Why Adoptees Struggle With Intimacy (And What To Do About It)
Intimacy is supposed to be one of the things we want most.
And for many adoptees, it is. The longing for genuine closeness — for a relationship where you are fully known and genuinely chosen — can be intense. Sometimes it feels like the thing you have been looking for your entire life.
And yet when closeness actually arrives, something often happens. A pull in the opposite direction. A sudden need for space. A picking of fights that didn’t need to be picked. A leaving before you can be left.
If this is familiar, I want to explain why it makes complete sense — and what you can actually do about it.
I'll be honest with you: I understand this from the inside. As an adoptee, I have spent time on both sides of this — wanting connection and making it harder than it needed to be. I didn't always have language for what I was doing or why. That's part of what drew me to this work.
The Root of the Problem: Love and Loss Arrived Together
For adoptees, the very first experience of love came packaged with loss.
Whatever the circumstances of the adoption — however loving the adoptive family, however thoughtful the placement decision — there was a loss at the beginning. A connection that existed and then didn’t. A person or people who were there and then were not.
The developing nervous system draws conclusions from early experience. And when the earliest experience of love includes separation, the nervous system learns something important: closeness is dangerous. People you love leave. Connection leads to loss.
This is not a conscious belief. Most adoptees who carry it cannot articulate it as a thought. It lives in the body, in the reflexes, in the patterns of behavior that show up in relationships without a clear explanation.
The result is what attachment researchers call an insecure attachment style — a set of strategies the nervous system has developed to manage the threat of intimacy. Those strategies look different depending on the person, but they share a common function: they keep people at a manageable distance.
How It Shows Up: The Common Patterns
Intimacy struggles in adoptees don’t always look the same. Here are the most common patterns I see in clinical work:
The avoidant pattern. This looks like independence, self-sufficiency, and a general preference for not needing people. Avoidant adults are often described by partners as emotionally unavailable, difficult to get close to, or dismissive of emotional needs. Underneath the self-sufficiency is a deep wariness of depending on someone who might leave.
The anxious pattern. This looks like intensity, preoccupation with the relationship, and a heightened sensitivity to any sign of withdrawal. Anxious adults often describe feeling like they want more closeness than their partner can give. Underneath the intensity is a terror of abandonment that makes even small distances feel catastrophic.
The disorganized pattern. This is the most complex, and it is more common in adoptees who experienced significant early trauma or multiple placements. It looks like wanting closeness and being afraid of it simultaneously — approaching and withdrawing, sometimes in the same conversation. The person who is the source of comfort is also experienced, at some level, as a potential source of danger.
The high-functioning isolation pattern. Some adoptees are genuinely warm, connected, and well-liked — and still maintain a private inner world that no one fully accesses. They can be present in relationships without being truly vulnerable. They give generously and receive poorly. They are, in a particular and lonely way, always slightly behind glass.
Why Relationships Can Feel Like the Highest-Stakes Arena
For adoptees, romantic relationships often carry an unusually heavy weight.
The longing to be chosen — genuinely chosen, by someone who stays — connects directly to the wound at the center of the adoption experience. When a romantic partner chooses you, something in you recognizes that this is what you have been waiting for. And when that relationship feels threatened, or when you sense — accurately or not — that the choosing might be revoked, the response is not proportionate to the situation. It is proportionate to the original wound.
This is why adoptees sometimes describe a level of anxiety or reactivity in relationships that doesn’t match what is actually happening. The current relationship is not the only relationship being processed. The original loss is always, in some sense, present in the room.
The Specific Challenges of Vulnerability
Genuine intimacy requires vulnerability — the willingness to be seen fully, including the parts you are not sure are acceptable.
For adoptees who carry shame about their origins, their identity, or the complexity of their feelings about adoption, vulnerability in a relationship can feel genuinely dangerous. What if the person sees those parts and decides, as someone once seemed to decide, that you are not worth staying for?
This fear can operate completely beneath conscious awareness. An adoptee may not consciously think: “I am afraid you will leave if you really know me.” But the behavior that prevents real knowing — the deflection, the humor that keeps things light, the sudden emotional unavailability exactly when things get most intimate — tells the story.
The fear underneath the wall — the one that says if you really see me, you might leave — is something I wrote about at length in Belonging: A Guided Journey Through Adoption Wounds & Wisdom. The identity and intimacy chapters go deeper into this territory than a single blog post can. If you are doing this work and want something to guide you through it, that is what the workbook is for.
