Ambiguous loss: Living with unresolved grief

By Bongiwe Sokhela

When you are locked in ambiguity, your grief is frozen in time; you cannot move on and you may not know whether you should be grieving or in mourning. Clinical psychologist Bongiwe Sokhela breaks down the uncertainty of ambiguous loss.  

Ambiguous loss occurs without any closure and often without answers. No death is easy, nor bears all answers but most types of loss have some form of conclusion or closure. There is a body and a grave that marks the end, there is often a clear target of anger during the grief process.

This kind of loss often leaves a person searching for more answers, complicates the process of grieving, and may result in unresolved grief.

The term was first coined by psychologist and author Paulina Ross in 1970. She described this type of loss within two main categories, these being “physically absent but psychologically present” (like a loved one who is missing or who disappeared without trace) and “psychologically absent but physical present” (like a loved one who has memory loss).

Those confronted by ambiguous loss have been known to fluctuate between hope and despair. Hope because new information sparks a promise of fresh possibility and despair because new revelations can also bring finality with no new answers. The loss one feels is mixed with uncertainty and achieving closure can be difficult. To overcome one needs to learn to embrace the unknown.

  • How would I know I am going through ambiguous loss?
  • Have you lost a child through miscarriage?
  • Have you been separated from a child through adoption?
  • Do you have a loved one with dementia or Alzheimer’s disease?
  • Do you have a relative with a mental illness?
  • Do you have a loved one who disappeared without a trace?
  • Do you have a loved one who died with no answers as to how they died?
  • Do you have a family member who died and the body was never found?
  • Do you have a relative in a coma or that is terminally ill?
  • Do you have a family member who was exiled or relocated to another country and have lost touch with?

If you answered yes to any of these questions or similar, and you have been struggling with closure or certainty you may be struggling with unresolved grief and ambiguous loss.

What is common among these examples is an obvious lack of finality or limited answers that help you gain closure. You may be left in limbo because you don’t know whether you should mourn their departure or be hopeful that some good news will come one day. The vacillation between the two extreme opposite emotions can keep you trapped in a vicious loop.  

Without falling into a trap of naming specific characteristics of someone dealing with ambiguous loss, it is safe to note that whatever you are going through is normal.

How do I cope?

Face your fears: Start by trying not to avoid the pain. Memories can bring tears and leave you in a state of sorrow and depression. Avoiding these emotions can keep you trapped in a false reality. Unless you find ways to work through the emotions in a safe space, with a professional or a trusted loved one, you may not control the inevitable surfacing of these emotions.

Cherish good memories: Try to find meaning to your experience by celebrating the life of the loved one. You may do this by creating a memorial that helps you to focus on positive thoughts and memories.

Challenge negative thoughts: Thought stopping is a cognitive behavioural therapy technique that can help you take charge of your emotions, your response to those emotions and take control of the emotional triggers.

Do not cut yourself off: It may feel like you are alone in this; a lot of people around you experience their own pain, it may not be the same as yours but that is why you should be sharing your thoughts and fears and find common ground in the type of emotions you all feel and the memories you share.

Fluctuating emotion: It is normal, embrace it; normal grief feels the same. Once you think you have healed, a memory or a smell or a thought may surface emotions and pain that you thought you had already overcome. The memory will fade but the reality of the person in your heart lives on.

Overcome guilt: Move forward without guilt. Remember guilt will surface but try not to own it, it is part of the healing process and it will pass.

Hope: If hope helps, hold on to it, without any denial.

Take your power back: Don’t run away from the truth; it will give you the power to make the right choices for those you still need to care for, around you.

How do I comfort or help someone going through ambiguous loss?

Be a friend or a loved one and be consistent in how you show up. Don’t confuse yourself as their therapist. The person is going through enough ambiguity, don’t add to it.

Help remove the angst. Often there are tasks that need to be taken care of with the hospital, the police, filling in reports or the courts and these may bring distress. Be there to offer your assistance.

Be kind to yourself and remember you may also be going through the same loss and grief. If you take care of yourself you will have the energy to be there for the one going through the ambiguity of the loss.

If you need more answers, talk to your doctor or therapist TODAY and take a positive step towards healing.