I was first introduced to the term “ambiguous loss” in my Marriage and Family Therapy graduate program.  When I learned about this theory, things started to click in my mind, and it has become an integral part of my work around grief and loss.  When many of us think of grief or loss, death is what tends to come to our minds.  But ambiguous losses are different from death and they are all around us affecting us in some distinct ways.

Defining Ambiguous Loss

Ambiguous loss is any loss that is ongoing and has no clear ending.  There is no resolution or solution to these types of losses, and they can’t be cured or fixed.  A prime example of an ambiguous loss is a loved one who is diagnosed with dementia.  The person is still physically present with us, but they are also partially gone.   Another example is a loved one who has a stroke, Parkinson’s Disease, addiction, severe depression or other mental illness, or even someone who is extremely preoccupied with their work.  In all of these examples, the person is still physically with us, but they are also gone in some ways.  In all of these cases, there is grief around losing the person we once knew and the relationship we once had with them.  There is also ambiguity about how the situation will play out over time and how long it will last.  If you are a caregiver, this type of ambiguous loss probably speaks loudly to you.

A second type of ambiguous loss is when someone is physically absent but psychologically present with us.  Examples of this would be a couple who has gone through a divorce, a spouse or parent that’s moved into a long-term care facility, a loved one in rehab, someone who is missing, or even a child you’ve given up for adoption.  In all of these circumstances, the person is physically absent from our lives, but they are still on our minds or what we might call psychologically present.  In many of these scenarios, there is ambiguity around where the person is, if they are well or not, or even if they are alive or dead.  

How Ambiguous Loss Affects Us

What all of these losses have in common, and what makes them so stressful to cope with, is the ambiguity they create.  The ambiguity itself creates uncertainty and stress in our lives making it hard to navigate these losses.  Our brains are not wired to like ambiguity.  We do much better when things are black and white, clear-cut, and we have concrete answers and solutions.  And in Western culture, we particularly value being able to solve, fix, and cure things.  We like to know how and when things are going to happen so we can plan accordingly.  But none of this is possible when we are experiencing an ambiguous loss.  There are oftentimes no clear answers, no solutions, no cure, no fix, and no clear road map.  There is a gradual slipping away for an unknown period of time.  

In addition to the ambiguity, what makes these losses distinct from death is the lack of verification of the loss and communal support and rituals.  With death, there is certainty.  There is a body or ashes, a death certificate, and communal rituals that mark the loss and aid us in our grieving.  We have a funeral, people send cards, call or text, and bring us food.  But this type of verification and rituals are absent for an ambiguous loss.  How do we mark the loss of a divorce or moving a parent into a memory care facility?

The lack of communal support/rituals coupled with the ambiguity can leave many people feeling stuck in the grieving process.  We may start to grieve that the person is gone in some ways but then we may feel guilty for grieving, especially if the person is still physically with us.  In turn, this may cause us to try and ignore the grief.  The struggle many people face is that these types of losses can sometimes go on for years, leaving people feeling as if they are stuck in limbo.  

Like with death, these losses bring up a mixture of emotions within us.  Feelings of sadness, despair, anger, frustration, hopelessness, helplessness, and ambivalence are some of the most common people experience.  For some of us, there may be a longing for the loss to come to an end but also not wanting to fully lose the person.  This can also create feelings of guilt and anxiety, making the grieving process more complicated.

Where to Go From Here

If you’re experiencing an ambiguous loss, you may find yourself struggling to navigate this unknown territory.  Here are some ways that I hope will help you during this time  

• Name the problem as the ambiguous loss.  Somewhere along the way, I heard that we can’t cope with a problem until we are able to name what the problem is.  Identify and name what you’re experiencing as an ambiguous loss.  The problem isn’t you, it’s the loss. 

• Accept there may not be closure.  With ambiguous loss, there is no clear ending but rather a gradual slipping away.  If we can stop wrestling with the desire for a resolution and accept the loss as it is, this can offer us some relief.  

• Increase your tolerance for ambiguity.  This is a hard one, but the more we can expose ourselves to situations of ambiguity, the more resilient we become.  Part of increasing our tolerance for ambiguity comes in the form of using both/and thinking rather than either/or.  My husband is both here and gone.  My brother may be sober or he may not be.

• Mark the small losses you encounter along the way.  For every new phase or shift in the loss, find some small way to acknowledge and ritualize this new loss.  This can be as simple as lighting a candle, writing a journal entry, or saying a prayer.

With any type of loss, reach out to people you know will love and support you during this time.  Social support is some of the best medicine for our souls. If you find yourself wanting professional help, you can reach out here to learn more.

Resources used for this article:

• University of Minnesota, “Understanding and Applying Ambiguous Loss: Its meaning and Application” 

• “Loss, Trauma, and Resilience” by Pauline Boss

• “Ambiguous Loss: Learning to Live with Unresolved Grief” by Pauline Boss