What Partners Need to Understand
If you are in a relationship with an adoptee and reading this, a few things are worth knowing:
The withdrawal is not about you. When your partner pulls away exactly when you feel closest, it is almost never a rejection of you specifically. It is the nervous system doing what it learned to do when closeness arrived.
Pressure makes it worse. The instinct when someone withdraws is often to pursue — to ask more questions, to need more reassurance that the relationship is okay. For a partner with avoidant patterns, this pursuit typically triggers more withdrawal. The counterintuitive move is to give space while remaining clearly available.
Consistency is the medicine. What slowly, over time, changes insecure attachment patterns is consistent, predictable presence. Not grand gestures. Not perfect attunement. Just the steady accumulation of being there, again and again, in a way that does not demand that the person perform their security before they feel it.
What Actually Helps: For Adoptees Working on This
The good news about attachment is that it is not fixed. The patterns formed in early experience are not permanent — they can change, with the right conditions and the right support. Here is what that looks like in practice:
Name the pattern. The first step is simply recognizing which pattern is yours. Not as a diagnosis or a life sentence, but as information. “I tend to pull away when things get close” or “I tend to panic when I sense distance” is enormously useful self-knowledge.
Slow the automatic response. Attachment patterns operate faster than conscious thought. The goal is not to eliminate the response but to create a small gap between the trigger and the behavior. That gap is where choice lives.
Practice tolerating closeness in low-stakes contexts. Intimacy is a skill that builds. Starting with smaller vulnerabilities — saying something true about how you feel in a moment where the stakes are relatively low — builds the nervous system’s capacity for bigger ones.
Work with a therapist who understands adoption. Attachment work is most effective in the context of a therapeutic relationship. The therapy relationship itself is a place to practice — to notice the patterns as they arise, and to have a different experience of closeness than the one that formed the original blueprint.
Be patient with the timeline. Attachment patterns that took years to form take time to change. The measure of progress is not whether the patterns disappear but whether they have less power — whether the gap between trigger and response grows, and whether you make different choices more often than you used to.
A Word to the Adoptee Who Is Tired of This
If you have been in multiple relationships that ended the same way. If you have watched yourself do the thing again, knowing what you were doing, unable to stop it. If you are exhausted by the gap between how much you want closeness and how hard you make it for closeness to arrive —
I want you to know this is not a character flaw. It is not evidence that you are incapable of love or undeserving of it.
It is evidence that your nervous system learned something very early and very powerfully, and that it has been trying to protect you ever since.
That learning can be updated. It takes work. It takes the right support. But it is not permanent — and you are not stuck.
Melissa LaCour is a Licensed Professional Counselor and adoptee based in Lafayette, Louisiana, specializing in adoption-informed therapy for adult adoptees and adoptive families. In-person in Lafayette and telehealth across Louisiana, Ohio, Minnesota, Georgia, and Indiana.
If intimacy is the thing you keep circling, therapy is a good place to start. Book a free 15-minute consultation. The Belonging workbook includes a full chapter on intimacy for adoptees.
Adoption Trauma in Adulthood — What It Is and Why It Still Shows Up
There's a particular kind of confusion that a lot of adult adoptees carry — and it goes something like this:
I had a good life. I was loved. So why does it still feel like something is wrong?
If that question has lived in you — quietly, persistently, sometimes surfacing at the most inconvenient moments — I want to offer you something: not a diagnosis, not a label, but a framework that might finally make some sense of it.
It's called adoption trauma. And it doesn't always look the way we expect trauma to look.
What Is Adoption Trauma?
When most people think of trauma, they think of a single, dramatic event — an accident, an assault, a disaster. Something with a clear before and after.
Adoption trauma rarely works that way.
Adoption trauma refers to the psychological and emotional impact of early separation from a birth parent — and the ripple effects of that separation across a lifetime. It can begin before a child has any conscious memory, before they have language, before they can form a narrative about what happened. And yet the body remembers. The nervous system remembers.
Researchers describe early separation from a caregiver as one of the most significant stressors an infant can experience. Even in cases where the adoptive home is warm, stable, and loving — the separation itself carries weight. It doesn't mean the adoption was wrong or that your adoptive family failed you. It means that loss, even early and pre-verbal loss, leaves a mark.
