1. Be aware during hospitalization that the adoptee is looking at most events occurring around him/her through a lens of rejection (visiting family leaving, psychiatrist leaving, no feedback from therapy group, etc).

2. When adoptees reach the core of their pain, they feel like orphans.

3. When most adoptees get close to the pain of adoption loss, they run away through disassociation. (Stop them. Ask, "Where did you go? We're not going to move on until we talk about this.")

4. Many hospitalized adoptees recreate their original abandonment among other patients.

5. Safe touch speaks volumes.

6. Adoptees from religious backgrounds may struggle with compliance. Help them to see that physicians and psychiatric medicine can be part of the miracle of healing and not something to be ashamed of.

7. During treatment consider showing John Bradshaw's "Homecoming" video where the person is asked to visualize visiting his/her dying birth mother.

Be there afterwards to process feelings.

8. Ask probing questions about adoption perspectives:

* Do you think about your birth mother on your birthday?

* Do you think your birth mother is alive?

* Do you think she would want to meet you?

* Do you think that the painful emotions you are experiencing could have anything to do with your relinquishment and adoption?

9. Educate patient about symptoms of unresolved adoption loss:

I feel like something's missing (something's not right inside).

I often feel like I don't belong (square peg in round hole).

I blow up easily and hurt others.

I sometimes fantasize about my birth family.

I am confused about my identity.

I push myself to be perfect.

I am terrified of rejection, abandonment.

I struggle with self-esteem.

I sometimes feel like my life was a mistake.

I feel like an alien--like I wasn't born.

I get up tight whenever I think about a reunion with my birth family.

I hate good-byes.

When an opportunity I had hoped for doesn't materialize, I secretly wonder if I have done something wrong or if there is something wrong with me.

I can't trust anyone but myself.

I can't understand how anyone could give up a baby.

I think I have suffered from depression most of my life.

I put on an "all-together" faÁade.

My life was a mistake.

Sometimes I just feel guilty for living.

I have an eating disorder.

I feel like no one understands me.

I am afraid God will abandon me when I die like I was abandoned by my birthmother.

I have a turbulent relationship with my adoptive mother.

10. Tell about others who were adopted and have similar feelings and struggles

Use the story of Moses (Exodus 2-4).

Read the story of Esther, who was also an adoptee.

Encourage adoptee to join an adoption support group (317-849-5651).

Work through adoptee workbook.

Surf the net for adoption-related web sites (www.adoptionjewels.org).

Support initiation of a search for origins and give assurance that I will grow no matter what the outcome.

11. Give hope

Remind adoptee that unresolved adoption loss is not an impossible mountain to overcome.

Give assurance that he/she is not going crazy. What he/she is experiencing (depression, anger, etc.) is normal for anyone who has suffered a traumatic loss. (Grief is to the soul as a fever is to the body. Grief is the heart's way of trying to heal itself).

Suggest that he/she will not always feel like a crisis is going on within. Teach that adoption is a life-long journey--you will experience trigger points, but not crisis.

Remind adoptee that meaningful, successful relationships with others are possible.

Teach God's opinion of them (Ezekiel 16: 4-7 Living Bible). Self-esteem will

grow and life purpose will be clarified.

Teach that no one else on this planet can fill his/her place in history.

The loss that is so painful can become a blessing-- growth will occur and someday adoptee will be able to help others who are hurting.

Say often, "I am here for you."

Credits: Sherrie Eldridge