Ambiguous Loss: Healing When the Grief is Still Happening

"...There’s something to be said for a loss with an ending date. There’s something else to be said for a chronic, on-going stressor, like… 2020."

I never listen to voicemails on my cell- I see a missed call, I call you back (or I don’t). Yet, I have mounting anxiety from the notifications persistently reminding me to clear my inbox. Last week I was sitting on the couch quickly pressing play and delete on what felt like was 427 voicemail messages. My daughter stopped me and said, “Don’t you want to save that one?” I had scrolled past a four-month-old voice message from my dad just saying, “Call me back”, and another six-week-old message from my grandmother wishing me a Happy Birthday.

My daughter continued, “Don’t you ever think about one day if they die and you forget their voice? But you could like, have that voicemail saved and listen to it over and over.” 

My oldest daughter lost her biological mom when she was two, my youngest lost her biological mom when she was nine. My own mother died when I was fourteen. While the circumstances around our losses differ, it’s a loss for each of us that is final… understood… over. While none of us will ever finish grieving our mothers, there’s something to be said for a loss with an ending date. There’s something else to be said for a chronic, on-going stressor, like… 2020. 

While I first wanted to reject the idea of talking about my dad and grandmother dying with my kid when she mentioned it, I had to do a little bit of mental gymnastics and pull my thoughts together quickly. As a general rule, I advocate that we don’t talk about health, death, dying, living wills, estate planning, grief, and the like, enough as families in the Black community- I just wasn’t mentally there for it at that moment when she sprung it on me. 

I started thinking about how everyone grieves differently and even more so, how many increasing conversations around grief and loss I have been having with my twenty-one-year-old since this pandemic and uprising began. 

I had to reflect on all the ambiguous loss that my daughter experienced throughout her young life as a former foster child and an adopted individual, and how she may be experiencing the current world. And the more I thought about it, the more I realized how crappy, and unnerving, ambiguous loss truly can be in all our lives and how much the ambiguity has been amplified of late. 

Psychologist, Pauline Boss, coined the term Ambiguous Loss in a 1999 publication about unresolved grief and the nuances of not being able to get closure in situations that we feel the loss. She articulated, 

“THE LAST AND MOST DIFFICULT STEP IN RESOLVING ANY loss is to make sense of it. In the case of ambiguous loss, gaining meaning is even more difficult than in an ordinary loss, because the grief itself remains unresolved. But if we cannot make sense out of ambiguity, nothing really changes. We merely endure.”

COVID-19 has forced many to grieve actual deaths of loved ones without traditional funerals or memorials due to social distancing guidelines or travel restrictions, affecting our ability to get closure in some instances. Additionally, we have canceled birthdays, anniversaries, weddings, graduations, and reunions, situations that we may find difficult to resolve emotionally. Students are grieving leaving schools, campus, their friends, and programs abruptly. We are continuing to grieve changes to routines, to our “normal”, and to our support systems. We are grieving a loss of privacy or space in our homes as we cramp up and quarantine, work from home, or spend more time in spaces that we otherwise wouldn’t have. We are grieving modified and canceled vacations, necessary restrictions for our immune health, the closing of recreational activities, the loss of travel, the lack of retail therapy activities, and not being able to hug one another.

For some, the pandemic affected scheduled medical procedures, therapy appointments, treatments, pregnancies, miscarriages, and abortions. It may have paused a college application or changed the trajectory of a new job, career, or training program. With society shutting down and reopening, decisions about daycares, new schools, new apartments, moving, divorces, separations, dating, relationships, new partnerships, and business start-ups, may have been slowed, changed or completely halted. 

These are losses to feel, too. 

Don’t guilt yourself for feeling upset, sad, conflicted, frustrated, or angry about the circumstances of loss in your life during this time.  

Author, Psychologist, and Marriage and Family Therapist, Sarah B. Woods, describes, “Ambiguous loss prompts an especially challenging kind of grief: It is confusing, and disorienting, and defies popular ideas about “closure.” 

When you include the added nuance of grieving feelings of loss around safety given the national conversations around state violence, Black lives, misogyny, and gender violence- the amount of ambiguous loss for our community becomes massive and communal. 

When experts can’t decide if we’re still in our first wave of COVID-19 outbreaks, already breached the second wave, or are bracing for a second round in the Fall of 2020, it may feel complicated to start trying to heal from losses of a pandemic that are ongoing. While demonstrations continue worldwide against institutional racism and state violence, it may feel inconceivable to have to grieve Rem’mie, Toyin, and others, when more of us are still being lynched as we speak, while framed as suicides. 

Robert Neimeyer, PhD, director of the Portland Institute for Loss and Transition and professor emeritus of psychology at the University of Memphis describes that “The losses include our sense of predictability, control, justice, and the belief that we can protect our children or elderly loved ones”. 

So how do we understand the ambiguity and loss that we’re feeling, to begin moving through a grief and healing process, if we may never get closure on some situations, while others are still currently ongoing?

