Ambiguous Loss

By Emily Becher and Emily Krekelberg; adapted by Sara Croymans

What is ambiguous loss?

Often when we talk about loss, it is to describe the experience of having someone or something in our lives and then its absence, with a clear line between the time before the loss and after. However, loss is often not this clearcut. Instead of an on-and-off switch of presence and then absence, it is more like a spectrum where the loss can feel unclear, confusing, and ambiguous. Some examples of ambiguous loss are serious and may be unexpected like living with a loved one who is experiencing dementia, a family in mourning for a missing person, and the losses experienced by people forced to flee their home countries. More common examples include experiences like adoption, divorce, and remarriage, relocation, or young adults transitioning out of the family home. Military families may experience ambiguous loss during a deployment, PCS (permanent change of station), or when a service member is severely injured.

Ambiguous loss can be highly stressful and traumatic because we often are unable to name and acknowledge it and therefore we are unable to grieve and move through the mourning process in a way that feels healthy. Pauline Boss, the developer of the theory of ambiguous loss, refers to it as a state of frozen or unresolved grief. Clear losses mean both the physical and psychological presence of that person or thing is gone. In ambiguous loss, someone or something may be physically gone but psychologically present (such as a deployed family member or a missing person) or physically present but psychologically gone (such as a loved one with dementia). The lack of clarity and closure can cause the grieving process to continue for years.

What can ambiguous loss feel like?

- A painful mixture of emotions. For example, both wanting a loss to become final in nature so you can begin to move on and also not wanting that to happen at all.
- Confusion around roles: Ambiguous loss is often associated with something called boundary ambiguity, which refers to confusion around what roles people play within families and who is considered to be a member of a family. Different family members might disagree about who is in and out of the family, causing fear and anger. For example, a child whose parents are separating may struggle with boundary ambiguity over the shift in roles and responsibilities in the family. Boundary ambiguity may also be experienced by military families during a deployment as there may be a shift in roles and responsibilities within the family.
- Seeking information to find clarity but with no success: When experiencing an ambiguous loss our instinct is to seek out information to help gain clarity and a sense of control over the situation. However, in situations of ambiguous loss, this can be very challenging and often lead to feeling more frustrated and helpless because there isn’t clear information or guidance. For example, someone researching on the internet about a loved one’s diagnosis of dementia that has an uncertain and unpredictable disease progression or attempting to seek clarification about a situation within the military-bureaucratic structure.

- Feeling stuck: Because ambiguous loss is so painful, a common experience is for people to refuse to acknowledge or face the truth of a difficult situation or loss. This can result in difficulty in taking important steps, making important decisions and taking time to say goodbye when the opportunity presents itself.
- Mental health symptoms: This can include symptoms of sadness and/or depression, anxiety, nightmares, hypervigilance (being on high alert for threats), difficulty sleeping, increased use of substances, and conflict in interpersonal relationships.

What can be done to cope with ambiguous loss?

As a service provider, suggest the following strategies to cope with ambiguous loss to the service members and families you work with.

Name it

The first and most important thing to do is to identify that you are experiencing an ambiguous loss and to name it.

Work as a team to face a common problem

During the ambiguous loss experience, many families experience intense conflict. However, it is important to reframe the issue to make sure everyone sees the problem as an ambiguous loss, and to focus on being a team facing a common adversary. It is important if possible to come together as a family and talk about what everyone is experiencing, allowing space for everyone’s emotions, and finding ways to talk about memories of the past and new plans for the future.

Make the leap to create some definition and find some clarity

Unfortunately in life, there are some times when there are no good answers. In cases of ambiguous loss at some point, we may need to take a leap to create some definition around the loss we are experiencing so we can find some clarity and move through the healing process. This may mean coming to terms with never knowing all of the facts about a situation and still finding a way to face it and begin to heal given the limited certainty we do have.

Be willing to compromise

Because of the ambiguity of the situation and loss, it is important to find a place where you can hold the ‘both/and’ type of thinking. This means that you may never be able to make the loss you are experiencing fixed and defined. But, perhaps, you can move to a place where you can accept the paradox of your loss, the both ‘here and not here’ nature of the experience you are going through in order to find some peace and resolution. As Pauline Boss says “Closure is a myth”- it is important to understand that you can find healing and peace, but you may never find closure and a satisfactory resolution.

Work to change what you can, and accept the things you can’t

Often in situations of ambiguous loss people feel a loss of control. Finding small ways to increase your sense of mastery over your life can be helpful, while also acknowledging and accepting that there are some things that are out of your control.

Grieve what has been lost, and celebrate what you still have. It’s okay to miss what is lost, but it’s important to focus on the present situation to continue to build resilience and move forward.

Find meaning

While challenging, it is important to try to find meaning in order to move forward through an ambiguous loss. Strategies to do this might include creating a ritual of some kind to help say goodbye, creating new ways of celebrating important holidays or family/community events, connecting with our spirituality and feeling connected to something larger than ourselves, finding ways to be optimistic and having hope, and avoiding self-blame by accepting that, sometimes difficult and painful things happen for no reason at all and no one is to blame.

How can you support individuals struggling with ambiguous loss?

As a service provider, help the individual know that what they’re feeling is normal; it is a normal response to an abnormal situation.

A great first step is for the individual to talk to a healthcare provider who can discuss their concerns and what the next steps might be. Suggest that therapy can be helpful and particularly family therapy if the ambiguous loss is affecting more than just one person. Encourage the individual to contact Military OneSource for free, confidential military and family life counseling. The American Association for Marriage and Family Therapy also offers a therapist lookup that can be a helpful resource.

Additional resources to assist you as a service provider include blog posts and podcasts by the OneOp Family Transitions and Family Development teams:

COVID-19 – Family Social Science Offers Coping Resources – blog post
Settling the Unsettled: Ambiguous Loss through Military Retirement – blog post
A Refocus on the Intersection of Vulnerabilities and Resilient Factors of the Heterogenous Military Family – podcast

References

Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: W.W. Norton & Co.

Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Harvard University Press.

Dahl, C.M. and Boss, P. (2020). Ambiguous Loss. In The Handbook of Systemic Family Therapy (eds K.S. Wampler, M. Rastogi and R. Singh). https://doi.org/10.1002/9781119438519.ch88

Krekelberg, E., and McGuire, J.K. (2021). A Changing Way of Life: Ambiguous loss and farming. University of Minnesota Extension, Centers for Family Development and Agriculture, Food and Natural Resources.

Emily Becher is an Applied Research and Evaluation Specialist at the University of Minnesota Extension Center for Family Development. Emily has a background in couple and family therapy and trauma-informed adult education.

Emily Krekelberg

Emily Krekelberg works for University of Minnesota Extension as the Extension Educator for Farm Safety & Health. Her work focuses on grain bin safety, livestock safety, tractor safety, farmer mental health, and suicide prevention. A passion of Emily’s is weaving together the science of production agriculture with the art of building resilience.

Sara Croymans, MEd, AFC, University of Minnesota Extension Educator, member of the OneOp Family Transitions team, military spouse, and mother.