Ambiguous loss: What it is and how to cope.
In 1969, Elisabeth Kubler-Ross wrote a book about the five stages of grief: Denial, anger, bargaining, depression and acceptance. Since then there have been numerous books and articles written on the subject of grief and loss, including articles from Michigan State University Extension. We know that everyone grieves in their own way, and in their own time. There is no prescriptive beginning and end to the process. Friends and family have rituals to recognize and ease pain through funerals, wakes, sympathy cards, casseroles and spending time together.
Dr. Pauline Boss has spent years studying and writing about family stress. In particular she has helped to bring the subject of ambiguous loss to the forefront of social and emotional health and wellbeing. What is ambiguous loss and why is it such a concern? Ambiguous loss is a loss that is unclear and therefore has no closure. Boss describes it as a relational disorder not an individual pathology; a problem that comes from a situation, not your psyche. The concern is loss without closure denies the family or individual of social acknowledgement or rituals such as a funeral and other normal means of coping, as described by the Kubler-Ross model. Families and individuals cannot seem to heal and move on with their lives.
There are two type of ambiguous loss:
- Physical absence with psychological presence (missing, disappeared, kidnapped, military deployment).
- Psychological absence with physical presence (traumatic brain injury, coma, dementia, addiction, autism, depression, Alzheimer’s disease).
There are coping options recommended by many experts in ambiguous loss. They include the following:
- Developing resiliency and finding comfort in the ambiguity – validating that it is what it is
- Reaching out to others – finding comfort in community and society
- Using mindfulness by accepting your feelings as they are, when they come up
- Self-care – rest, recreation, accepting help and finding humor in life’s situations
- Acceptance and letting go – being comfortable with the imperfection of life
- Storytelling – remembering the past, sharing and enjoying pleasant memories
- Finding a mastery of the controllable in everyday life – cleaning house, cooking, laundry
- Concentrating on making new memories – creating new ways to celebrate what is
Finally, coping includes loving the questions of ambiguous loss.
There are many resources out there to help you learn about strong emotions and coping skills. MSU Extension has two courses, RELAX: Alternatives to Anger and a new class that will be offered in the fall of 2014 called Stress Less with Mindfulness.
“Be patient toward all that is unsolved in your heart and try to love the questions themselves like locked rooms and like books that are written in a very foreign tongue… And the point is, to live everything. Live the questions now. Perhaps you will gradually, without noticing it, live along some day into the answer.” Bohemian-Austrian Poet (1875-1929), Rainer Maria Rilke