Ambiguous losses are shrouded in uncertainty, seem to go on forever, and show no signs of ending. They are much more prevalent than the general public realizes, and cause much confusion for would-be caregivers who try to provide support for the bereaved.
The first type of ambiguous loss involves uncertainty with regard to whether the person involved has actually died. Someone falls off a cruise liner at sea. A soldier is reported missing in action in a war zone. A child disappears without a trace. An adult is missing in a mountain climbing accident. Is the person still alive or have they died? Can survivors ever find out? Some types of ambigious loss in cases of suspected suicide or was it an accident?
The second type of ambiguous loss is of a psychological nature. As a son of an alcoholic, I am very aware that there are many families who had absentee alcoholic fathers or mothers, even though both parents were living under the same roof. There is always uncertainty when the person would be home and in what condition (inebriate or sober). Addictions to various drugs bring sadness and long-term grief for family members.
Alzheimer's disease and comas induced by accidents are other examples of physical presence, but uncertainty as to the condition of the persons who are ill. Divorce and remarriage, as well as immigration, heavily blur family lines and are additional examples of uncertainty. It will be helpful in dealing with these losses to be aware of the following.
First and foremost, ambiguous losses have an immense devastating impact on those who suffer through the uncertainty. These types of loss can cause what appears to be never ending pain, confusion, and sadness. Trying to understand the dilemma from the point of view of the mourner is critical to providing the best support possible.
Next, troubling emotions and physical stress is ever present, since the usual predictable and assuring factors that bring some sense of security or knowing are absent. Frequent anti-stress measures such as walking, yoga, soft music, and massage are critically important in managing any type of ambiguous loss. Diversions are essential as mourners are easily immobilized and become stuck in their grief.
Then we need to realize that social dislocation and perceptual differences in viewing the loss is common. For example, children of a family, who have been deserted by one parent, may feel different (henor worship, they were the reason the parent left, or they despise them with repulsive bitterness) toward that parent or have an opposite view of the remaining parent who is still in the home. In other families with a missing member, one person may feel the person who has not been found has died, while another holds out hope that the person will be found alive.
Working your way out of ambiguity is no simple task when you are thinking one minute the person may be alive, and the next minute you feel they are dead. Hope and hopelessness come and go, and often, support from others is incomplete or nonexistent because there is no certainty that the loss is real. Depression and high anxiety are common. And, psychological loss of a person due alcohol or drug addiction, divorce, etc. can be every bit as damaging as physical absence. "Who is or is not part of my family?" is a haunting question for many.
If you are dealing with ambiguous loss of any type, find professional assistance. There are counselors with much expertise in this area, who can help you sort out feelings, as well as look at the pros and cons of taking specific actions depending on the nature of the loss. Discover the ways others have dealt with uncertain losses, take and use what rings true for you, and let the rest go for the present time.
Also, if you are a friend of someone dealing with ambiguous loss, here's how you can help. First, be infinitely patient and nonjudgmental. You cannot begin to imagine the gnawing, ongoing inner turmoil that uncertain loss generates. Your presence and confidence in the person to be able to live with this loss will provide the powerful reassurance that is so desperately needed. The person or family will find a way, but never imply there is something wrong with them for not moving on as you may feel they should.
New ways of looking at the world are needed and mourners can find highly individual coping strategies to deal with uncertainty. You can be a sounding board. Support their efforts. Encourage professional input, and make clear they will find a way that works for them. Equally important, encourage social interaction and rely on their spiritual traditions.
Finally, most important of all, push the crucial need for open communication among all family members. Having had two divorces within my own family, this is not always easy to do. Yet, airing differences with patience and respect, coupled with complete disclosure, can be most helpful, especially for the children. Recognize that as the months and years go by, symbolic remembrances are important, bouts of loneliness will be common, reevaluation of relationships can be useful, and the resiliency of most will be evident.
In summary, uncertain loss is a major source of continuous grief and pain, and is much more prevalent than is normally recognized. It can be lived with, but much input is needed from professional sources and researchers, who have found successful strategies. Do a Google search on ambiguous loss to start your education.
Above all, if you are mourning an ambiguous loss, find a counselor or a support group who can provide the confidence needed to deal with the devastating long-term effects. This counselor can also provide a valuable service in helping you find meaning in your loss so you will be able to live with the uncertainty. Changing your perception of any event, that is reframing it, can prove to be a highly successful coping strategy.
John T. Catrett, III
Scissortail Hospice Chaplain
124 East Broadway,
PO Box 1216
Drumright, OK 74030
918.352.3080