Chapter 4 · Language and the Clinical Encounter

Your language gives you away

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Every question you ask does two things. It asks the thing, and it tells the client what kind of answer you're expecting. With most clients that second part is harmless. With an adopted client it's often decisive.

Take "tell me about your family." Perfectly ordinary. For an adoptee it contains a choice you didn't know you were making them make: which family? Most will give you the adoptive one, because that's what you seem to expect, or because it's safer, or because they learned a long time ago not to mention the other one unless asked directly.

Or "was your adoption a good experience," which treats the whole thing as an event with a verdict. Or "I see you were adopted as an infant," which files it as background. Or, when they finally bring you something hard, "but your adoptive parents loved you," which is warm, and true, and ends the conversation. None of those are mistakes exactly. They're the cultural story about adoption showing up in ordinary clinical phrasing.

I asked an adoptee about the questions people ask her. Listen for the ones that made her decide what to say next.

So the move is to widen the frame before the client has to. Instead of "tell me about your family," something like "tell me about the people in your life, and how you came to be in family with them." Both are available, and they organize their own answer. Instead of "was it a good experience," try "what's your adoption like for you right now," which assumes it's current and doesn't lead anywhere.

And when they bring you something, the most useful thing you can say is almost nothing. Tell me more about that. What's that like for you. That sounds too simple to be a technique, but following exactly what the client said is what keeps the material available. Your language is rarely neutral here. Every phrasing is either inviting more or signalling that less is wanted.

Review

Cultural assumptions about adoption live inside standard clinical phrasings. With most clients they pass unremarked. With adoptees they signal what's welcome. Three territories are worth watching.

Questions about family

  • Closes it: "Tell me about your family." Assumes one family, and makes the client choose silently.
  • Opens it: "Tell me about the people in your life, and how you came to be in family with them." Both connections are available; the client organizes their own answer.

Questions about adoption itself

  • Closes it: "Was your adoption a good experience?" (assumes a verdict). "How do you feel about being adopted?" (invites a feeling without asking what's active). "I see you were adopted as an infant" (files it as background).
  • Opens it: "What is your adoption like for you right now?" Assumes adoption is current, leads nowhere in particular, leaves room for whatever they're carrying.

Responses to what the client brings

  • Closes it: "But your adoptive parents loved you" (redirection, however warm). "That sounds hard, but it was a long time ago" (treats it as finished). "Your biological mother must have loved you very much to make that choice" (supplies a meaning they didn't ask for and may not hold).
  • Opens it: "Tell me more about that." "What is that like for you?" Following what they actually said returns the work to them.

The underlying rule:

  • Your language is rarely neutral. Every phrasing either invites more material or signals that less is wanted.
  • These are patterns for attention, not a script. What opens one client closes another.

Continued considerations

  • Listen back to your own intake questions. Which of them assume one family?
  • Where else in your practice does a standard phrasing carry an assumption you've never examined?
  • Sit with this: what do you do when a client gives you the short answer, and you can tell it's short?