Ambiguous Loss — Finding comfort when your grief is complicated

Grief is difficult to navigate for all of us. It is generated by varied circumstances and can take many forms. We often associate grief with the death or loss of someone we deeply love or care about, but we can also grieve when faced with the loss of expected outcomes, a change in the health of others or ourselves, a perceived difference in the security and safety of our environment or after disturbing events. Many of these experiences fall under the heading of “ambiguous loss,” a term coined in the 1970s by University of Minnesota professor emeritus Pauline Boss. Dr. Boss used the term to describe the emotional reaction of families or friends of military personnel missing in action, who dealt with the paradox of the simultaneous “absence and presence” of their loved ones. Ambiguous loss is a relational disorder caused by the lack of facts or closure surrounding the loss of something loved or dear to us. 

We now use this term when describing loss that takes a psychological form, rather than a physical state, such as loved ones who are born with or develop neurological disorders, mental health disorders or substance abuse problems. It can also refer to empty nest syndrome, relationship changes, such as divorce, breakups or estrangement or coping with a change in our physical abilities. 

Loss that involves a primarily physical change rather than emotional or mental change can also be ambiguous: death, with or without a body to mourn, such as a soldier missing in action or a loved one’s disappearance or abduction. An immigrant’s loss of her or his homeplace, parental or spousal abandonment, or the loss or use of a limb or a physical ability would also fall in to this category.

Ambiguous loss frequently involves long-term grieving and adjustment but is considered a normal process. We can live with the sadness of loss for long periods of time. We can and will grieve in our own way and for as long as necessary. Experiencing ambiguous loss does not mean that there is something wrong with us. The disorder it brings to our lives originates outside of our own bodies and minds and is susceptible to comfort from others and community-based interactions.

Becoming comfortable with uncertain or undeserved circumstances surrounding a loss is challenging but can provide a sense of relief for those left behind. That being said, grief can become depression when it takes over our daily functioning and prohibits us from taking care of ourselves and moving forward with our lives. This is the time when our grief should be examined by meeting with a therapist or participating in a therapy group. Seeking outside support is especially important for caretakers, who face emotional up and downs while witnessing the loss of a patient’s functioning mind and/or body due to disease or accident while managing their physical symptoms at the same time.