This is sometimes called developmental trauma or early relational trauma — trauma that is less about a single event and more about a disruption to the foundational experience of safety, connection, and continuity.
Why It Shows Up in Adulthood
Here's what's true about trauma that happened very early in life: it doesn't necessarily show up as a memory. It shows up as a pattern.
You may not remember being placed. You may not have a clear narrative around your earliest separation. But if your nervous system learned, in those first days or months or years, that connection is precarious — that the people you love might disappear — that lesson gets encoded somewhere deep. And it tends to drive behavior from that place, long after the conscious mind has moved on.
For many adult adoptees, adoption trauma surfaces not as flashbacks or nightmares but as:
A persistent, low-level anxiety about being left — in relationships, in friendships, even in professional settings
Difficulty trusting that love is stable, even when there's evidence it is
Patterns of pushing people away before they can leave first
An exquisite sensitivity to criticism, rejection, or feeling unwanted
A sense of not quite belonging — anywhere, to anyone, including yourself
Emotional responses that feel disproportionate to the situation, as if the reaction is older than the moment
A body that is often tense, vigilant, or difficult to settle
None of these are character flaws. They are the logical output of a nervous system that learned early that the world was uncertain.
"But I Had a Happy Childhood"
This is one of the most common things I hear — and one of the most important to address.
Having a loving adoptive family and experiencing adoption trauma are not mutually exclusive. In fact, many adoptees who had genuinely wonderful childhoods still carry this — because the trauma didn't happen in the adoptive family. It happened before it. It happened in the original separation.
Gratitude and grief are not opposites. You can be deeply grateful for the family that raised you and still carry a wound from the one you were separated from. Those two things do not cancel each other out. They simply coexist — and that coexistence is one of the most disorienting parts of the adoptee experience.
The pressure to choose — to be either grateful or wounded, either fine or struggling — is one of the cruelest things the adoption narrative imposes on adoptees. You don't have to choose. Both are true. Both are allowed.
How Adoption Trauma Lives in the Body
Dr. Bessel van der Kolk's landmark work established something that trauma-informed therapists know well: the body keeps the score. Trauma that isn't processed cognitively doesn't disappear — it relocates. It lives in the nervous system, in patterns of tension and activation, in the ways the body responds to perceived threat long after the actual threat is gone.
For adoptees, this can look like:
Hypervigilance — a baseline alertness, always scanning for signs that connection is about to be withdrawn. Feeling exhausted by relationships in a way others don't seem to understand.
Emotional dysregulation — big responses to things that others find minor, because underneath the current moment is the original one. The body doesn't distinguish clearly between then and now.
Shutdown or numbing — the opposite of hyperarousal, but coming from the same place. Some nervous systems respond to chronic stress by going quiet, flat, unreachable. This can look like depression, disconnection, or what one of my clients once described as "watching my life from behind glass."
Somatic symptoms — chronic tension, digestive issues, fatigue, headaches — the body's way of holding what the mind hasn't processed.
None of this makes you broken. It makes you human — and it makes you someone whose early experience was more complex than the simple story you may have been given.
Adoption Trauma Looks Different for Different Adoptees
It's worth saying clearly: adoption trauma is not universal or uniform. Every adoptee's experience is shaped by a complex combination of factors — the circumstances of their placement, the quality of their adoptive home, their temperament, whether they experienced additional adverse experiences before or after adoption, whether their adoption was domestic or international, same-race or transracial.
Some adoptees carry significant, identifiable trauma. Others carry something quieter and more diffuse. Some don't identify with the word "trauma" at all — and that's valid too.
What matters is not whether your experience fits a particular label. What matters is whether naming it — in whatever form it takes — helps you understand yourself more clearly and move through the world with more freedom.
The Particular Complexity of Transracial Adoption
For adoptees raised in families that didn't share their racial or cultural background, adoption trauma can carry additional layers.
When your physical appearance, cultural heritage, or racial identity differs from your adoptive family's, you may have navigated questions of identity without anyone who could mirror that experience back to you. You may have received messages — overt or subtle — about which parts of yourself were acceptable and which were awkward or inconvenient. You may have felt caught between communities, belonging fully to neither.
