Ambiguous Loss
*Excerpts from an article written by the Cleveland Clinic in February 2022 by Kia-Rai Prewitt, PhD
I read this article online recently and wanted to share some of it. I think it is so relevant to what we experience as we are challenged by our loved ones’ substance use. Some of us may be more familiar with what is called ‘anticipatory grief’, which is another term used for this experience. I hope the article speaks to you the way it did to me.
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It has been more than 40 years since family therapist Pauline Boss, PhD, first coined the term ‘ambiguous loss’ and published her book by the same name.
Ambiguous loss refers to loss without closure. At its core, ambiguous loss is about a lack of resolution. Dr. Boss created categories to differentiate between physical and psychological loss.
Type one deals with physical loss, like when you don’t know for sure whether someone you love has died or what has happened to them. For those of us who have loved ones with substance use disorder this can be a daily concern. Often our loved ones are physically absent under unknown, uncertain or unresolved circumstances. Even if you know where the person is or what has happened to them, this kind of loss includes circumstances like estrangement or incarceration.
Type two deals with psychological loss, including mental or emotional disappearance. Psychological absence with physical presence. Your loved one is physically present, but they have changed emotionally or cognitively.
Often with our loved ones’ substance use we experience both types of loss.
Closure is an important piece of the complicated puzzle that is grief. It provides us with some way to process what has happened. We typically crave closure because our brains are wired to analyze information and our environment. There is no closure when a loved ones’ personality changes as a result of substances and/or mental illness and it makes them nearly unrecognizable to you.
When we do not have all of the information we lose our sense of control and our thoughts fill in the blanks. Those thoughts can be terrifying because there is nothing to confirm if what you are thinking is right or wrong. You are left longing for what used to be or for answers to questions.
Grief looks different for everyone. When we are experiencing ambiguous loss it can feel like ongoing trauma because there is no answer. Other people may not even recognize that you are grieving at all. The grief/loss can feel isolating because it can be overlooked. This makes it especially difficult for the person experiencing it.
Humans crave consistency and predictability, so when things are unpredictable we often feel anxious, depressed and isolated.
TIPS FOR COPING WITH AMBIGUOUS LOSS
1. Name what you are going through. You might not even recognize your grief for what it is - but now you have a name for it. Just being able to put a label on what you are experiencing can help begin healing.
2. Work toward acceptance. Acceptance is not the same as closure. In the absence of closure it is important to try to make peace with this new reality.
3. Reach out for support. Identifying and connecting with family or a close friend who can help support you. You may be surprised to learn that they are having similar experiences. You can also look for a support group for people who have experienced the kind of loss you have.
4. Get involved in a cause. Some people cope with loss through action, like joining organizations focused on issues that have person meaning. You may also end up connecting with other people who are at or have been where you are.
5. Be kind to yourself. Try giving yourself grace and gentleness as you work through your grief. This is a time for self-compassion. Be kind to yourself when you are struggling with difficult emotions, the same way you would provide compassion to someone else if they were experiencing what you are.
If you find that you are having trouble coping look for a therapist who can help you work through your pain. It may be best to search for a therapist who specializes in grief or who has training in the type of loss you are experiencing. You do not have to deal with this on your own.
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For many years I coped with my loved ones’ substance use in isolation. Finding a Holding Hope group with Moms Stop the Harm has helped me to stay grounded and much more able to weather the trials. Sharing my experiences, hearing others, finding a supportive, nonjudgmental community has felt like survival to me. There are Holding Hope groups across Canada as well as virtually. If you are interested in knowing more or joining a group you can email canadaholdinghope@gmail.com or check the Moms Stop the Harm website.
You are not alone.
Wanda LeBlanc, Coordinator for BC Holding Hope