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National Counsel for Adoption Article


POSTED MAR 01, 2016

Post-Adoption Services: Acknowledging and Dealing with Loss




The word œadoption often conjures up joyful images of families coming together, created out of an abundance of love. Adoptive parents are ecstatic welcoming their new child or children into the family; relatives and friends celebrate with them, offering support and encouragement. Some imagine that life for the newly adopted child will now unfold in typical œfairy tale fashion, since the happy ending a loving family has been found.

But what about the other side of adoption the side that can often involve complicated feelings of loss and grief and, sometimes, lifelong unanswered questions? Losses are inherent in adoption. An adopted child has, by definition, first lost the parents who conceived and perhaps for a time raised and cared for them. Even in adoptions within the birth family, or those in which the birth parents are actively involved, there has still been a loss a disruption of the parental relationship with the birth mother and father.

The obvious loss for birth parents and birth relatives is the loss of the daily relationship with the child, the right to parent and make decisions for them. The hopes and dreams a birth parent has for their child may still exist, but the ability to steer them toward those dreams belongs to another parent or parents. The adoptive parents, who see their own dreams coming true with the adoption of their child, may also feel a sense of loss over a wished-for biological child, which they do not verbalize for fear of appearing ungrateful or making their adopted child feel like a œsecond choice.

So what is the œreal adoption experience sadness or joy, loss or connection? In truth, it is all of these at once. Complicated emotions weave in and out of the lives of all impacted by adoption adoptees, adoptive families, and birth families.

Seven Core Issues

To better understand the adoptive experience and how loss impacts it, we can look to the work of Silverstein and Kaplan (1982), who identified seven core issues in adoption: Loss, Rejection, Guilt/Shame, Grief, Identity, Intimacy, and Mastery/Control. Looking at these issues from the standpoint of the adoptee though others involved in adoption can experience the same issues we see how each of these may have a profound impact on the child, with certain issues taking center stage while others fall back to await their turn. It makes sense to look at Loss as the center of the other six, which all contribute to and are affected by the initial and overriding sense of loss.


Sometimes a child’s loss of their birth parents is dismissed, considered unimportant for those adopted as infants soon after birth. But research has shown that babies can recognize their mother’s voice even prior to birth. The experience of this loss of the birth mother cannot be eliminated, no matter how early babies meet or are adopted by their adoptive parents.

An adopted child has lost not only their birth parents, but likely other family members as well. Even if there is an open adoption agreement, contact may be limited to birth parents, excluding grandparents or other relatives the child loved or was loved by. One of the hardest losses is the loss of siblings. Sibling relationships are often our longest-term relationships in life, and many adoptees yearn for connection with their siblings, even those they never knew.

For the children who go on to be moved from place to place, whether through different relatives’ homes or foster care placements, each new loss builds upon the previous one, with an accumulating weight of increased trauma.


Feelings of rejection can be felt by some adoptees, as they struggle to make sense of their relinquishment. Regardless of whatever logical explanations they have been given, some can still feel abandoned. After all, they see other families who have made other choices in which children were not placed. If poverty was an issue, they might ask, why couldn’t the parents find a way to make it work and parent their child, like so many other families do? Children who were unable to live with the birth parents because of addiction issues might feel their parents chose the addiction over them. The feeling of rejection can become especially difficult if there are other birth children still living in the home; the adoptee can’t help but question, œWhy me? Why wasn’t I worth keeping?


It’s common for adopted children to wonder whether their placement or relinquishment was their fault. Even children adopted as infants often wonder if there was something they did œwrong as a baby that made their parents not want them.

Secrecy in adoption once played heavily into these feelings. The message often sent to adopted children was that there was something so shameful about them or their background, they were better off never knowing of or discussing it. Even children understand that secrets are often about things that are considered shameful, things people don’t want to admit out loud. Changes in adoption practices have decreased the level of secrecy, as more adoptions remain open to some degree or become open after having been closed. But if adoption is not openly and frequently discussed in the adoptive family, adopted children can still be made to feel as though their adoption is something to be embarrassed of.


The loss inherent in adoption needs to be recognized and grieved. Parents and others surrounding adopted children often try to downplay the feelings of loss, wanting to spare the child emotional pain. When this is the reaction children receive about their loss and grief, they try to hold it in instead.

