“Once people become more comfortable with the ambiguity and the uncertainty, they are freer to imagine and discover new sources of hope.” ~ Pauline Boss
We often talk about loss in connection with death, but there is another type that we all have experienced this last year regardless of whether or not we have lost someone. We have been unable to have family and social gatherings, celebrations, performances, graduations, marriages, funerals; we have had to cancel vacations, change job responsibilities, deal with fluctuating mental health, etc. Doctor and hospital visits have been complicated by reduced visitors…many women had to give birth without a significant other or parent present and had restrictions on visitors. All of that is loss, more specifically, ambiguous loss.
The term ambiguous loss was coined by Pauline Boss while she studied families of pilots missing in action during Vietnam in the 1970s. She describes two different kinds of ambiguous loss: the first involves physical absence while the second involves psychological absence. Examples of physical absence include a missing person from abduction, the military, college, war, terrorism, a natural disaster, adoption, immigration, etc. Examples of psychological loss include dementia, Alzheimers, mental illness, brain injury, a chronic illness, autism, depression, addition, workaholism, etc.
Due to our new COVID-19 reality, grief from loss has become a constant. But for most, it is not grieving of the death of a loved one, but a global, inescapable sense of loss that is tied to changes in our daily routines, missing planned celebrations, and being physically separated from friends and family. Ambiguous loss prompts an especially challenging kind of grief: It is confusing and disorienting, and is often without bounds or limits (meaning there is no closure). With the pandemic, there is no clear “end” in sight. This is part of what makes our emotional experience of this disease so taxing–we somehow have to exist in the unknown of our current lives. It feels untenable and unsustainable.
Ambiguous loss is not marked by the usual feelings of sadness or grief that accompany the loss of a loved one. The feelings of stress, sorrow, and frustration we feel is complicated and…ambiguous. The kind of grief we are experiencing is especially challenging because of the loss of more intangible parts of our lives; many of us are no longer able to cleanly divide work from home, or paid time from playtime. We have to wear all the hats while figuring out how to survive. While we are trying to find ways to soothe ourselves and each other, we are canceling birthdays, vacations, and weddings. We are also losing scheduled surgeries, new jobs, the ability to pay rent, and, overall, the feeling that we can predict what will come next and that we are in control.
Feeling distressed due to ambiguity is normal and understandable. The complicated grief we are experiencing due to the shifting sands of our current lives and the accumulation of impalpable losses is completely valid. So how do we deal? Here are five suggestions to cope with the ambiguous losses we are experiencing:
- Name the experience. Name the ambiguity as the problem. If we are feeling stressed, but can give a name to the stressor, it helps us remember this is not our fault. Naming the COVID-19 pandemic as our “ambiguous loss” is the first step to accepting our emotional reactions and begin the coping process.
- Stay healthy. The constant strain of living with uncertainty takes a large physical and psychological toll. It is not unusual to develop health problems, depression, anxiety, and phobias. Though we may have to force ourselves through the motions, it is imperative that we eat properly, exercise regularly, and get quality sleep. We have to take care of ourselves or else we will have a new set of problems to deal with.
- Get help. Ambiguous loss is often isolating (especially so with the quarantining and social distancing regulations from COVID-19). We cannot do this alone; we need help. We must talk with trusted loved ones and maybe even a trained, experienced therapist. Get the help and tools to work through ambiguous loss.
- Practice spirituality. Finding a source or higher power to believe in, that is bigger than ourselves, yields peace and purpose. Whether we attend religious services, read scripture or faith-promoting literature, meditate, or incorporate any other sort of spiritual practice, it will help us navigate ambiguous loss
- Celebrate what remains. Find joy in the small things. We cannot feel guilty when we laugh or smile or do something ordinary or joyful. The best way to overcome loss in general is to celebrate the good moments of life. Life is fragile and unpredictable; we have to make the most of it!
Pauline Boss said, “Ambiguous loss can freeze the grief process. People can’t get over it, they can’t move forward, they’re frozen in place.” Because this kind of loss occurs without closure or clear understanding, it leaves us searching for answers, which delays the grieving process and can result in unresolved grief. This pandemic is isolating, as ambiguous losses often are. But because we are universally grieving, we are not alone. We will develop new rituals in the future, and we will experience those together. In order to prepare, it will be important for us to take care of ourselves in the present so we can have that bright future we yearn for. I am in this with you. Please feel free to contact me today to get help. We got this!
Melissa Cluff is a Licensed Marriage and Family Therapist based in North Texas, providing face-to-face and telehealth therapy options to clients in Texas.
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- Family Caregiver Alliance: Caregiving and Ambiguous Loss
- Harvard University Press: Ambiguous Loss: Learning to Live with Unresolved Grief
- Nation Council on Family Relations: Ambiguous Loss Resources
- PsychoAmbiguous Loss Theory: Challenges for Scholars and Practitioners — by Pauline Boss; published in Family Relations (FR), 2007logy Today: COVID-19 and Ambiguous Loss
- Psychology Today: Ambiguous Loss
- Well and Good: How to Deal With Ambiguous Loss—the Grief You Feel When Closure Isn’t an Option