Young girl standing outside and thinking

By JaeRan Kim, PhD

Adapted, with permission, from two articles by JaeRan Kim, PhD (“Understanding Ambiguous Loss” and “Adoption and Loss”) in MN ASAP Family Voices, a publication of Minnesota Adoption Support and Preservation. MN ASAP was a collaboration of the Minnesota Adoption Resource Network and NACAC.

Ambiguous loss—a feeling of grief or distress combined with confusion about the lost person or relationship—is a normal aspect of adoption. Parents who adopt children with special needs may feel ambiguous loss related to what the child could have been had he not been exposed to toxic chemicals in utero, or abused and neglected after birth. Birth parents experience loss when a child is removed from their home.

For children placed in foster care, this type of loss tends to happen over and over again, and is incredibly hard to process. To help children better manage these repeated traumas, foster and adoptive parents, as well as child welfare workers, must be sensitive to the role ambiguous loss plays in foster and adopted children’s behavior.

Ambiguous Loss and Child Welfare

Ambiguous loss occurs in two situations: when a person is physically present but psychologically unavailable, or when a person is physically absent but psychologically present. The latter type is most common in foster care and adoption.

Children who enter foster care lose contact with their birth parents, physical surroundings, and sometimes their siblings, and enter an extremely tenuous situation. Will the child be reunited with the birth parent and siblings? Will the parent fight to get the child back? How long will this take? Will the child remain with the same foster family until he goes home, or will he move again? What if the child can never go home?!

A child who is placed with a family of a different race loses something else. As editors Sheena McCrae and Jane MacLeod point out in Adoption Parenting: Creating a Toolbox, Building Connections, transracial families cannot hide. The anonymity of being in a regular family vanishes when the “conspicuous family” goes on any public outing.

School can be another source of unsettling grief. When a child moves among several schools, both social and educational continuity is broken. The child loses chances to develop lasting friendships and keep up with peers academically. If a child has FASD or another learning disability, or simply missed a lot of school earlier in life, school is an environment in which the child can feel out of place, cut off from same-age peers and their activities, or even looked down upon. Youth may mourn and be angry that prior circumstances or disabilities now keep them from fitting in at school and having a positive school experience.

The symptoms of ambiguous loss often mirror those of post-traumatic stress disorder. A child will commonly experience:

  • difficulty with changes and transitions, even seemingly minor ones
  • trouble making decisions
  • psychic paralysis or the feeling of being overwhelmed when asked to make a choice
  • problems coping with routine childhood or adolescent losses (last day of school, death of a pet, move to a new home, etc.)
  • a sort of learned helplessness and hopelessness due to a sense that he has no control over his life
  • depression and anxiety
  • feelings of guilt

Even children adopted before age one, who have no conscious memory of their birth parents, may experience symptoms of ambiguous loss as they approach their teens. In Ambiguous Loss: Coming to Terms with Unresolved Grief, author Pauline Boss states, “Although the birth mother is more conscious of the actual separation than is the baby…the birth mother is thought about often and kept psychologically present in the minds of both the adoptive mother and the adopted child.”

Children whose adoptive parents rarely discuss the absent birth parents or birth siblings feel the loss more keenly. In a study of young adult adoptees published in a 2005 issue of the Journal of Social and Personal Relationships, sociocultural researchers Kimberly Powell and Tamara Afifi correlate heightened ambiguous loss symptoms with children and youth who lack information about their birth parents and have lived with a family who failed to honor the adoptees’ connection with their family or culture of origin.

As Pauline Boss suggests, “the greater the ambiguity surrounding one’s loss, the more difficult it is to master and the greater one’s depression, anxiety, and family conflict.” This holds true for the following reasons:

