Ambiguous loss

Ambiguous loss is a term used by psychologists and other specialists to describe a relationship that is broken without a clear ending or resolution. This can occur for a variety of reasons. Someone may be physically absent, such as a soldier who is missing in action. It can also occur when someone is physically present but disconnected in some way, such as when an aging parent has dementia or a teen is addicted to drugs and disengages from the family. Ambiguous loss can also occur in situations such as a divorce that breaks ties with extended family members or in the long-distance separations that result from immigration.

Ambiguous loss can trigger feelings of sadness, anxiety, guilt, and stress. It can interfere with daily activities such as eating, sleeping, and socializing. Because the situation is uncertain and resolution is delayed or might never come, ambiguous loss is often more difficult to overcome than the loss of someone to death. Experts say that family therapy and community-based interventions are the best ways to help someone overcome ambiguous loss.

Background

Ambiguous means something that is unclear or can be viewed in more than one way. The word comes from the Latin ambi, meaning “both ways,” and agere, meaning “to drive.” In the sixteenth century, the word came to mean something that is obscure or not distinct.

In the 1970s, American psychology professor and family therapist Pauline Boss noted that many people experienced a form of grief that was similar to the one felt by those whose loved one died. When someone dies, the bereaved can recognize and begin to accept the death in a number of ways. These include hearing a physician’s pronouncement, seeing the deceased, attending a funeral or other service, and reading a death certificate. These can all help people process their loss and move through the stages of grief to acceptance.

However, Boss observed a number of types of losses that severed a relationship in a way similar to death but without these clear markers and indicators. For example, when people are physically absent because of a war, a kidnapping, running away, or a disaster, those left behind experience loss but without the same sense of permanence as death. Those left behind can alternate between hope that the person will return and fear for the person and what he or she might be going through. This uncertainty interferes with the grieving process and can make it difficult for people to move past the loss and begin their own emotional healing.

Boss also believed that other circumstances trigger similar senses of loss without any clear resolution being available. For example, a person may be physically present but mentally or emotionally unavailable because of Alzheimer’s disease, a traumatic brain injury, or an addiction. These conditions can cause family members and friends to miss the person they once knew even though the person is still physically present. Boss coined the term ambiguous loss to refer to this condition. It has since come into general use among therapists to describe the emotional trauma of all uncertain losses.

Overview

Ambiguous loss is the grief and emotional pain experienced by those who lost a loved one without the opportunity for closure. When a family member or friend disappears or is physically present but mentally unavailable because of a physical or an emotional illness, people have feelings similar to those experienced after a death. The loved one is suddenly unavailable and the remaining family and friends grieve that loss, but it is more difficult for them to find resolution.

Survivors of war, genocide, and natural disasters may have lost family members and friends but may not immediately know their fate. Other disasters such as plane crashes, lost ships, or people who have gone missing under suspicious circumstances can trigger a sense of ambiguous loss. Until the person returns or his or her remains are found, the survivors may always wonder what happened and feel a sense of uncertainty. This is one reason that governments try to find and repatriate the remains of fallen soldiers—to bring a sense of closure to the survivors.

In the present day, other forms of ambiguous loss are more common. Alzheimer’s disease and other types of dementia steal people’s memories and make them unable to recognize their closest family and friends. In addition to caring for the physical needs of their loved one, people feel the loss of the person they once knew.

Divorce is another common cause of ambiguous loss. If one person involved in the divorce did not want it, he or she may experience the loss of the relationship and the shared experiences of being married. Some people who became related through the marriage may also feel torn apart. For example, a woman may miss the relationship she had with her former mother-in-law even if she no longer wanted to be married to the woman’s son.

Ambiguous loss causes many of the same symptoms as a loss due to death. Individuals may feel sadness and grief, anxiety, and confusion. They may have trouble eating and sleeping and may withdraw from socialization. People coping with ambiguous loss may also face other challenges. The uncertainty of their loved one’s fate can affect everything from their daily mood to their future plans. It might also impact their financial state. People may feel guilty if they continue with life while their loved one is missing or unable to participate because of a mental illness.

Boss and other experts note that ambiguous loss has an external cause and is not the result of a person not processing a past experience. As a result, it is less likely that individual therapy will be helpful. Experts recommend family- or community-based treatments instead.

Bibliography

“About Ambiguous Loss.” Ambiguous Loss.com, www.ambiguousloss.com/about/. Accessed 26 Mar. 2019.

Beam, Christopher and David Dudley. “Living With A Loved One’s Disappearance.” AARP the Magazine, Aug.-Sept. 2014, www.aarp.org/home-family/friends-family/info-2014/loss-of-loved-ones-grief.html. Accessed 26 Mar. 2019.

Boss, Pauline. Ambiguous Loss: Learning to Live with Unresolved Grief. Harvard University Press, 2014. books.google.com/books?id=a0x1cusSgNEC&printsec=frontcover&dq=boss+pauline&hl=en&sa=X&ved=0ahUKEwjdrNel8Z‗hAhXLq1kKHYywA1YQ6AEIKjAA#v=onepage&q=boss%20pauline&f=false. Accessed 26 Mar. 2019.

Boss, Pauline E. and Janet Yeats. “Ambiguous Loss: A Complicated Type of Grief when Loved Ones Disappear.” Bereavement Care, Aug. 2014, www.researchgate.net/publication/271943194‗Ambiguous‗loss‗A‗complicated‗type‗of‗grief‗when‗loved‗ones‗disappear. Accessed 26 Mar. 2019.

“Caregiving and Ambiguous Loss.” Family Caregiving Alliance National Center on Caregiving, www.caregiver.org/caregiving-and-ambiguous-loss. Accessed 26 Mar. 2019.

Mendoza, Marilyn A. “Ambiguous Loss.” Psychology Today, 5 Sept. 2017, www.psychologytoday.com/us/blog/understanding-grief/201709/ambiguous-loss. Accessed 26 Mar. 2019.

“Pauline Boss: The Myth of Closure.” On Being with Krista Tippett, 13 Dec. 2018, onbeing.org/programs/pauline-boss-the-myth-of-closure-dec2018/. Accessed 26 Mar. 2019.

“What is ambiguous loss?” Alzheimer Society Canada, alzheimer.ca/en/Home/Living-with-dementia/Grieving/ambiguous-loss-family. Accessed 26 March 2019.