This isn't a criticism of transracial adoptive families. It's an acknowledgment that the work of navigating racial and cultural identity is real, it matters, and it deserves space in any honest conversation about adoption and healing.
What Healing Actually Looks Like
Healing from adoption trauma is not a linear process, and it is rarely a destination you arrive at once and stay. It is more like a relationship you develop — with your own history, with the parts of yourself that adapted to survive, with the grief that may not have had anywhere to land until now.
A few things that genuinely help:
Adoption-competent therapy. Not every therapist is equipped to work with adoption trauma. Look for someone who is adoption-informed, has training in attachment and trauma, and doesn't minimize the complexity of your experience. Approaches like internal family systems (IFS) can be particularly effective for early developmental trauma.
Language. One of the most consistently healing things I see in my work is the moment a client finds language for something they've been living wordlessly. Frameworks like the 7 Core Issues of Adoption don't diagnose you — they name what's already there. And naming it changes your relationship to it.
Community. There is something irreplaceable about being witnessed by people who understand from the inside. The adoptee community — through podcasts, support groups, online spaces — offers a kind of belonging that even the best therapy can't fully replicate.
Structured self-reflection. For adoptees who are ready to do deeper work but aren't yet in therapy — or who want to supplement the work they're already doing — guided reflection can be a powerful tool. My workbook, Belonging: A Guided Journey Through Adoption Wounds & Wisdom, was written specifically for adult adoptees and covers these themes chapter by chapter, with space to write, reflect, and integrate.
Somatic practices. Because adoption trauma often lives in the body, healing often has to happen there too. Breathwork, yoga, movement, body-based therapy — these aren't luxuries. For many adoptees, they're essential.
A Word About Resilience
I want to be careful here, because resilience is a word that gets weaponized against adoptees.
You're so resilient. It's often meant as a compliment — but it can function as a way of closing the conversation. Of saying: you survived, so you're fine, so let's move on.
Resilience is real. Many adoptees have developed extraordinary capacity for adaptation, empathy, insight, and strength — in part because of what they've navigated. That is worth honoring.
But resilience and healing are not the same thing. You can be highly functional and still be carrying something unresolved. You can be strong and still be hurting. You can have survived beautifully and still deserve more than just survival.
The goal isn't to be resilient in spite of your adoption story. The goal is to understand it, integrate it, and build a life that is genuinely yours — not just one that looks okay from the outside.
You Don't Have to Have It All Figured Out
If this post has surfaced things that feel tender or confusing — that's not a sign that something is wrong with you. That's a sign that something in you is ready to be looked at.
You don't have to resolve it today. You don't have to have the right words for it yet. You don't have to decide whether "trauma" is the right word for your experience before you're allowed to take it seriously.
You're allowed to start wherever you are.
And wherever you are — with whatever you're carrying — there is a path forward. It isn't always easy, and it isn't linear, and it doesn't end with a ceremony or a certificate. But it is real. And you are not alone on it.
Melissa LaCour is a Licensed Professional Counselor based in Louisiana, specializing in adoption, relationships, and life transitions. She is also an adoptee. Learn more at melissalacour.com.
If you're ready to go deeper into your adoption story, the Belonging workbook was written for exactly this moment.
Further reading: Van der Kolk, B. (2014). The body keeps the score. Viking. Boss, P. (1999). Ambiguous loss. Harvard University Press. Verrier, N. N. (1993). The primal wound. Gateway Press. Brodzinsky, D., Schechter, M., & Henig, R. M. (1992). Being adopted: The lifelong search for self. Doubleday.
The 7 Core Issues of Adoption — A Guide for Adult Adoptees
If you've ever felt like something in you was quietly off — like you were carrying a weight you couldn't name, grieving something you couldn't point to, or struggling in relationships in ways you couldn't fully explain — there's a good chance no one ever gave you language for it.
I know that feeling. I'm an adoptee too.
For a long time, the adoption narrative most of us were handed went something like this: You were chosen. You were loved. You were given a better life. And maybe all of that is true. But it's also incomplete — and that incompleteness is exactly where so much adoptee pain lives. In the gap between the story we were given and the one we actually lived.
The 7 Core Issues of Adoption framework, originally developed by adoption professionals Deborah Silverstein and Sharon Kaplan Roszia, changed a lot of that for me — both personally and in my work as a counselor. Because for the first time, it gave names to things that had always been there but never had words.
