strategies for greater shame resilience. It would also equip a therapist to the above approach in acquiring education in adoption sensitive counselling (Janus, 1997) and the guide of the holistic approach of the seven core issues of adoption (Silverstein & Kaplan, 1982).

Research highlights that this is an area that requires more investigation for serving the birth mothers of ‘shame’ in the professional field of counselling.


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