What Is Ambiguous Loss and How to Cope With It?

Pauline Boss, the researcher who coined the term, explains why loss without clear documentation of its permanence is so difficult to manage. Plus, she and others share tips for coping.

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dying flower in a vase dropping petals
Going through a breakup, losing health or physical functioning, or having someone you love go missing are all examples of ambiguous loss.Juj Winn/Getty Images

Your brother is incarcerated. He’s alive, but you’ve lost access to him, and you worry about his safety, never knowing exactly what he’s going through. Or: Your partner has checked out emotionally from your relationship; they are both physically present and not fully there. Or: You’re living through climate change and COVID-19, and while the world you grew up with is still partly there, you’ve lost some of it — as well as a sense of safety and security about the future.

All of these situations, though quite different from one another, fall under a concept called ambiguous loss. There isn’t a death, but there is loss nonetheless.

What Is Ambiguous Loss?

“Ambiguous is just defined as unclear loss with no documentation of permanence of the loss,” says Pauline Boss, PhD, the researcher who coined the term and has led the field of research around it (more on that below).

While dealing with a more clear-cut loss —?a death —?is devastating, an ambiguous loss doesn’t have the trappings that let us know our loss and grief are valid, says Boss, who is an emeritus professor in the department of family social science at the University of Minnesota in St. Paul. She says that’s why ambiguous loss can be among the most stressful — because there’s often no burial, no neighbors dropping off food after the funeral, and no formal recognition by others that we’ve lost something.

Boss has spent decades trying to normalize that stress — showing that our reaction in the face of an untenable, uncertain, confusing loss is not a personal failure to cope. Instead, she says, the situation is the problem, not the person trying to get through it.

There are many situations that fall under ambiguous loss, including:

  • Breakups and divorce
  • Migrating to a new country and missing your homeland (There’s an evidence-based scale psychologists developed to better understand psychological challenges with leaving one’s homeland and adjusting to life in a new country.)
  • A childhood that lacked adequate parenting
  • Racism, transphobia, war, pandemics, and other losses of safety
  • A person who’s gone missing, where you don’t know for sure if they’re dead or alive
  • The loss of a body part, or a shift in what your body or mind can do

What Are the Types of Ambiguous Loss??

Boss has outlined two main categories of ambiguous loss: physical absence with psychological presence (such as when a person goes missing and there’s ambiguity around whether they’re alive or dead) and psychological absence with physical presence (such as when someone has dementia).

Researchers have suggested, for example, that the concept of ambiguous loss can help social workers and other therapists better design strategies to help caregivers of people with dementia cope with the initial losses of roles, family functions, and relationships when it comes to that diagnosis, and later on cope with the bereavement process.

In a special issue of the journal Family Relations focused on ambiguous loss, Boss writes that some have described these two versions of ambiguous loss as “leaving without goodbye” and “goodbye without leaving.”

Others challenge the idea that ambiguous loss should be used in all of these contexts though.

Sherry Dupuis, PhD, a researcher at the University of Waterloo in Ontario, Canada, who specializes in aging and who previously published a?study?on ambiguous loss, says she’s become more critical of the theory as a framework for family members of those with dementia.

“Ambiguous loss perpetuates the stigma associated with dementia and the idea that people living with dementia lose their personhood,” she says.

9 Tips for Coping With Ambiguous Loss?

No matter the particular situation, oftentimes with ambiguous loss there’s a lot of uncertainty about how to feel about the situation, says Lara Rogers Krawchuk, LCSW, a clinician who specializes in ambiguous loss and teaches at the University of Pennsylvania’s School of Social Policy and Practice in Philadelphia. She says people might find themselves thinking: “Is this a loss, is it not? Should I grieve it, should I not?”

Indeed, Boss says: When a loss is complicated by ambiguity, and people are unsure if they are truly experiencing a loss, it freezes the grieving process. That makes it hard for people to feel they can live their lives well. Here are some tips to help you unfreeze and process what you’re feeling.

1. Know That Your Loss Is Valid

The nature of this type of loss means that, unfortunately, others often don’t recognize it as such. But regardless of other people’s response, what you’re going through is real — and worthy of grief. “Only the person experiencing the loss knows and can decide if it’s an important loss,” Krawchuk says.

Simply naming it as an ambiguous loss can help you begin to make sense of a seemingly senseless situation, Boss and Krawchuk say. That, in turn, can help you start to feel less frozen.

