From Parental Migration to ADHD Symptoms: A Psychoanalytic Exploration of Left-Behind Children

When parents migrate for labor, either domestically or internationally, they often leave their children behind with their grandparents, motivated by securing their future despite the profound challenges of physical separation. Thus, the left-behind children first experience separation and loss of the parent(s). After family reunification and immigration, these left-behind children must cope with separation and loss again – the loss of the substitute family, mostly grandparents. In addition, they must acculturate and become accustomed to everyday life in the new culture. In this paper, we describe how left-behind children experience acculturative stress in an immigration country based on previous double loss experiences. We also formulated the clinical hypothesis that despite the presence of grandparents, parental separation creates a psychological traumatic gap in these children that initially cannot be symbolized and acts out in a body-near manner of symptoms typical for ADHD as a defense against separation anxiety, depression, and aggression. We will illustrate this hypothesis with two clinical case vignettes: one about a child left behind at age four for 4 years before immigrating to Germany, exemplifying first-generation migration, and another about the offspring of a left-behind child in Switzerland, representing second-generation migration. Together, these vignettes highlight the enduring, unconscious traumatic impact of parental migration. The psychoanalytic technique of “scenic understanding” is discussed as a fruitful therapeutic approach.