Ambiguous loss occurs when the loss of a loved one is unresolved and their physical or psychological status is uncertain. There is no clear conclusion or resolution with this type of loss. Some ways to cope with and heal from ambiguous loss include counseling, finding the right support systems, and prioritizing self-care.
What Is Ambiguous Loss?
Ambiguous loss is a relational disorder caused by a lack of clarity or facts surrounding the loss of a loved one, as defined by Pauline Boss, Ph.D.1 She referenced ambiguous loss and the grief resulting from it in cases of immigration, addiction, and catastrophic illnesses.
The lost loved one is either physically absent but emotionally present, or physically present but psychologically absent.
“Ambiguous losses involve a lack of clarity regarding whether a loved one is in or out of the family. There are two types of ambiguous loss–one in which a person is physically present and psychologically absent, such as the case of Alzheimers or alcoholism. The second type is the opposite of the first–someone is physically absent and psychologically present, as in the case of someone who has gone missing in action or a child who is missing.”
Kelly Maxwell Haer, PhD, LMFT Executive Director of Boone Center for the Family at Pepperdine University
There are differences between the grief resulting from ambiguous loss and other types of grief, including anticipatory grief; however, Boss believes that ambiguous loss is the most difficult to endure. The uncertainty of it takes over the lives of family and loved ones. Confusion and uncertainty prohibits them from beginning a traditional process of grieving.2
The optimal outcome for someone who experiences ambiguous loss is to learn to incorporate meaning into their life while continuing to love and remember their missing loved one.3
Symptoms of Ambiguous Loss
When it comes to ambiguous loss, some people may continue on with normal rituals and daily life, while others may suspend life and remain in a sort of limbo. The ongoing stress of ambiguous loss impacts people in numerous other ways, too.
Common symptoms of ambiguous loss include:
- Hopelessness
- Depression
- Confusion
- Anxiety
- Ongoing stress
- Despair
- Physical symptoms like headaches, digestive issues, loss of appetite, or overeating
- Inability to sleep
- Increased drug or alcohol use as a means of coping
- Increased body aches and tension
- Preoccupation with thoughts of a missing loved one
7 Examples of Ambiguous Loss
If someone is physically missing and there is no information on where they are or what their condition is, then ambiguous loss is the inevitable consequence. Their loved ones must learn to process these circumstances and navigate their lives as best they can.
Here are seven examples of circumstances that can cause feelings of ambiguous loss:
- Kidnappings or unrecovered bodies: Victims of violent crime/kidnapping may or may not be found and recovered. Their location and status can be uncertain or never resolved. This can lead to feelings of guilt, confusion, anger, helplessness, guilt, hopelessness
- Those who are deployed in the military: If engaged in active combat, members of the military are often not allowed to share information or communicate with loved ones about where they are. This is especially frightening for loved ones during times of war or when military personnel are stationed in unstable countries.
- Chronic mental health problems: People with ongoing chronic mental health problems face ongoing daily struggles and challenges. They’re physically present but not emotionally or psychologically available. Symptoms can escalate, especially if they are non-compliant with medications and treatment opportunities.
- Traumatic brain injury: This kind of diagnosis comes with uncertainty in terms of the extent and nature of recovery. It can cause people to behave uncharacteristically and they may lose control of their emotions, behavior, and thoughts.
- Immigrants: Immigrating to a new country involves incredible risk. This person’s status may be unknown to loved ones for a long time. They may end up moving from place to place or not have the ability to communicate for extended periods of time. In some cases, their fate is never discovered.
- Homelessness: People who are homeless often live in isolating and uncertain circumstances. They may choose not to communicate with loved ones or not be able to. Unpredictable access to healthcare, shelter, and food can compromise their safety, health, and well-being.
- Drug & alcohol addiction: People with an addiction history often struggle through multiple relapses. This creates isolation and leads to uncharacteristic behaviors. They may be unable to communicate with loved ones or choose not to update their status due to instability and uncertainty.
8 Ways to Cope With Ambiguous Loss
It’s important to find some balance between keeping a missing loved one in your heart and mind and getting through your day. As you await information, it can become increasingly challenging to meet the demands associated with living your daily life and managing your responsibilities and relationships.
Here are eight tips on how to cope with ambiguous loss:
- Eat well, sleep well, and exercise often: These are the foundations for dealing with stress regardless of the source
- Prepare yourself for triggers: Events like anniversaries, holidays, and birthdays can be triggers for painful emotions. If you know a trigger is coming, engage in increased self-care efforts. Ensure that you’re in a safe place and with people who can provide understanding and comfort.
- Seek therapy: It may be difficult to talk with family members, especially if they’re experiencing similar challenges. A therapist with expertise in grief and loss can help you to navigate your emotions and come to an understanding about the best ways to navigate pain and uncertainty.
- Identify trusted resources: The National Council on Family Relations has created an extensive resource page specifically designed for those who struggle with ambiguous loss and grief4
- Join a peer support group: Support groups can help you to identify your feelings and feel less alone5
- Acknowledge and identify what you’re feeling: Give yourself permission to feel grief, anger, and loss. This is a new situation and you need time to learn how to cope, understand what is happening, and take better care of yourself.
- Identify friends, family, and mentors: Share your thoughts, feelings, and fears with whomever you perceive as being safe, comforting, and non-judgmental
- Find comfort in religion/spirituality: Spend time with people who share your religious or spiritual beliefs. Talk to your religious or spiritual guide if you have one.
When to Get Professional Help for Ambiguous Loss
If you feel overwhelmed by the loss of a missing loved one, it may be time to see a therapist. Self-isolation is another indication that professional help may be needed.
One type of therapy that may be useful for those experiencing ambiguous loss is family counseling. People grieve the loss of loved ones differently. In addition, the fact that a family member is missing alters the relationships and dynamics among remaining family members. This alteration and adjustment can be confusing and disruptive. It can create a cascade of angry and hurt feelings that disrupt communication.
If you’re already looking for a grief counselor or therapist and you’re not sure where to begin, you could start your search through an online therapist directory, where you can sort by location, expertise, and insurance coverage.
Final Thoughts
Learning how to live your life when someone you love is not physically or psychologically present can feel impossible. The initial stages of ambiguous loss often create chaos, confusion, isolation, and fear. Reach out to friends, family, and mental health professionals as a lifeline to help you navigate one of life’s most challenging and confusing circumstances.6
For Further Reading
Ambiguous Loss Infographics
