Ambiguous loss: a complicated type of grief when loved ones disappear
Keywords:
ambiguous loss, unresolved loss, complicated grief, lack of closure, resilienceAbstract
AbstractAmbiguous loss is an unclear loss that continues without resolution or closure. It is a relational rupture that can be physical or psychological. The chronicity and complexities of ambiguous loss create symptoms that may be construed as medical disorders such as depression or persistent complex bereavement disorder. Because the family's story of loss may never have an ending, the therapeutic goal shifts to resiliency. Tthe authors present six guidelines about meaning, mastery, identity, ambivalence, attachment, and hope. They have been found useful in empowering individuals and families to move forward with their lives despite the ‘not knowing’. Links to chronic sorrow and disenfranchised grief are also discussed.
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Publishing.
Becvar
DS (ed) (2012). Handbook of family resilience. New York: Springer.
Boss P (1977). A clarification of the concept of psychological father presence in families experiencing ambiguity of boundary. Journal of Marriage & the Family 39(1) 141–151.
Boss P (1980). The relationship of psychological father presence, wife's personal qualities and wife/family dysfunction in families of missing fathers. Journal of Marriage & the Family 42(3) 541–549.
Boss P (1999). Ambiguous loss. Cambridge, MA: Harvard University Press.
Boss P (2002). Ambiguous loss: working with families of the missing. Family Process 41, 14–17.
Boss P (2004). Ambiguous loss research, theory, and practice: Reflections after 9/11. Journal of Marriage & Family 66(3) 551–566.
Boss P (2006a). Loss, trauma, and resilience. New York: Norton.
Boss P (2006b). Resilience and health. Grief Matters: The Australian Journal of Grief and Bereavement 9(3) 52–57.
Boss P (2010). The trauma and complicated grief of ambiguous loss. Pastoral Psychology 59(2) 137–145.
Boss P (2011). Loving someone who has dementia. San Francisco, CA: Jossey Bass.
Boss
P (2012a). The ambiguous loss of dementia: a relational view of complicated grief in caregivers. In:
M
O'Reilly-Landry (ed).
A psychodynamic understanding of modern medicine: placing the person at the center of care. London: Radcliffe, 183–193.
Boss
P (2012b). Resilience as tolerance for ambiguity. In:
DS
Becvar (ed).
Handbook of family resilience. New York: Springer, 285–297.
Boss P, Beaulieu L, Wieling E (2003). Healing loss, ambiguity, and trauma: a community-based intervention with families of union workers missing after the 9/11 attack in New York City. Journal of Marital and Family Therapy 29(4) 455–467.
Boss P, Carnes D (2012). The myth of closure. Family Process 51(4) 456–469.
Boss
P,
Caron
W,
Horbal
J (1988). Alzheimer's disease and ambiguous loss. In:
CS
Chilman and EW
Nunnally (eds).
Chronic illness and disability: families in trouble series (Vol. 2). Thousand Oaks, CA: Sage
–140.
Boss P, Caron W, Horbal J, Mortimer J (1990). Predictors of depression in caregivers of dementia patients: boundary ambiguity and mastery. Family Process 29(3) 245–254.
Boss P, Greenberg J (1984). Family boundary ambiguity: a new variable in family stress theory. Family Process 23(4) 535–546.
Boss
P,
Dahl
C (2014). Family therapy for the unresolved grief of ambiguous loss. In:
DW
Kissane and F
Parnes (eds).
Bereavement care for families. New York: Routledge.
Boss
P,
Roos
S,
Harris
DL (2011). Grief in the midst of uncertainty and ambiguity. In:
RA
Neimeyer, DL
Harris, HR
Winokuer (eds).
Grief and bereavement in contemporary society: Bridging research and practice. New York: Taylor and Francis, 163–175.
Caron W, Boss P, Mortimer J (1999). Family boundary ambiguity predicts Alzheimer's outcomes. Psychiatry: Interpersonal & Biological Processes 62(4) 347–356.
Dempsey M, Baago S (1998). Latent grief: the unique and hidden grief of givers of loved ones with dementia. American Journal of Alzheimer's Disease and Other Dementias 13(84) 84–91.
Doka K (1989). Disenfranchised grief: recognizing hidden sorrow. Lexington, MA: Lexington Books.
Harris D (2010). Counting our losses: reflecting on change, loss, and transition in everyday life. New York: Routledge.
Kissane
D,
Parnes
F (eds) (2014). Bereavement care for families. New York: Routledge
Kushner HS (1981). When bad things happen to good people. New York: Schocken.
Kushner HS (2012). The book of Job: when bad things happened to a good person. New York: Schocken.
Merton
RK,
Barber
E (1963). Sociological ambivalence. In:
E.
Tiryakian (ed.).
Sociological theory: values and sociocultural change. New York: Free Press, 91–120.
Neimeyer
RA,
Harris
DL,
Winokuer
HR (eds) (2011). Grief and bereavement in contemporary society: bridging research and practice. New York: Taylor and Francis.
Olshanksy S (1962). Chronic sorrow: a response to having a mentally defective child. Social Casework 42, 190–192.
Robins S (2010). Ambiguous loss in a non-Western context: families of the disappeared in post-conflict Nepal. Family Relations 59, 253–268.
Robins S (2013). Families of the missing: a test for contemporary approaches to transitional justice. New York/London: Routledge Glasshouse.
Roos S (2002). Chronic sorrow: a living loss. New York: Brunner-Routledge.
