LOSS
Fears ultimate abandonment
Loss of biological, genetic, and cultural history
Issues of holding on and letting go

REJECTION
Placement for adoption as a personal rejection
Can only be “chosen” if first rejected
Issues of self-esteem
Anticipates rejection
Misperceives situations

GUILT / SHAME
Feels deserving of misfortune
Ashamed of being different
May take defensive stance
Anger

GRIEF
Grief overlooked in childhood or blocked by adult leading to depression and acting out
May grieve lack of “fit” in adoptive family

IDENTITY
Deficits in information about birth parents, birthplace, etc. may impede integration of identity
May seek identity in early pregnancies or extreme behaviors in order to create a sense of belonging

INTIMACY & RELATIONSHIPS
Fears getting close and risking reenactment of earlier losses
Concerns over possible incest (e.g. with an unrecognized sibling)
Bonding issues may lower capacity for intimacy

CONTROL / GAINS
Adoption alters life course
Aware of not being a party to initial adoption decisions, in which adults made life-altering choices
Haphazard nature of adoption removes cause-and-effect continuum