The Kindness of Strangers In the Face of Child Abandonment

A boy is abandoned in a psychiatric ward by his mother. He is described as violent and depressed. The hospital likens him to a “trespasser” and social services need time to figure out what to do with him.¹ Although there are no available statistics to track the numbers of child abandonment cases, those in the health care and social services trenches know they are not rare.

Many will recall the spate of abandoned babies in Houston in 1999. Some were found dead.² As a result of the public uproar, laws were passed permitting the anonymous relinquishment of unharmed babies in designated safe places, such as hospitals and fire stations, without risk of prosecution.

Another epidemic of abandoned children occurred in Nebraska in 2008. One of the last states to pass the safe haven law, Nebraska did not specify age (most state safe haven laws applied only to newborns and infants). As a result, dozens of children were abandoned, some dropped off by relatives in Nebraska after long trips from out of state.³

Although the child welfare system, private adoption agencies, families, schools, health care providers, and churches all provide opportunities for safely relinquishing children, tragedies continue to occur.⁴

A recurring theme
Child abandonment, mostly in the form of exposing newborn babies, is an ancient and pervasive theme in myths, folktales, and religious literature.⁵ Moses was found by the Pharaoh’s daughter and rose to lead the Jewish people. His was an astounding outcome for a child left in a basket on the Nile (he would have otherwise been killed by the Egyptians) and perhaps a comforting story for parents who were constrained to abandon their children.

Two foundlings, the twins Romulus and Remus, are the legendary founders of Rome. The statue of the Capitoline Wolf suckling the children-and similar images on coins, altars, mosaics-may have conveyed the powerful message that abandoned children should be taken care of and that there can be greatness in their future.

A leap forward of millennia brings us to Superman, a hero of our times, who is another foundling. His parents shipped him off on a spacecraft from his native planet Krypton because of an impending catastrophe,. He landed in rural America, where he was adopted by the Kents, who taught him to use his superhuman powers to help humanity.⁶

Similar stories have been reported from non-Western societies. The Yaudapu Enga of New Guinea, for instance, have a narrative in which supernatural beings take abandoned children and raise them to live privileged lives.⁵

Romancing the family
The existence of such narratives across cultures and times suggests that there may even be something appealing about not being raised by the family of origin. Freud named the estrangement from the parents and the fantasy of being an adopted child raised by people of higher social standing “family romance.” Freud noted that the effort of replacing real parents with superior ones is an expression of the child’s longing for his or her own idealized parents.⁷

Not all child abandonment tales cast a positive light, however. Oedipus should have been left to die as an infant. Instead he was given to a shepherd and was eventually adopted by royals. Yet, his life was doomed and he unwittingly fulfilled his tragic fate by killing his father and committing incest with his mother.

In Orson Welles’s masterpiece, Citizen Kane is a happy child as he plays in the snow outside the family home. Even though his parents are poor, peace and security preside. When he is removed and is given financial affluence elsewhere, he is unhappy. As an adult, he uses the money and power that he amasses to buy love or cause others to feel equally miserable.

A look at the past
One wonders whether in the old days deserted children were actually rescued, as the tales suggest, and what happened to them. How prevalent was child abandonment, and what were its causes? Last names frequently given to foundlings in Italy are among the most common to this day and hint at the prevalence of child abandonment in the past: Esposito (exposed) in Naples, Innocenti (innocents) in Florence, Proietti (cast out) in Rome.⁸

Going back in time, historian John Boswell estimates that urban Romans abandoned 20% to 40% of their children in imperial times.⁹ Most of the children were rescued. Since there was no institutional arrangement for abandoned children, the children survived thanks to aliena misericordia, or the “kindness of strangers,” an expression used in Latin legal texts to indicate the motivation of the persons who took in abandoned children and raised them, a generosity admired in the public consciousness.

Without a doubt some of these children became slaves, but most were apparently granted the status of foster children. Children were abandoned in great numbers throughout Europe. Several theologians of the early Christian church argued that men should not use prostitutes because they might unwittingly commit incest with a child they had abandoned, which suggests that child abandonment was quite prevalent and that its outcomes were not necessarily positive.

Parents may have abandoned their offspring in desperation because they were not able to support them; in shame because of their physical conditions, unwelcome gender, ominous auspices, or because they were illegitimate or the product of incest; in the interest of the household if inheritance would be compromised; in the hope that someone of greater means might raise them in better circumstances; or in callousness because they just did not want to be parents-the children ended up being sold for profit.

Early Christian authors treated child abandonment as infanticide. However, disapproval was later replaced by sympathy toward the misfortunate birth parents. Much of the concern revolved around the issue of baptism because unbaptized infants could not go to heaven. Whereas infanticide and abortion were condemned, abandonment was not. A similarly tolerant attitude prevailed in medieval Muslim society.

In the thirteenth century, at a time when child abandonment was on the rise due to demographic growth and adverse economic circumstances, foundling homes were established in Italian cities as part of an attempt by civic institutions, both religious and secular, to handle social problems. One of the features of these foundling homes (probably originated at the hospital of the Holy Spirit in Rome) was the “ruota,” a revolving door in a niche in the wall that allowed a parent or a servant to deposit a child safely without being observed. It was a turning point: the private “kindness of strangers” was superseded by public intervention.

Some parents who had abandoned their children eventually reclaimed them. Ironically, the chances of finding them alive were not great, since more than half of the foundlings did not survive the first year of life. Children could disappear quietly through the revolving doors of foundling homes, out of sight and mind, into oblivion or death.

