In my research and practice I explore the special issues and concerns that birthparents, adoptive parents and adoptees face. There are normal crises that occur. While all families and individuals go through developmental stages, the special circumstances that adoption creates add issues and complexity to the process of development. These issues are normal and healthy under the circumstances that surrender and adoption create. A systemic approach is needed in order to work with adoptive family systems.
Crises can be normal and can even lead to transformation.
And when speaking of the adoptive family, the birthparents are included, whether or not they are known. Things that birthfamilies take for granted may pose serious dilemmas for adoptive families. One example is medical history. Physicians say that dealing with an adoptee is like dealing with a coma victim in the sense that critical and current family history information is often missing and impossible to get. For this reason I have come to recommend leaving at least a channel open in all adoptions for the updating of medical information.