Loss is part of life. In places with seasons, like Chicago, we see it in the trees and on the ground. Leaves unfurl in all their vibrant green glory in spring, but fade to crumpled brown in winter, leaving only bare branches. Streets are freshly paved in spring while winter rips them to shreds. Relationships come and go in much the same way – sometimes quietly, naturally and other times chaotically, violently.

Most losses are fairly obvious to us and to others. The passing of a loved one. The rupture of a marriage or partnership. Even the death of “normal” – when a pandemic sends life-as-we-know-it to a screeching halt. Ambiguity is often built into these losses, though: Will I ever feel better? Will I always feel this hole in my heart? Are we ensconced in a permanent “Walking Dead” scenario? 

Nothing is as cut and dry as it seems. 

Relationships and life itself are strewn with ambiguity. And “over” rarely means completely over in our minds, hearts, and souls. So let’s just face life’s perplexing paradoxes head-on. 

That’s where ambiguous loss (AL) enters the fray. AL is a relational disorder caused by a lack of facts surrounding the loss of a loved one. While the term is most often reserved for catastrophic, traumatic situations, none of us will escape its milder forms. Ever been ghosted? Then you already know what I mean. 

Simply put, ambiguous loss is loss without closure.

Types of Ambiguous Loss

There are two types of AL:

• Type One occurs when there’s physical absence with psychological presence. A common example is divorce, while a more extreme example is the disappearance of a loved one by kidnapping.

• Type Two occurs when there’s psychological absence with physical presence. We often see this in Alzheimer’s Disease or traumatic brain injury. 

Here are some specific examples:

• Immigration & Deportation (Type One AL): I’ve worked with several clients who are undocumented and haven’t seen family in decades due to their status. Until the advent of FaceTime, Skype, and Zoom, this disconnection was often debilitating. Even now, the absence of a hug given or received can produce a depth of loss and loneliness that’s difficult to convey.
  
• Addiction & Dementias like Alzheimer’s Disease (Type Two AL): These are situations where the person is there but not there – themselves and yet not.
  
• Consequences of war & natural disasters  (Type One AL): The brain lacks an algorithm for processing situations where loved ones are gone, but we don’t know what became of them, and likely never will. It requires an ability to accept the not-knowing. 

AL is similar to complicated grief – a state in which feelings of loss are debilitating and don’t improve even with considerable time. With AL, a lack of closure interferes with our ability to fully process the associated grief and loss. 

The human brain is bent on closing gaps. For instance, when you see the image below, the brain recognizes it as a circle – despite the fact that it’s not (it’s a Buddhist Enso circle and has its own meaning). 

In AL, the brain will exhaust itself attempting to complete the circle, and we remain in a type of “frozen grief.” Unless we actively intervene. 

Coping with Ambiguous Loss

Kidnapping may be uncommon – even in the most dangerous locales – but caring for an aging parent with dementia is not. Relationships ending with a meaningless text or no contact at all is, sadly, a frequent occurrence in this “swipe-left” society. So how do we cope with AL’s large and small?

AL can’t be labeled as a mental disorder because it’s instigated by external events and not the individual psyche. (Thank god – it’s bad enough without pathologizing the person experiencing it!). And it’s always relational. So relational interventions, like family therapy and community-based treatment, are most helpful in the healing process. It’s notable that these same relational interventions work – at least in part – because they, by their very nature, target the loneliness and isolation inherent in AL.

If you’re dealing with this type of loss or know someone who is, I highly recommend the book Loss, Trauma, and Resilience by Pauline Boss, who coined the term. 

In the book, Boss recommends guidelines for living with AL. They include:

• Normalizing Ambivalence: You didn’t choose this situation, so there’s no reason to pretend that it’s all you’d ever hoped for. Ambivalence is a natural outcome of unsolicited change.
  
• Reconstructing Identity: What does it mean to be a mother of an estranged child? How does one co-parent with a spouse who’s now an ex? We need to redefine ourselves in a way that makes sense and feels authentic. And there may be several iterations in this process. Who you are at one month into the loss will probably be different than the you that emerges a year later. Give yourself time, space, and compassion during this journey.

• Adjusting Mastery: New skills will likely be needed in your new role. “Ex-spouse” requires an entirely different skill set than “spouse,” for instance. This is an opportunity (I use the term loosely) for personal growth, as these new skills are sure to be useful in other areas of your life.

• Revising Attachment: Whether you’re now parenting your parent or releasing your responsibility for a substance-addicted adult child, you’ll have to redefine the nature of the relationship – the type and quality of attachment. More distance (or more proximity) – literally or figuratively – will be part of your adjustment.

• Finding Meaning: I’m not suggesting a dive into denial or toxic positivity, but sometimes there is meaning to be made of what is undoubtedly a painful situation. Caring for a loved one with dementia is brutal. But sometimes it opens a new chapter in the relationship – one in which parenting reverses and a new type of love is shared. Likewise, many a charitable organization has been built out of loss, and getting involved in a related cause can generate both meaning and community.

I’ve riffed on AL today because we will all experience this type of loss at some point and yet the term itself is one of psychology’s best-kept secrets. I mean, you’ve never heard of it before, have you? 

The reality is that we don’t have innate circuits for integrating ambiguous information, so we’re forced to build our own or risk serious consequences. 

A common technique in mindfulness meditation is “noting” the thoughts that steal our present moments. We tack on a title (a name or category, like “planning” or “worry”) and much more freely return to our anchor (the breath, for instance). We’re able to let go. And, over time, we become aware of thought patterns. When we know where the mind regularly goes during distraction, we learn what needs attention in our lives. Noting is a powerful technique. 

Now you have a name for this particular kind of loss, and that name holds a similar power.