On Becoming an Adoption Family Therapist: Setting up in Shanghai, China
I had the immense privilege of working as an in-house therapist at a group foster home in the outskirts of Shanghai. With a shoestring budget and a newly rescued therapy dog following me around the building, I was able to set up a play therapy corner on one end of the school room. It was a relatively humble set up, bolstered by random donations from Shanghai’s sizable expat community. However, years later when I set up the brand new play area in my private practice, I don’t believe I fully recreated the warmth and magic of this first space. Perhaps its power lay in the impact I saw every day we spent there and the enthusiasm with which the kids bolted in at the beginning of their turn.
Every morning the verbal children would greet me at the door with “Wo shang ke ma?” (“Will I attend class?”). The non-verbal children would tug me towards the therapy room with a surprising force for their small size. None of the children (nor I) had the Chinese verbage to describe what actually it was that I was contributing to their ecosystem. We would simply say that it was a class about emotions, and I was an emotions teacher. As a therapist, my formal title in China was Xīn li Yi Sheng 心理医生, or “Heart and Mind Doctor,” which seemed like a huge overstatement of my power.
Most days I felt more like a helpless observer than any sort of doctor. I would crouch next to a child splayed on the ground with sadness and anger. I would offer my heavily accented words of comfort. Sometimes, I would speak out loud the simple truth that we tried not to validate as staff in an orphanage: “Yes, this IS sad” “Yes, this IS unfair” “Yes, you want to be with mama.”
Most of the kids had been institutionalized too long to have explicit memories of their first “mama.” When they cried, at least on the surface, it was often for the attention of their caretaker mamas who were juggling a situation with another child, clocked out, checked out, or sometimes, heartbreakingly, back in their Chinese provinces of origin. The managers of the orphanage tried hard to create consistently with the “mamas,” but at the end of the day, it was a paid position and sometimes it reinforced the kids’ view that adults would all eventually abandon them. To use our therapy jargon, these kids had an insecure attachment to their foster home caregivers.
My graduate school textbooks described healthy boundaries with my clients and offered models for non-contact child therapy. But these were orphaned toddlers. My textbooks did not prepare me for the fervor with which these children longed to touch and connect. I spent most of my workday with one child perched on my hip, clinging with a desperate energy. I was never more conscious of my outsized role in their hearts than when I transitioned from one therapy client to another. The anxious protesting was piercing.
On the long taxi ride from work every day, I would cling to Xiao Mi and try to convince myself that I had made a tiny difference in these children's lives. I was grateful for the long transition between therapy in the foster home and my actual home. I too struggled with blurred boundaries, and I too felt pulled into the desperation to attach. I needed to remind myself every day that my purpose was to provide therapy, and no more.
Learn more about Natalia here.