It is commonly recognized in psychoanalysis that early life events impact the self and relational experiences of patients. There is, however, less recognition that an early event that is mainly within the first day of a baby’s life and that doesn’t appear to be a traumatic experience can nonetheless have a life-long impact. This article examines the role of early loss in adoptees and how it presents itself in the relational context. I explore this notion through the review of a case of an adult adoptee struggling with her sense of herself and the role of her relationships due to her fears of abandonment. My work with the patient is followed as she progresses from fear and isolation to vulnerability and intimacy.