We know that grief will always come out in one way or another. Children can only benefit from understanding the basic stages of grief, and being provided with an emotionally safe environment in which to express it. Adopted children are sometimes told they should be grateful for their new life, but this is an unfair burden to place on them to expect only joy and gratitude without recognition of the sadness and loss.


All young people, adopted or not, have to figure out their identities. It is common today for people to seek a connection with their past through genealogy whole industries have sprouted up to help with this search, which is ultimately about identity and the importance of one’s history. Even television has gotten into the act, helping celebrities go through the search to discover their distant roots. Is it any wonder, then, that children and adolescents struggle so hard to understand who they are?

Adopted children experience all the same stressors and confusion as their non-adopted peers, but they also have to try and mesh their identity within their adoptive family with that of their birth family. Children who have lived in multiple placements often have more trouble figuring out where they fit in, where they belong in the world. Those who have little information about their history or background may feel that a whole part of their identity has been lost. If adopted internationally or transracially, they have also lost important parts of their culture and history, and this can make it even more difficult to determine their identities.


Developing emotional intimacy requires trust and an ability to open oneself up and be vulnerable. This can be a challenge for anyone. But for adopted children who may have felt rejected, possibly multiple times, and who may not see themselves as deserving of love and intimacy it can feel like too much of a risk. Avoidance of intimacy then becomes a way to provide some self-protection.

Developing intimacy and connections with trusted adults and peers is a key task of childhood, and the inability to achieve this goal inhibits development and growth into adulthood. Intimacy as an adult also brings up issues related to sexuality, family, and childbirth, all things that can stir up strong feelings in adoptees about their own birth parents, history, and birth.


We all strive to feel a sense of control over our lives. This is a classic struggle for teens and young adults, who feel a new and strong drive to be in control of their choices and options while still dealing with ambivalence over giving up the safety of childhood. For an adopted person, this struggle takes place against a backdrop of complete lack of control over one of the most important decisions in their life joining their adoptive family. Power struggles can become a way to feel some sense of control and to achieve mastery over their own choices in life.

How Loss Can Impact Adopted Children

Over the years we have come to a better understanding of how these losses in adoption can impact children.

In infant adoption, there is more of an emphasis on involving the adoptive family early on when possible, even during pregnancy, to help build the attachment between them and the baby. The adoptive parents may be present for the birth, and take the child home from the hospital at discharge. While this can’t completely negate the loss for the child, it is an improvement on past practices of placing the child in temporary foster care for a period of time while finalizing legal steps.

Today, children living in foster homes who become eligible for adoption are often adopted by their foster parents, with whom they have an existing relationship, rather than having to go through yet another move and establish new relationships, experiencing yet another loss on their way to adoption. There is an increased emphasis on keeping children within their extended family when possible, allowing for guardianship, kinship care, or adoption by a relative. This allows the child to maintain family ties, even though there is still a change in relationships and a loss related to the parental roles.

Adoptive parents often make efforts to become knowledgeable about and inclusive of their adopted child’s heritage or culture, to try to reduce the sense of disconnection with their own identity. Open adoption has become increasingly common. For those who were adopted through a closed process, searches can successfully reunite them with their birth families. Even international adoptees are increasingly finding ways to search for birth families and reestablish lost connections.

Families may need help in identifying triggers for loss, and anticipating the losses inherent in transitions. Just being able to acknowledge these feelings without guilt or shame can be healing for many children. Issues of loss may come up at unexpected times, including those times most seen as joyous occasions high school or college graduation, weddings, births, and religious ceremonies are all examples of times when adoptees may feel a stronger sense of loss at the absence of the birth family. Mother’s Day and Father’s Day can bring up feelings of wanting to celebrate the parents who raised you, while still missing the parents, known or unknown, who are not there. Family reunions can be painful for the adopted child who listens as everyone else discusses where someone’s chin or eyes or crooked smile came from.

Divorce can be particularly painful for adopted children, who have already lost parents once and are facing a loss of full-time parents again. Close friends moving away can trigger painful feelings of loss and abandonment. Moving off to college is a big step toward independence for many, but it can also trigger feelings of loss for adopted children, who fear losing their relationship with their family. These feelings can be overwhelming for adopted youth, even more so because adopted people may fear hurting their adoptive parents and feel a need to keep their feelings to themselves.

