The Seven Lifelong Issues in Adoption: Healing Paths for Adoptees, Birth Parents, and Adoptive Families

Diego Vitelli
Apr 28
5 min read

Adoption is not a singular event sealed by a judge’s signature — it is a lifelong journey with evolving emotional landscapes for adoptees, birth parents, and adoptive parents. In their groundbreaking 1988 article, Deborah N. Silverstein and Sharon Kaplan outlined the Seven Lifelong Issues in Adoption, a framework that continues to profoundly shape how we understand the enduring impact of adoption experiences.

This post explores these core issues across the different voices of the adoption constellation: adoptees, birth parents, and adoptive parents. It also weaves in the importance of working with adoption-competent, adoptee-centered therapists who are trained to address these nuanced emotional dynamics in compassionate and transformative ways.

Whether you're new to adoption, well into your journey, or simply curious, I invite you to reflect, feel, and perhaps begin a new conversation — with yourself, your family, or a trusted professional.

Understanding the Seven Lifelong Issues in Adoption

Silverstein and Kaplan’s Seven Lifelong Issues include:

Loss
Rejection
Guilt and Shame
Grief
Identity
Intimacy
Mastery/Control

Each issue is experienced differently depending on one's role in the adoption constellation. Let's dive deeper into each perspective.

Adoptees: Holding the Complexity of Adoption

Loss: Even in the most loving adoptive environments, adoptees experience a primal loss — separation from biological roots, genetic mirrors, and a sense of "what might have been." Loss is often invisible to others yet profoundly felt by adoptees as a silent backdrop to life milestones.
Rejection: The sense of rejection — “Why wasn’t I kept?” — can quietly live beneath achievements, relationships, and moments of joy. This perception can make vulnerability with others a fraught experience.
Guilt and Shame: Adoptees may wrestle with feelings of being "too much" or "not enough," internalizing shame that wasn't theirs to carry. There’s often guilt about feeling sadness or anger toward birth or adoptive families, leaving emotions suppressed or minimized.
GriefGrieving a family not known, a history not fully told, or experiences never had, is complex and ongoing. Adoptees often need permission — sometimes external permission — to name and honor their grief.
Identity: "Who am I?" is a universal human question, but for adoptees, this journey can be layered with mystery, dual loyalties, and fragmented narratives. Searching for one’s place often continues throughout the lifespan.
Intimacy: Forming close relationships can be complicated by fears of loss, rejection, and emotional abandonment. Trust may be fragile, even with trusted partners or friends.
Mastery and Control: Adoptees sometimes seek to manage their environments meticulously as a response to early experiences where they had little or no control.

Adoptee - "In what ways have I unconsciously carried someone else’s story as my own — and what would it look like to begin writing my own?"

Working with an adoption-focused therapist can help adoptees untangle these lifelong threads with compassion, offering a space to explore loss, develop a coherent identity, and build empowered connections with others.

If you're an adoptee seeking deeper understanding or healing, reaching out to an adoptee-competent therapist could be a transformative step toward owning your full, authentic story.

Birth Parents: Living with the Ripple Effects of Placement

Loss: For birth parents, placing a child for adoption creates an enduring wound. Loss is often disenfranchised — society may expect them to move on without space for continued grieving.
Rejection: Birth parents can feel rejected by society, their families, and even by the child they placed, particularly if there is no ongoing relationship.
Guilt and Shame: Feelings of shame often permeate birth parents’ experiences: shame for becoming pregnant in difficult circumstances, shame for choosing adoption, or guilt about the child’s potential future struggles.
Grief: Grief for birth parents is typically lifelong. Holidays, birthdays, and milestones can reignite the ache of absence.
Identity: Birth parents must integrate the reality of being a parent without the daily role of caregiving. For some, societal stigma compounds the challenge of claiming this identity.
Intimacy: Trusting others with one’s heart — especially after the profound vulnerability of placing a child — can be intimidating. Some birth parents describe feeling emotionally guarded or unworthy of love.
Mastery and Control: Many birth parents grapple with questions like: “Did I make the right choice? Could I have fought harder?” The struggle for peace with decisions made in often excruciating circumstances is lifelong.

Birth Parent - "How can I honor the depth of my love and loss while embracing my full humanity beyond the adoption decision?"

Seeing an adoption-literate therapist allows birth parents to safely unpack the layers of loss, grief, and identity formation in a judgment-free space.

If you're a birth parent carrying silent or visible wounds from placement, know that compassionate support is available — you don’t have to walk this lifelong road alone.

Adoptive Parents: Walking with Awareness

Loss: Adoptive parents often encounter loss, too: loss of fertility dreams, loss of a traditional biological narrative, and sometimes the loss of fantasy expectations about parenting.
Rejection: Despite strong bonds, adoptive parents may fear rejection by the child, especially during adolescence or identity-searching phases.
Guilt and Shame: Adoptive parents may feel guilt about the privileges of raising a child born to another or shame if their family doesn’t match societal ideals or “happy ending” myths.
Grief: There can be grief about what adoption could never fully heal — such as gaps in genetic or cultural heritage — and grief for struggles their child might face.
Identity: Adoptive parents navigate a dual identity: they are both a full parent and someone raising a child whose origins lie elsewhere. Balancing pride and humility is key.
Intimacy: Deepening emotional bonds sometimes requires tolerating the child’s complex emotions about adoption without personalizing them.
Mastery and Control: The desire to "fix" or control the adoption narrative can backfire. Adoptive parents must learn to hold space for ambiguity, not certainty.

Adoptive Parents - "Am I making room for my child’s whole story — even the parts that are painful for me to hear?"

Adoptive parents benefit tremendously from adoption-sensitive therapy, especially during transitional life stages (childhood to adolescence, launching into adulthood) when adoption themes often resurface more vividly.

If you are an adoptive parent wanting to build deeper trust and emotional resilience in your family, consider connecting with a therapist who understands the full spectrum of adoption dynamics.

Why Specialized Adoption Therapy Matters

General therapy can be helpful, but adoption-focused therapy offers critical nuances:

Validating Ambiguous Loss: Recognizing grief that is often invisible.
Normalizing Complex Emotions: Avoiding binary labels of "good" or "bad" adoption experiences.
Supporting Identity Development: Especially for transracial, transcultural, or closed-adoption experiences.
Enhancing Family Communication: Helping adoptive families hold open, emotionally honest dialogues.

Working with a therapist who understands the Seven Lifelong Issues — and who centers the adoptee's voice — creates an empowering pathway for every member of the adoption constellation.

Final Thoughts: Adoption Is a Journey, Not a Destination

Adoption journeys evolve over a lifetime. Loss, rejection, guilt, grief, identity, intimacy, and mastery are not problems to solve, but realities to honor with compassion and openness. Whether you are an adoptee, a birth parent, or an adoptive parent, your experience matters.

You do not have to navigate this journey alone.

Your emotions are valid. Your grief is real. Your story deserves space.

Interested in working with an adoptee-focused therapist? Reach out today — whether for a consultation, resources, or simply a conversation. Healing, connection, and empowerment are possible at every stage of your adoption journey.