Pauline Boss (Harvard University Press, November 2000)
Barbara Feinberg, Life Coach/Psychotherapist, Futures
Barbara Feinberg, LISW-S, IMFT is a life coach/psychotherapist and certified 21/64 trainer and consultant with particular expertise in the emotional impact of wealth. Her clients have a wide range of issues, many related to life transitions.
Ambiguous loss is one without closure, leaving the bereft stuck, unable to move on.
Alzheimer’s disease and other forms of dementia are pervasive in our society. These conditions can precipitate sorrow without closure, a response that is different from and considered far more difficult than the reactions commonly seen after a death.
Those who care for and about loved ones diagnosed with these and many other disabling conditions struggle with complex and challenging practical considerations and related decisions.
Often, the responsibility for making such decisions falls to children and grandchildren. The relationships between generations, different values, geographic dispersion and varying degrees of understanding the needs and status of the declining family member may provoke intense conflict in families.
High net worth families may have considerably more choice and flexibility in arranging necessary care. However, the potential disruption of individual and family functioning related to mourning a profound loss before the death of their loved one cannot be resolved with financial resources alone.
Pauline Boss, in her fine book Ambiguous Loss, conceptualizes this little understood variant of grief as a trauma impacting on the whole family.
Ambiguous loss of a family member who is physically present and psychologically absent, includes those who:
• Have dementia • Suffer from mental illness and/or addiction • Face a life-threatening illness • Become disabled • Are workaholics
Ambiguous loss is also present when families are faced with a psychological presence that is physically absent. These “lost” may include those who:
• The military identifies as missing in action • Disappear without a trace • Leave a committed relationship and sever contact • Cut themselves off from family contact • Live far away, arein touch, but not seen (as in the families of immigrants)
In all of these cases, the usual rituals and community support associated with mourning are likely to be missing, “disenfranchising” the grief. In fact, those dealing with such ambiguity may be told to “get over it” despite the lack of closure that can prevent a healing bereavement process.
Responding to change in family dynamics and structure requires a tolerance for not knowing, a different definition of “hope,” clarity about who is in and who is out of the family, and a communication process that supports a new definition of family.
Since ambiguous loss is ubiquitous, we can all benefit from understanding the nature of this experience. I encourage professionals in a variety of disciplines and the community at large to read this very valuable book.