Ambiguous Loss: Living with the pain of uncertainty

23 Jan Ambiguous Loss: Living with the pain of uncertainty

Ambiguous Loss: Living with the Pain of Uncertainty

Before I was a therapist, I had not heard the term ambiguous loss. I know now that I experienced it. Ambiguous means inexplicable. These ambiguous losses of mine were deeply felt for many years at an unconscious level.

I support people dealing with childhood trauma and other overwhelming life events. As a result, I now talk about ambiguous loss a lot. I have written about ambiguous loss in regards to mother relationships and adoption. Here, in a dozen or so paragraphs, I will explain ambiguous loss more broadly.

Like so many things, a first step to living with more clarity, acceptance, and self-compassion is naming what has happened or is happening to us.

Ambiguous Loss

Ambiguous loss, a term coined by Pauline Boss in the 1970’s and described as a relational rupture caused by a lack of facts and unacknowledged grief. This grief extends out to systems and organizations as well as people. Originally, Boss was studying the impact of having a father who was physically present, but psychologically absent, which is one type of ambiguous loss. In this case there is a yearning for closeness with a father who is always working. He is gone, but not dead. This presents hope for change, grief that it is not occurring now, and uncertainty about the future.

Physically Present, but Psychologically Absent: 

• • • Dementia/Alzheimer’s/Traumatic brain injury
    • Chronic mental or physical illness that alters personality &/or energy levels.
    • Narcissistic, self-absorbed, abusive parent
    • Non-emotional or emotionally unintelligent parent
    • Lack of common ground or connection with sibling(s)
    • Workaholic partner or parent
    • Addiction
    • Affair – emotional, physical, both

The other type of ambiguous loss is described as a loss where there is physical absence, but psychological presence. The classic example of this loss is a soldier missing in action. Loved ones are suspended in hoping that the soldier is alive and will return. The soldier is alive in the psyche, however, there are no facts to substantiate this hope.

Psychologically Present, but Physically Absent:

• • • Divorce or another breakup.
    • Estrangement
    • Relinquished child – voluntary or involuntary
    • Lost family due to relinquishment; adoption
    • Infertility
    • Soldier missing in action.
    • Country of origin & culture through immigration due to:
      • economic opportunity
      • war
      • genocide
      • adoption
      • natural disaster

The Pain of Uncertainty

Ambiguous loss is an uncertain state, which our brains do not handle well. There is deep grieving without a verifiable death or the ability to go back to the way things used to be. In many cases, the loss is centered on what is desired vs. the reality of what is.

In all situations, ambiguous loss is infused with longing and hope. When someone dies, aching for our loved one to return to life is normal. The difference is that we do know that it is not possible, for certain.

Death is very unlike the grief that surrounds yearning for a relationship to change, a country to be returned to, an adoption not to have happened, or a chronic disease to be cured. The fantasy of healing or of turning back time is understandable.

Acceptance of Uncertainty

Accepting the loss that is present does not mean that you approve of it or no longer feel grief. Acceptance is allowing for what is instead of waiting for something to change. Hope and a sense of agency can return in the form of accepting the pain and reality of the situation.

Often when wishing for what cannot be decreases, there becomes space for dealing with the current condition where there is room for taking charge and gaining back a degree of certainty. For example, accepting that your adult child’s addiction is worse during the holidays, so you attend more Al-Anon meetings in December for support instead of hoping this year is different.

Below are some ideas that might work for you or spark other ideas that are even better.

Feelings Wheel

Dr. Gloria Wilcox developed the feelings wheel to help pinpoint emotions. Primary emotions are in the center, then secondary emotions, tertiary on the outer rim of the circle. Getting clearer on what is felt brings clarity and a sense of groundedness. There are many versions online to download.

Journal

Write down feelings and keep a record of what is occurring. Notice changes or patterns over time to help anticipate, adjust, and plan.

Support Groups

Find a group that deals with your issue. Surround yourself with others that are having a similar experience to normalize and validate. Additionally, people that have dealt with what you are going through for a longer period of time can offer insight and dispel mystery.

Individual, Couple or Family Therapy

Depending on how ambiguous loss is impacting you &/or your family system, therapy allows space to process feelings, deal with conflict, and improve communication.

Dealing with ambiguous loss is tough stuff. Practice patience, self-compassion, and consider support for yourself and family. Pauline Boss said, “Sadness is treated with human connection.” I wholeheartedly agree. There is no need to go through this alone.

For more on Ambiguous Loss by Pauline Boss

• Ambiguous Loss: Coming to Terms with Unresolved Grief
• The Myth of Closure: Ambiguous Loss in a Time of Pandemic and Change 
• Loving Someone Who Has Dementia: How to Find Hope while Coping with Stress and Grief