This post is my attempt to share that framework with you — not in clinical language, but in the language of someone who has lived it.
What Are the 7 Core Issues of Adoption?
The 7 Core Issues are a set of emotional themes that tend to emerge for people affected by adoption — particularly adoptees, but also birth parents and adoptive families. They were identified as a framework in the early 1980s and have since become foundational in adoption-competent therapy.
Here's the important thing: these aren't stages to get through. They're not a checklist or a diagnosis. They're more like threads — ones that run through the fabric of an adoptee's life, showing up in different forms at different ages, in different relationships, in different seasons.
You may recognize all of them. You may only recognize two or three. Either way, that recognition is the beginning of something.
1. Loss
Every adoption story begins with a separation. And with that separation comes loss — often multiple layers of it.
For adoptees, loss might mean the loss of birth parents, biological family, cultural roots, medical history, or simply the story of your own origin. It can feel like a missing piece you can't locate, a vague emptiness that surfaces in unexpected moments.
What makes adoption loss so complicated is that it often goes unrecognized — even by the adoptee themselves. There's no funeral, no clear moment of mourning, no cultural ritual for the kind of grief that comes from losing something you never fully had. Researchers call this ambiguous loss — grief without closure.
You might notice this as: A low-level sadness you can't explain. Feeling most aware of something missing at life milestones. Being moved by stories of family reunion in ways that catch you off guard.
2. Rejection
Even when adoption was the most loving decision a birth parent could make, the child who was placed often doesn't experience it that way — at least not internally, and not always consciously.
The wound of rejection says: I was left. Therefore, something must be wrong with me.
This belief rarely lives at the surface. It lives underneath — in a heightened sensitivity to being excluded, overlooked, or unwanted. It shows up in relationships, in work, in how much devastation a small slight can carry.
This is what therapists call rejection sensitivity — and it's one of the most common things I see in my work with adoptees. It isn't a character flaw. It's a nervous system response to an early experience of separation.
You might notice this as: Feeling disproportionately hurt when someone pulls away. Anticipating rejection before it happens. Choosing people who confirm your worst fears, or keeping everyone at a safe distance.
3. Guilt and Shame
Guilt says: I did something wrong. Shame says: I am something wrong.
Adoptees often carry both — quietly, and often without knowing it.
There can be guilt about grieving a birth family you never knew. Guilt about searching for birth relatives, as if curiosity is a betrayal. Guilt about being angry, or sad, or complicated when the world expects you to be grateful.
Shame can attach to the very fact of being adopted — a deep, wordless belief that being placed means you were somehow defective or unwanted. It's often what keeps adoptees from talking about their experience at all.
The research of Dr. Kristin Neff on self-compassion shows what most therapists know from experience: shame grows in silence and heals in connection. Naming it — even just to yourself, on paper, in a therapist's office — is the first step toward putting it down.
You might notice this as: Minimizing your own pain ("I shouldn't complain"). Hiding parts of your story. Feeling like a burden when you bring up your adoption experience. A deep discomfort with your own anger or grief.
4. Grief
Adoption grief is real — and it is one of the most unacknowledged forms of grief there is.
You can grieve something you never had. You can grieve a relationship that never had the chance to form, a family you came from but may never know, a version of your life that didn't happen. This is called disenfranchised grief — grief that isn't openly acknowledged or socially supported.
Adoption grief doesn't follow a neat timeline. It tends to come in waves — sometimes quiet for years, then surfacing powerfully around a milestone: a birthday, a pregnancy, becoming a parent yourself. Grief in adoptees also doesn't always look like sadness. Often it looks like anger, numbness, or avoidance.
You might notice this as: Sadness that feels larger than the situation. Anger that seems to come from nowhere. Emotional flatness or shutdown. Being especially affected around anniversaries, birthdays, or milestones.
5. Identity
Who am I?
It's one of the most fundamental questions a human being can ask — and for adoptees, it often comes loaded with additional weight.
Identity is built from many sources: family resemblance, shared stories, cultural traditions, genetic history. For many adoptees, some or all of those sources are absent, unknown, or complicated by the presence of two families and two separate stories.
For adoptees in transracial or international adoptions, identity can carry another layer entirely — navigating racial or cultural identity within a family that doesn't share it, often in communities that don't reflect it back.