  • It is hard to resolve grief when one does not know if the loss is temporary or permanent. Children in foster care, and even some in adoptive families, often feel great ambivalence about accepting a new family when there is even the slightest chance the birth family may still reclaim them.
  • Uncertainty about losses prevents children from easily reorganizing roles and relationships in their family. Children who served as their younger siblings’ caregiver in the birth family, for instance, can find it exceedingly hard to relinquish that role in a new family. In fact, separation from the birth family may make a child even more determined to fulfill the task of caring for her siblings.
  • Clear, symbolic rituals do not mark foster care and adoption losses. Society recognizes death through funeral ceremonies, but there is no somber equivalent to observe losses caused by separation from the birth family. Knowing that a parent or birth siblings are still somewhere out there can be confusing and anxiety-inducing for foster and adopted children. Will they run into members of their birth family by accident? Will their parents or siblings contact them someday?
  • The lost relationship is not socially acknowledged or is hidden from others. For adoptive families and their relatives and friends, an adoption is cause for celebration. Children who are adopted, however, may feel confused or guilty about expressing happiness over being legally disconnected from their birth family. Extended family members and members of the community may not fully appreciate that adoption is directly tied to losing one’s birth family.
  • Others negatively perceive the circumstances that led to the loss. When children are removed from families in which they are neglected or abused and placed with foster or adoptive families, many believe that the children are being rescued. Children, however, even when parents mistreat them, often feel a fierce loyalty to their birth families. After all, life with the birth family may be all they know. It is familiar. Social workers and foster/adoptive parents who believe children should be grateful for being placed in better functioning families need to understand how very differently children in foster care may view their situation.

How to Help Children Deal with Loss

When children—like those in or adopted from foster care—experience multiple losses, the psychological damage may extend well into adulthood. Ambiguous loss can erode trust, and adults who cannot trust typically struggle with relationships—sometimes avoiding closeness to forestall loss, sometimes clinging to a bad relationship due to deep-seated abandonment issues. The sooner children can address issues raised by ambiguous loss, the more likely it is they will learn better ways to deal with the fallout.

Below are some suggestions that can benefit children troubled by loss:

  • Help your child to identify what he has lost. In addition to losing birth parents, he may have lost extended family members and old friends, his home and neighborhood, contact with people who share his heritage or looks, his family surname, or even his home country and native language.
  • Give voice to the ambiguity. Acknowledge and validate your child if she expresses feelings of loss. Show that you understand and sympathize.
  • Redefine the parameters of what constitutes a family. Boss writes, “Acting as if the membership list of an adoptive family is etched in stone may in the end be more stressful than explicitly recognizing that the family has some ambiguous boundaries.”
  • Give your child permission to grieve the loss of his birth family without guilt. Suggest times and places where your child is welcome to express his grief, and ways in which he can grieve. Talking, journaling, drawing, or venting feelings through intense exercise are just a few options.
  • Create a “loss box.” Debbie Riley, a therapist and author who works with adopted teens, guides clients as they decorate a box into which they can put items that represent things they have lost. By creating the box, youth participate in a ritual that acknowledges their loss, and construct a controlled vehicle for revisiting their losses in the future.
  • Include birth parents and other birth family members in pictorial representations of the adoptive family tree. One option would be to depict an orchard where trees grow side by side. The birth family, former foster families, or other significant people in the child’s life can be other trees in the same family orchard.
  • Be conscious of how certain events—birthdays, holidays, adoption day, etc.—may trigger intense feelings of loss. Add or alter family rituals to respect the child’s feelings. On birthdays, for instance, you could add an extra candle to the cake in memory of the birth family. Or you might make a point of saying something like, “I bet your birth mom and dad are thinking about you today.”
  • Keep your expectations reasonable. A child’s need to grieve over ambiguous losses will not be fully cured, fixed, or resolved in any predetermined time frame, if ever. Let your child know that feelings related to these losses will come and go at different times in her life, and provide a safe person to whom she can express those feelings.
  • Model normal, healthy responses to loss. If you or your parenting partner suffers a loss, share your feelings openly. Let your children see you mourn, so they can learn how you express sadness and anger about loss. For boys, seeing a grown man cry can be especially instructive.

Losses may loom especially large when children approach adolescence. Missing pieces of their history make the task of developing a confident self-identity much more complicated. Some will feel that they are destined to make the same mistakes as their birth parents, so foster and adoptive parents must be especially careful to avoid unflattering comparisons between the teen and a birth parent, and stress that a large part of an individual’s identity is a matter of personal choice, not some preordained fate.

Parents must also recognize that, by parenting a child who has experienced staggering losses, they will realize losses in their lives too. Support from other parents who are struggling with similar issues is key. Conversations with other foster/adoptive parents may bring to light a new way to approach issues linked to ambiguous loss, or just help you to feel less alone. Loss is an inevitable part of adoption; acknowledging the role of ambiguous loss in children’s perceptions and actions is the first step in the long journey of healing.