Back to the present
There are no studies that have specifically looked at the health outcomes of abandoned children. An “abandoned child syndrome” has been proposed that would include psychological and physiological symptoms extending into adulthood, such as alienation from others, guilt, fear and uncertainty, sleep and eating disordered patterns, fatigue, lack of energy and creativity.¹⁰ The long-term negative impact of child maltreatment, on the other hand, is well-established in the medical and psychiatric literature as a nonspecific risk factor for a wide range of psychopathology and functional impairment in adolescence and adulthood, including behavioral, social, and academic domains.¹¹

Are the outcomes better for abandoned children in institutional or foster care? According to the results from the Bucharest Early Intervention Project, the first randomized, controlled trial of foster care as an intervention for institutionalized children, children removed from institutions and placed in foster families display better attachment patterns, improved measures of affect, and reduced prevalence of internalizing disorders.¹²

Aliena misericordia, or the kindness of strangers, is by itself no substitute for public intervention, but it should inform public intervention, from legislation to funding, planning, implementing, and monitoring programs. Tales from different cultures and epochs subtly remind us that abandoned children who are adequately nurtured may rise to the top of society. Even more importantly, our public consciousness tells us that abandoned children deserve their fair chance in life, and that we should keep an eye on the revolving doors that public intervention may create.

Dr Suardi is an adult, pediatric, and forensic psychiatrist in Washington, DC. He reports no conflicts of interest concerning the subject matter of this article.

References1. White J, Castaneda R. 10-year-old boy with psychiatric problems is stranded in Children’s Hospital. The Washington Post. 2011. http://www.washingtonpost.com/local/10-year-old-boy-with-psychiatric-problems-is-stranded-in-childrens-hospital/2011/10/26/gIQAQajKKM_story.html. Accessed January 10, 2012.
2. Yardley J. A flurry of baby abandonment leaves Houston wondering why. New York Times. 1999. http://www.nytimes.com/1999/12/26/us/a-flurry-of-baby-abandonment-leaves-houston-wondering-why.html?pagewanted=all&src=pm. Accessed January 10, 2012.
3. Ball K. The abandoned children of Nebraska. Time. 2008. http://www.time.com/time/nation/article/0,8599,1859405,00.html. Accessed January 10, 2012.
4. Pollock K, Hittle L. Baby abandonment: the role of child welfare systems. 2003. http://www.cwla.org/programs/baby/babymonographintro.pdf. Accessed January 10, 2012.
5. Viazzo PP. Abandonment. http://www.faqs.org/childhood/A-Ar/Abandonment.html. Accessed Janaury 10, 2012.
6. Wikipedia. Superman. http://en.wikipedia.org/wiki/Superman. Accessed January 10, 2012.
7. Freud S. Family romances. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol 9 (1906-1908). New York: Vintage Books USA; 1909; 235-242
8. Italian Surnames. http://familyhistory.byu.edu/Downloads/Italian_Extraction_Guide/Italian_Extraction_Guide-Section_C_Part_2.pdf. Accessed Janaury 10, 2012.
9. Boswell J. The Kindness of Strangers. Chicago, IL: The University of Chicago Press; 1988.
10. Wikipedia. Abandoned child syndrome. http://en.wikipedia.org/wiki/Abandoned_child_syndrome. Accessed Janaury 10, 2912.
11. Child Welfare Information Gateway. Long-Term Consequences of Child Abuse and Neglect, April 2008. http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.pdf. Accessed January 10, 2012.
12. Bos K, Zeanah C, Fox NA, Drury SS, et al. Psychiatric outcomes in young children with a history of institutionalization. Harvard Psych Rev. 2011;19:15-24.

References:

References

1.

White J, Castaneda R. 10-year-old boy with psychiatric problems is stranded in Children’s Hospital. The Washington Post. 2011.

http://www.washingtonpost.com/local/10-year-old-boy-with-psychiatric-problems-is-stranded-in-childrens-hospital/2011/10/26/gIQAQajKKM_story.html

. Accessed January 10, 2012.

2.

Yardley J. A flurry of baby abandonment leaves Houston wondering why. New York Times. 1999. http://www.nytimes.com/1999/12/26/us/a-flurry-of-baby-abandonment-leaves-houston-wondering-why.html?pagewanted=all&src=pm. Accessed January 10, 2012.

3.

Ball K. The abandoned children of Nebraska.

Time

. 2008.

http://www.time.com/time/nation/article/0,8599,1859405,00.html

. Accessed January 10, 2012.

4.

Pollock K, Hittle L. Baby abandonment: the role of child welfare systems. 2003. http://www.cwla.org/programs/baby/babymonographintro.pdf. Accessed January 10, 2012.

5.

Viazzo PP. Abandonment.

http://www.faqs.org/childhood/A-Ar/Abandonment.html

. Accessed Janaury 10, 2012.

6.

Wikipedia. Superman.

http://en.wikipedia.org/wiki/Superman

. Accessed January 10, 2012.

7.

Freud S. Family romances.

The Standard Edition of the Complete Psychological Works of Sigmund Freud

, Vol 9 (1906-1908). New York: Vintage Books USA; 1909; 235-242

8.

Italian Surnames.

http://familyhistory.byu.edu/Downloads/Italian_Extraction_Guide/Italian_Extraction_Guide-Section_C_Part_2.pdf

. Accessed Janaury 10, 2012.

9.

Boswell J.

The Kindness of Strangers

. Chicago, IL: The University of Chicago Press; 1988.

10.

Wikipedia. Abandoned child syndrome.

http://en.wikipedia.org/wiki/Abandoned_child_syndrome

. Accessed Janaury 10, 2912.

11.

Child Welfare Information Gateway. Long-Term Consequences of Child Abuse and Neglect, April 2008.

http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.pdf

. Accessed January 10, 2012.

12.

Bos K, Zeanah C, Fox NA, Drury SS, et al. Psychiatric outcomes in young children with a history of institutionalization.

Harvard Psych Rev

. 2011;19:15-24.