While studying families of pilots missing in action during Vietnam in the 1970s, Dr. Boss named ambiguous grief to describe a physical absence with a psychological presence, such as with missing persons (like the military example above), divorce, miscarriage, and desertion. The term also describes psychological absence with physical presence, as with cases of dementia, traumatic brain injury, chronic mental illness, or addiction. And when you're tasked with handling ambiguous loss, the feelings that arise are often complicated because there's no real recovery.
“Ambiguous loss can freeze the grief process.” says Dr. Boss, “People can't get over it, they can't move forward, they're frozen in place.” Unlike with death, there is no proof that allows for any sort of conclusion. There's no funeral and there's no script, so to speak, to follow.
“Ambiguous loss can freeze the grief process. People can't get over it, they can't move forward, they're frozen in place.” —psychologist Pauline Boss, PhD
With death, eventually you reorganize family roles, and somebody takes over what the lost person used to do, says Dr. Boss. “But when somebody is just missing, oftentimes the families will just wait, and that can go on for years, sometimes for a lifetime.” This can lead to difficulty in making decisions, dysfunction within a family or friendships, and general confusion derived from simultaneously harboring love and hate for the missing person. For instance, someone suffering from ambiguous grief may just wish the whole ordeal were just over but then feel guilty for those very feelings. “Those are normal reactions to an abnormal situation,” says Boss.
In effect, those markers of frozen grief can sometimes cause symptoms that appear psychiatric, such as depression. But Dr. Boss advocates building resilience to live with the loss instead of seeking psychiatric intervention. How? The following tips can help you build resilience and cope with ambiguous loss.
5 tips for coping with ambiguous loss
1. Give a name to what you’re experiencing
Just knowing that what you’re going through has a name and being able to recognize it is the first step in building resilience to the loss, says Dr. Boss. It allows you to start teasing out meaning from it. Keep in mind that this meaning looks different to anyone who experiences it—even two people from the same family.
2. Find a therapist
Finding a mental-health professional who has worked with people navigating a similar feeling is crucial for being able to build the resilience key to living with loss. And if any therapist suggests finding closure or gives you a timeline for getting over your loss, find a new therapist, Dr. Boss says.
3. Join a support group
“Seek out other people who are walking in the same shoes,” advises Boss. Whether it's a support group for caretakers of spouses of Alzheimer’s patients or an empty-nesters club, there is a group for almost everything. Online or in-person, finding a community will help you feel seen.
4. Celebrate what remains
Learn to embrace the happy-sad: While you’re grieving what and who is lost, there tend to be built-in silver linings right under your nose. For example, maybe a person can no longer be your go-to hiking buddy after having endured a serious injury, but they're more than able to be your go-to moviegoing friend instead. While you might have lost something sacred, there are always things to be gained.
5. Discover new hope for the future
“Once people become more comfortable with the ambiguity and the uncertainty, they are freer to imagine and discover new sources of hope,” Dr. Boss writes in the journal Bereavement Care.
Frozen grief won’t vanish, but having something new to dream about can help people live with an ambiguous loss. This could be as simple as finding a new activity you’re excited about or imagining what you might do with your future, whether it be a new job, traveling, or a relationship.
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