2. Don’t Pathologize Your Reaction

Remember that it’s the uncertainty of the situation that’s abnormal — not your reaction to it, Boss says. She says that after a disaster, such as a tsunami or terrorist attack, people often think they see their missing relatives walking down a busy street. “There’s no harm in that,” she says. If there’s no death certificate, nobody should tell you that it’s impossible you saw someone, or that you’re imagining things. The situation is uncertain.

Likewise, if you’re experiencing the loss of a relationship, or of your sense of safety, however you react to it is completely understandable, Boss and Krawchuk say.

3. Don’t Pathologize Others’ Reactions, Either

If, let’s say, you and your sister are responding differently to your mother’s dementia, and you each think the other’s reaction is strange, that’s quite common. “There's a lot of misunderstandings between family members and loved ones in these realms,” Krawchuk says, “because they may interpret things differently. They may be in different places regarding their loss or their grief.”

So if you’re feeling some friction between you and a family member or friend dealing with the same ambiguous loss, Krachuk suggests being gentle with one another and listening to one another, and knowing that you’re interpreting the situation in different ways.

4. Allow Multiple Truths to Coexist Using ‘Both/And’ Thinking?

Thinking in absolutes and extremes, Boss says, can make things more difficult —?whether it’s extremely doom-filled thinking, or extremely positive. Instead, it’s crucial to practice flexible, “both/and” thinking, where you hold two seemingly opposed ideas in your mind at once. This reflects the reality of the situation more accurately, and helps increase your tolerance for uncertainty.

That means instead of saying to yourself: “My brother is incarcerated and it’s the same as if he’s dead”; try saying to yourself: “My brother is both out of reach and calls me once a month.”

Likewise, instead of saying: “The pandemic has changed things, but I feel amazing about it!”; try saying: “The pandemic has made me feel less safe, and it also led me to a career in public health.”

It’s holding the various truths of the situation in your mind at the same time that helps, Boss says.

5. Ask Yourself What You Might Need to Adjust

Depending on the type of loss you’re experiencing, there may be ways you need to reconstruct your identity or your roles, Boss says. For instance, if someone in your family is no longer present in some manner, you might feel guilty completing a woodworking project they left half-finished, or reorganizing who does what chores.

But in order to keep functioning, Boss says, you or your family may need to adapt to the loss by shifting roles, rather than keeping them static.

6. Spend Time With Others

Boss says peer groups, book clubs, sports clubs, and spending time with a friend can all help (provided that the people you’re around don’t say insensitive things).

While talking with people who can relate to your type of loss can help, so can simply being around others. “Anything that has human connection and erodes isolation,” Boss says.

7. Consult a Professional

There’s no such thing as a normal grieving process, and the same goes for coping with ambiguous loss. Boss says that while ambiguous loss theory points out that it’s the situation that’s the problem, not your reaction to it, there are still times when we need professional help.

If you’re feeling hopeless or helpless, she says, speak with a therapist or call a support hotline, as those feelings can lead to suicidal thoughts and self-harm.

Krawchuk adds that you might consider seeking additional support if you’re having trouble getting through your daily tasks, feeling increasingly anxious, swinging from anxiety to sorrow and back again, having trouble sleeping or eating, or feeling physical pain. Again, remember: there’s nothing wrong with your reactions or feelings; but if they’re distressing, sometimes seeking professional support can help you cope.

8. Find New Things to Feel a Glimmer of Hope About

The ambiguous situation itself may never change —?so forcing yourself to hope that a missing person will return, or that a disease will reverse itself, or that you’ll get back together with an ex may only keep you frozen.

Instead, Boss says, find new things to feel hopeful about. You might get involved with a group trying to effect policy change that would help prevent future loss like the one you’re facing. Or, you might focus on something completely unrelated to what you’re going through, whether that’s new connections within your community, or thinking about your larger purpose in life.

9. Do Away With the Idea of ‘Closure’

“Closure is a good word to use in real estate when you close a deal,” Boss says. But, when it comes to grief, it’s often used in unhelpful ways, she says.

There is no moment you can point to, nothing you can close a door to or sign off on as “complete” or “in the past” when it comes to grief, Boss and others say. That’s true even for a clear-cut loss —?a death — Boss says, and it’s certainly true of an ambiguous loss.

Loss —?whether ambiguous or not — isn’t something you grieve in a linear way, and isn’t something you simply close the door to. That’s why it’s often upsetting when people tell you to “just move on.” Instead, the idea is to give yourself permission to grieve, to increase your tolerance for several truths coexisting at once, and to incorporate the loss into your thinking — such that you can find new things to think about and get involved in while acknowledging that the loss is still there.

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