LOSS
Infertility equates with loss of self and immortality
Issues of entitlement lead to fear of loss of child and overprotection

REJECTION
Feeling of being ostracized because of procreation difficulties
May make partner the scapegoat
May expel adopted child to avoid anticipated rejection

GUILT / SHAME
Ashamed of infertility
May believe childlessness is a curse or punishment
Religious crisis

GRIEF
Must grieve loss of “fantasy” child
Unresolved grief may block attachment to adopted child
May experience adopted child’s grief as rejection

IDENTITY
Experiences a diminished sense of continuity of self
“Role Handicap”—I am a parent / I am not a parent

INTIMACY & RELATIONSHIPS
Unresolved grief over losses may lead to intimacy and marital problems
May avoid closeness with adopted child to avoid loss

CONTROL / GAINS
Adoption experiences lead to “learned helplessness” where sense of mastery is linked to procreation
Lack of initiative