Therapist and professor Pauline Boss coined the term “ambiguous loss” to describe unique types of losses for which there is no closure. Prototypical examples are when a loved one goes missing and is never heard from again, or a parent or partner develops Alzheimer’s disease and slowly ceases to be the person you once knew despite being physically present.
Because these fall outside the realm of “typical loss,” the folks left behind experience more enduring and more complicated grief. Most of us are prepared to deal with losses that are concrete and finite. We have rituals—burials, commemorative tattoos—that help us mark the end of a chapter. When loss is ambiguous, there are no such rituals and no finality. People around us are often ill-equipped to help. They may be confused or put off by the intensity of our grief. They might even regard it as inappropriate or unfounded. It can be tremendously isolating.
It’s no wonder that Dr. Boss asserts that ambiguous loss is the most traumatic and hardest type of loss to face. Ambiguous losses violate our sense of control, certainty, and justice. They shake our identities and disrupt our relationships with other people.
Still, in almost five decades of working with people who have suffered ambiguous losses, she and others have identified concrete steps to help people cope with, and live well after, experiencing ambiguous loss.
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What Types of Situations Create Ambiguous Loss?
As a family therapist, Dr. Boss’s work has mainly focused on two types of situations having to do with the loss of loved ones. In the first, the person is physically gone, but without a (confirmed) death. They are not here but not gone either. Examples include:
- Missing persons, kidnapped children
- Incarceration
- Deployed military personnel
- Divorce
- Adoption
- Immigration
In the second, your loved one is still physically present, yet they have left you in some meaningful way. These people are here but not here. This can occur due to:
- Dementia, Alzheimer’s
- Traumatic brain injury
- Addiction
- Certain mental illnesses
What these have in common is relationship. The relationship you once had has been severed, and there is no guarantee (or no realistic chance) it will ever return to normal.
Researchers and practitioners use the ambiguous loss framework to understand other types of situations as well. The experience of loss is entirely subjective. Any time a loss feels complicated or unresolvable, or you believe others won’t acknowledge the depth of your loss, you might experience it as ambiguous. Homesickness might manifest as mild sadness or deep grief. Divorce devastates some and comes as a welcome relief for others. One parent of a transgender child may feel ambiguous loss over the little boy or girl they had known, while the other parent does not.
Even deaths can trigger ambiguous loss if you feel you can’t grieve freely because:
- You weren’t close to the person by societal standards (e.g., employee, social media friend)
- Your relationship was illicit or taboo (e.g., former lover)
- The nature of the death might elicit shaming or judgment from others (e.g., driving drunk)
Unique Challenges of Grieving an Ambiguous Loss
Psychologically, humans are wired for certainty. We want to control and master our environments. To that end, we need to see the world as fair and just. Ambiguous losses topple those illusions. Not only do people have to deal with the losses themselves, but also the shattering of their worldview.
Not surprisingly, then, ambiguous losses cause profound grief. Grief is nothing like the tidy five-step process you might expect. Even “normal grief” (yes, that really is the technical term) is messy. Beyond that, there are many different types of grief. Ambiguous losses may lead to grief that is complicated, chronic, or disenfranchised (when you feel that others won’t validate your grief).
Then there’s the self-doubt that arises when you aren’t sure whether your grief is appropriate. If your loved one is missing, and you start to grieve, does that mean you’ve given up hope? After a miscarriage, some parents wonder if they are “allowed” to grieve for a child they didn’t get the chance to know. Is their loss “big enough?” Is their pain too much?
These are rhetorical questions, of course, meant to highlight the complexities of ambiguous losses. Too often, we lack the roadmap to deal with these types of situations. When people around us experience ambiguous loss, the discomfort of not knowing the right thing to say means we often don’t say anything. The griever understands that they are not supposed to speak about their loss so as not to make others uncomfortable. We may even get frustrated with others’ grief, wishing they would get over it and move on. Of course, this leads to isolation and further pain.
Coping with Ambiguous Loss
Boss suggests that ambiguous loss, and the complicated grief that it causes, are the hardest losses to cope with. She describes the grief process as “frozen” because the usual advice—find closure—doesn’t apply to these situations. People feel like failures because they can’t “get over” their feelings, when really the problem isn’t the persistent grief. It’s the lack of understanding and social support for the grieving person.
