Adoption and its issues touch many lives. Sometimes a person doesn't know how, or if, conflicts in their life may be connected to relinquishment and adoption. SEVEN CORE ISSUES IN ADOPTION described by Silverstein and Kaplan (c 1986) affect the adoptee, the birth parent/s and the adoptive parent/s. Those seven core issues are: LOSS, REJECTION, GUILT/SHAME, GRIEF, IDENTITY, INTIMACY and CONTROL. If any of the following items cause feelings of sadness, fearfulness, hopelessness or anger to arise in you, talking to a therapist that is familiar with adoption issues may prove helpful to you.

LOSS
The adoptee may fear abandonment in many relationships. Issues about holding on and letting go may by apparent. Self-esteem can be difficult to maintain and can lead to isolation from old and new relationships. Adoptive parents often have not grieved enough about their losses, such as infertility or miscarriage. The birth parents may not be able to stop thinking about the lost child.

REJECTION
The adoptee may blame her/himself for the fact that their parents didn't want them and feel unworthy of the adoption. Adoptive parents may feel like they no longer fit into their families who do not have fertility problems. Birth parents may reject him/herself as irresponsible and unworthy because he/she permitted the adoption.

GUILT/SHAME
The adoptee may believe she/he deserves misfortune because of shame of being different. Adoptive parents can feel shame about childlessness and believe it is a punishment. Birth parent can feel shame/guilt for placing child in adoption. They can also feel shame for being a party to guilty secret.

GRIEF
Adoptee may not have grieved enough the loss of their birth family and that can cause depression and acting out. Adoptive parents may need to grieve the loss of the perfect child, they expected to have. Birth parents can delay grieving for years resulting in conflicts with relationships in their present family.

IDENTITY
The adoptee may behave in extreme ways, over-adaptive or rebellious, in order to determine if they belong. Adoptive parents might develop a sense of lower self esteem, as they are not "blood" related to their adoptee. Birth parents can develop a sense of diminished self-esteem that can effect present parenting of subsequent children.

INTIMACY
The adoptee might find it fearful to get close to someone. Past experience has so many losses in it. Bonding can be poor which can lead to poor intimacy in relationships of childhood and adulthood, especially marriage. Adoptive parents, with unresolved grief over losses, can experience marital difficulties. They may avoid true connection with the adoptee to avoid further loss. Birth parents can find that they also have intimacy issues, which relate to loss.

CONTROL
The adoptee realizes that adoption alters their life course. They had no part in the adoption decision. They can experience feelings of helplessness or powerlessness in day to day relationships. Adoptive parents can feel that they will not be effective in generating a life plan when they have not been able to generate their own children. Birth parents often see the relinquishment/adoption as out of their control. This can make it difficult for them to actualize a self-direction.

While these issues need to be acknowledged and addressed during and after the adoption process, they don't diminish the positive effects of adoption. Adoption is the best alternative for children who can't be raised by their birth parents and for parents who want to provide a loving home for children. The opportunity it affords children to grow up in a loving home with parents who care for them far outweighs the difficulties that may arise from the process.

Dr. Beirich is a psychotherapist in practice in Los Angeles. She is a member of the Independent Psychotherapy Network.

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