Counseling for Ambiguous Loss: One Expert’s Approach

Ambiguous loss is loss without closure. There is no body to view or bury, no death certificate, no inkling of what happened to your loved one. Uncertainty and worry become part of your days and seep into your being.

Though ambiguous loss has many of the same symptoms as Post Traumatic Stress Disorder (PTSD), therapists and counselors treat it differently. Counseling hinges partly on how long you have been suffering from ambiguous loss and the strength of your support system. It also hinges on family structure.

Several years ago, I suffered an ambiguous loss when a close relative died. I attended the memorial service and, for reasons unknown to me, most of my relatives treated me like a stranger. Hardly anyone talked to me and I wasn’t asked to participate in the service. From the stories relatives shared, and the large photo display, I realized their memories of the deceased differed from mine.

In fact, I hardly recognized the person my relatives described. This made me feel more like a stranger.

Therapist Pauline Boss, PhD, is credited for first identifying ambiguous loss. She has developed specialized treatment for it and describes the approach in her book, Loss, Trauma, & Resilience. She thinks therapists should communicate with empathy, not sympathy. Focusing on sympathy could make the person feel like a victim.

Boss also thinks therapists should help the person find meaning in their loss. With this approach, the therapist helps the person “make sense of an event or situation.” It is hard to make sense of any situation without meaning. So how do you find it? According to Boss, the ways include naming the problem, turning to religion/spirituality, forgiveness, small good works, rituals, and hope.

Another counseling step is to temper one’s concept of mastery. Americans tend to think they can master anything. We can’t. Sooner or later, the time comes when you must accept the facts. While Boss thinks people can’t get over such massive losses as September 11th, we may “learn to live with the loss and ambiguity.”

In time, people who have grappled with ambiguous loss need re-think their attachment to the person. Some people disconnect from the person prematurely, according to Boss, and others act as if nothing has changed in their lives. A healthier approach is to detach gradually and stay connected to caring, supportive people.

I didn’t get counseling for ambiguous loss. However, I did think about my attachment to my deceased relative. My memories of this person are still clear in my mind. The memory of the painful memorial service has faded, probably due to the fact that I accepted pain and did my grief work. Caring for my grandchildren is now the focus of my life.

You may, or may not, be able to let go of painful feelings. Seek counseling if the emotional pain is unbearable and impacting your life negatively. Learning about ambiguous loss helped me immensely, and I think it will help you. You may also benefit from joining a support group.

Harriett Hodgson 2012

Harriet Hodgson

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Harriet Hodgson has been a freelancer for 38 years, is the author of 36 books, and thousands of print/Internet articles. She is a member of the Association of Health Care Journalists, Minnesota Coalition for Grief Education and Support, and Grief Coalition of Southeastern Minnesota. In 2007 four of her family members died—her daughter (mother of her twin grandchildren), father-in-law, brother (and only sibling), and the twins’ father. Multiple losses shifted the focus of Hodgson’s work from general health to grief resolution and recovery, and she is the author of eight grief resources. Hodgson has appeared on more than 185 radio talk shows, including CBS Radio, dozens of blog talk radio programs, and dozens of television stations, including CNN. In addition to writing for Open to Hope, Hodgson is a contributing writer for The Grief Toolbox website, and The Caregiver Space website. A popular speaker, she has given presentations at public health, Alzheimer’s, hospice, grief, and caregiving conferences. Hodgson’s work is cited in Who’s Who of American Women, World Who’s Who of Women, Contemporary Authors, and other directories. For more information about this busy wife, grandmother, author and family caregiver, please visit www.harriethodgson.com.

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