Identity formation isn't a one-time event. It's a lifelong process — and adoption adds threads that others simply don't have to weave.
You might notice this as: Difficulty answering "where are you from?" Feeling like you're performing a version of yourself rather than being it. Wondering who you would have been if your life had gone differently. A strong hunger to know your genetic history — to see your face in someone else's.
6. Intimacy
If early attachment is disrupted — if the first relationship you had with a caregiver ended in separation — your nervous system learns something: connection is not permanent. People leave.
That lesson doesn't go away just because you grow up in a loving home. It often shapes how adoptees move through relationships for years, even decades.
Intimacy struggles in adoptees tend to show up in one of two ways: pulling away when things get too close, or clinging to connection out of fear it will disappear. Both patterns are rooted in the same place — early disrupted attachment — and both are intelligent adaptations to an early experience that said love might not be safe to fully trust.
The good news: attachment patterns are not fixed. They shift — through insight, through safe relationships, through good therapy, through the slow accumulation of experiences that teach your nervous system something different.
You might notice this as: Difficulty letting people fully in. Relationships that feel intense early, then suddenly feel threatening. Choosing unavailable partners. Emotional walls you can't quite explain, even to yourself.
7. Mastery and Control
Adoption is a decision that was made for you, not by you. Before you could speak, before you could choose — the most fundamental circumstances of your life were arranged without your consent.
For many adoptees, this early experience of powerlessness leaves a lasting imprint. The need to control — your environment, your relationships, your outcomes — can become a way of compensating for that original lack of agency.
This can look like perfectionism, rigidity, over-planning, difficulty trusting others. It can also look like the opposite — learned helplessness, giving up control entirely, as if trying never mattered anyway.
Neither is a character flaw. Both are understandable responses to an early experience of having no say.
You might notice this as: Intense discomfort when plans change. Difficulty delegating or trusting others. A strong need to manage outcomes. Or alternatively, passivity — difficulty advocating for yourself because it never felt like it mattered.
These Issues Don't Work in Isolation
One of the most important things to understand about the 7 Core Issues is that they don't exist separately. They feed each other. Loss creates the conditions for rejection. Rejection fuels shame. Shame makes intimacy feel dangerous. Fear of intimacy drives control.
For most adoptees, there's one or two that feel most central — that seem to sit at the root of the others. Identifying yours isn't about labeling yourself. It's about finally having a map for terrain you've been navigating in the dark.
What to Do With This
If any of these resonated — even quietly, even uncomfortably — that recognition matters.
You don't have to have all the answers today. You don't have to resolve decades of experience in an afternoon. But you can start giving it language. And language is where healing begins.
A few places to start:
Work with an adoption-competent therapist. Not every therapist is trained in adoption issues. Look for someone who identifies as adoption-informed, has experience with attachment and trauma, and doesn't require you to simply "be grateful." Psychology Today's therapist finder lets you filter by adoption specialty.
Find your people. The adoptee community is real and growing — podcasts like Adoptees On, online communities, support groups. Being witnessed by people who actually understand is its own form of healing.
Go deeper with structured reflection. If you're ready to do this work in a more guided way, my workbook Belonging: A Guided Journey Through Adoption Wounds & Wisdom was written specifically for adult adoptees — and it's built entirely around these seven issues.
A Final Word
The 7 Core Issues framework didn't exist to diagnose you or categorize your pain. It existed to say: this is real, it has a name, and you are not alone in it.
You were not too sensitive. You were not too complicated. You were not too much.
You were navigating something genuinely complex — without a map, without language, and often without anyone around you who fully understood what you were carrying.
Now you have some of the map.
Keep going.
Melissa LaCour is a Licensed Professional Counselor based in Louisiana specializing in adoption, relationships, and life transitions. She is also an adoptee. Learn more at melissalacour.com.
If you're ready to go deeper, Belonging: A Guided Journey Through Adoption Wounds & Wisdom will be available in Summer 2026 as a digital PDF and print edition.
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Sources & Further Reading:Silverstein, D. N., & Kaplan Roszia, S. (1982). Seven core issues in adoption.Roszia, S. K., & Maxon, A. D. (2019). Seven core issues in adoption and permanency. Jessica Kingsley Publishers.Boss, P. (1999). Ambiguous loss. Harvard University Press.Doka, K. J. (1989). Disenfranchised grief. Lexington Books.