Rather than finding closure and moving on, the goal with ambiguous loss is to find a way to live with the ambiguity, develop resilience in lieu of closure, and continue to live a meaningful life despite the sadness.
Concrete Steps You Can Take
When Boss works with someone who is experiencing ambiguous loss, her first step is to name and validate the person’s experience: “What you are experiencing is an ambiguous loss, the most difficult kind of loss because there is no closure.” Simply naming the experience often provides relief, as the person sees that their feelings are real and understandable. You can offer yourself this validation. Give yourself permission to feel your feelings without worrying about whether they are okay, too much, or too prolonged.
Find Support
Ideally, you’d be able to rely on friends and family for emotional support, but that may not be the case. Either way, there are other people out there who have had experiences similar to yours. They will be there for you if you seek them out.
You may choose to find a therapist as well. However, Boss stresses that it’s important not to pathologize your grief. In other words, don’t assume something is wrong with you because you’re grieving. Your feelings are legitimate reactions to painful, sometimes horrific, events. If you want someone to talk to, a therapist can be a great option. If you are unable to function or are thinking about self-harm, definitely seek help.
However, friends, family, even therapists shouldn’t push you to “get better,” nor expect your grief be what they consider normal. (This is itself unfair, as no two experiences of grief are identical.) Look for a therapist who has experience with ambiguous loss.
Work on Both/And Thinking
This is also known as dialectical thinking—allowing the mind to hold two contradictory, even seemingly incompatible, beliefs simultaneously. Some cultures are more comfortable with this than others. Americans tend not to be great at it.
Consciously work on accepting this new way of thinking. For example, you might practice telling yourself:
- “My partner no longer remembers me, and he is still the person I married.”
- “I no longer live there, and that country is still my home.”
- “I’ve never met my biological parents, and I still miss them.”
Find Meaning
This doesn’t necessarily mean you have to find meaning in the situation that causes you pain, although it’s great if you can. Rather, you look for ways to continue to live a life that includes purpose and even joy despite the pain. There’s a reason so many people who have lived through trauma go on to help other victims—it provides a sense of purpose. You might find meaning in your work, exercise, a spiritual practice, or a hobby.
These types of activities can also help you reassert your sense of mastery. As you devote your time and energy to a pursuit, you shape the outcome and control a piece of your world once more.
Create Your Own Ritual
If you couldn’t have, or weren’t able to attend, a memorial for someone lost or deceased, do something on your own. It need not be big as long as it feels meaningful to you.
In cases of not-here-but-not-gone losses, people grieve the loss of traditions like family holidays, trips to the summer cabin, or even having nightly dinners together. Ask yourself what types of new rituals you can create that fit your new circumstances. This is another way to find meaning in your present reality, too.
Grief in the Time of COVID
At the beginning of COVID — approximately 7,239 months ago — I wrote that we were individually and collectively experiencing ambiguous loss. That remains as true as ever. Children and parents lost the end of one school year and the beginning of another. You might be grieving for milestones you couldn’t celebrate, lost jobs, loved ones, travel, or simply the world as we knew it in the distant past of January.
It seems to me that many people are either downplaying or unaware of how much the stress and angst of living in 2020 is affecting them. If you’re reading this and coming to see your experience through the lens of ambiguous loss, the same coping tools apply here. Start by acknowledging and validating your experiencing of ambiguous loss. Your feelings are understandable reactions to unfathomable circumstances. Work on finding support where you can and finding new ways to find meaning and control. Practice both/and thinking: “I want to eat out in restaurants, and I understand why they are closed right now.” “I want my kids to have a normal school year, and I know that’s not possible.”
I can’t stress enough that there is no playbook for grief. As I said, the experiences of loss and grief are intensely personal. The goal is to practice self-awareness and self-acceptance so that whatever your situation, you can address it.
Additional resources from Dr. Pauline Boss
Loving Someone Who Has Dementia
Family Stress Management, 3rd ed.
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