Even minor events can hold a different meaning for adopted children. Family portraits and photo albums may highlight physical differences. School projects offer any number of challenges, and much has been written about alternatives to the œfamily tree project or the baby photo guessing game, which don’t always work well for children in adoptive families.

Acknowledging and Addressing the Losses in Adoption

Years ago, adoption was hardly talked about. Adoptive parents were often matched with babies who looked like them, with the expectation that the children would œpass as biological children. Many adopted children were not even told they had been adopted, sometimes finding out because of an offhand comment by a relative or learning the truth only after their adoptive parents died. Even if they always knew they were adopted, adoptees were isolated and often didn’t know anyone else dealing with the same issues. But today adoption is far more common, and people are more open about it. Many families have some experience with adoption either because of relatives or friends, even if they have not adopted themselves. Support groups and meet-ups can help adopted children connect with others who have similar life experiences.

Adoption is sometimes referred to as the œsolution, and children are told their adoptive family is their œforever family. But it isn’t always permanent, despite the best of intentions and expectations. This is particularly true with children who come into an adoptive home with significant trauma from past abandonments, disruptions, and other traumas. Reducing disruptions requires a better job of preparing both children and families for the transition, and providing the support and therapeutic interventions needed for a successful adoption.

Despite our best efforts to lessen some of the painful aspects of adoption while still acknowledging that they exist, some adoptees will always feel these losses. Sometimes there is a need for therapy that can help children work through these issues, accept and mourn their losses, and find ways to grow through their experiences.

Adoption-competent therapists may use a loss box to help children identify and cope with their losses. A loss box is a therapeutic project providing a small box, decorated by the child to reflect their own thoughts, hopes, and dreams. Within the therapy session, specific losses are identified, discussed, and mourned; the child can draw or write about the loss, and then place it in the box. The act becomes symbolic of the child’s decision to recognize and mourn, but then to let go of the loss and put it in a secure place.

Another technique for dealing with difficult feelings is to use masks. Similar to techniques discussed by Debbie Riley of C.A.S.E. (2006), masks can provide a unique medium for adoptees to explore their feelings and self-image. The symbolism of the mask brings to the forefront the ways that the adoptee masks their inner feelings and self-image, while providing a different image to the outside world. In our therapeutic practice, we often have the child decorate each side of the mask separately one side showing the public side of their face, and the other side revealing the internal, private side. The results can be startling when seen together.

Not all of the work takes place within the therapy office, of course. One of the most valuable things that a therapist can do in working with an adopted child is to work with the family as a unit, building and strengthening the connections between members and fostering stronger attachments. Families need help understanding how important it is to talk about these losses, and how they may trigger feelings and reactions in the adoptive parents as well.

Eliminating secrecy in adoption is not just about identifying the birth family; it is about acknowledging the pain, the questions, and the ambivalence, along with the joy. It is normal for an adoptive mother to feel sad when her child spends Mother’s Day focused on the loss of the birth mother. But denying these feelings on both sides only allows the pain and sense of disconnection to grow buried, perhaps, but getting stronger. Families need to learn to recognize and accept these feelings, to avoid allowing them to result in loyalty conflicts that separate, rather than unite.

Adoptive parents can help their children to find ways to honor and celebrate the birth family, even in closed adoptions. Even if the birth parents are not involved or not present, talking about them on Mother’s Day and Father’s Day, setting an extra place at the dinner table on Thanksgiving to say thanks for the birth family, or including the birth family in one’s thoughts and prayers and conversations are all ways to acknowledge their continued presence in the lives of the adoptive family as a whole.


Loss is inherent in adoption, but it is not the whole of adoption. Feelings of loss or sadness will ebb and flow for all those whose lives are touched by adoption, interspersed with feelings of great joy and celebration. Those touched by adoption will be better able to deal with it when they are prepared and provided with the supports, services, and understanding that can help them move through the natural transitions and emotions intrinsic to this complex, life-impacting, and lifelong experience.



Riley, D. & Meeks, J. 2006. Beneath the Mask: Understanding Adopted Teens. Burtonsville, MD: Case Publications.

Silverstein, D. & Kaplan, S. 1982. Lifelong Issues In Adoption. Retrieved from