We must first explore the types of ambiguity that threaten our healing process. Boss (1999) describes two types of Ambiguous Loss of people; Type One, where there is “physical absence with psychological presence” and Type Two, where there is “psychological absence with a physical presence”. 

Have you ever experienced feelings of loss where someone is not physically near but still in your thoughts, on your mind, in the conversation, or very much a part of the narrative? Social distancing has caused us to feel physically estranged from others and we have no defined timeline for when we may be able to hug again, have casual sex again, visit those with compromised immune systems, sit in close quarters, or in general, be in intimate settings with loved ones. 

Outside of pandemic related distancing, we may feel an ambiguous loss in terms of a physical absence yet psychological presence, with adoption, miscarriage, immigration, incarceration, divorce/separation, military relocation, with missing, abducted and exploited children, or a variety of other physically distant, yet complicated scenarios that lack formal ‘closure’ or ending. 

The other type of ambiguous loss is when someone is still physical near but may be psychologically absent. Caregivers or friends and family of loved ones with dementia, addiction/ substance abuse, aging parents, individuals with TBI’s, intellectual disabilities or severe mental illness, for example, may experience feelings of loss despite a person still being nearby if they are unable to connect emotionally or communicate in meaningful ways. 

Because these situations are ongoing, or not finalized, seemingly unending- it can be difficult to envision yourself ‘moving on’ and/or embracing healing from painful occurrences and losses. Without allowing ourselves to jumpstart the grieving process, “Ambiguous loss can freeze the grief process. People can’t get over it, they can’t move forward, they’re frozen in place,” says Boss. 

So, with no end in sight to the threat of COVID-19, nor the threat of society to my Blackness- I want to start my journey to healing anyway. I want to do more than simply endure this strange time in my life. 

I plan to take time to name how I’m feeling. To actually acknowledge that I am grieving quite a few things. That this anger is rooted in sadness and frustration; that I miss some people. I’m going to embrace the ambivalence I feel about being home, about going back to work, about protesting, and still being afraid of mass gatherings. To find ways to be safe and useful. To be okay with not being useful to anyone but my own healing sometimes. I’m going to give myself permission for ambiguity and “both-and’s” to exist in my narrative in this moment. I’m going to continue to find concrete ways to honor the uncertainty. 

I will allow myself to dream and envision possibilities for a future that seems vague, because without any hope, I know I will remain stuck. 

My daughter, and many other young people who have lived their lives in the uncertainty of foster care systems and group homes, have taught me that being able to live without daily uncertainty is a privilege. Not knowing when you’ll ever see a family member again is something that foster youth deal with regularly while ‘professionals’ sort out court-mandated visitation schedules. Ambiguous losses around living situations, attachment to loved ones, one’s own identity, personal belongings, environments, routines, familiar communities, ideas of safety, household values, and more can all change in the blink of an eye when you grow up in the system and move from home to home. 

Some of us are just learning for the first time what ambiguous loss feels like and the toll that uncertainty and long-term grief have on our minds and bodies. Some have been learning how to move through this kind of insecurity and turbulence for most of our lives. 

A Psychologist from Columbia University, George Bonanno, explains that “Grief is also transient, even when we’re in the midst of its clutches. People should expect to fluctuate between moments of sadness and mourning, and moments of acceptance or even happiness, he says. “People who cope well with loss usually move in and out of those states. It’s OK to allow yourself to be distracted and entertained, and even to laugh.”

So, as I learn to navigate a confusing time, I will laugh. And I will be okay with myself when that laugh turns into an ugly cry, and I don’t even have words for why I’m sobbing.  I’ll celebrate between the tears and not let the rage steal my Black joy. I’ll intentionally celebrate Black joy. And I’ll forgive myself- for whatever I’m being hard on myself for in that moment- because I don’t need to be a source of stress for myself when the world is stressful enough.  

I’ll recognize that my grieving in this pandemic will look different from yours. My reaction to the stressors of this racial and gender violence is undoubtedly influenced by my own history with loss- with ambiguous loss. Each of us will process differently.

I think I will take my daughters’ advice and save that voicemail. You never know when you just want to hear your grandma singing Happy Birthday. And with all the uncertainty in the world these days- something as simple as a voice message saved for a later rainy day, is something my kid just reminded me to not take for granted. 

Disclaimer: Nothing stated above is intended to or should serve as a substitute for medical advice or diagnoses rendered to you by your individual doctor or other health care provider. If you feel that you need immediate assistance for mental health, stress, or substance abuse, please see a licensed provider, or you may call 1-800-662-HELP for SAMSHA’s National Helpline 24/7, 365.

About the Author: Carly King is a social worker with a Master of Science in Social Work from Columbia University and a Bachelor of Art in Psychology from Temple University. She centers anti-racism work, policy practice, child and maternal well-being, and has a professional history in child welfare services. She is a foster and adoptive momma, cat mom but dog person, and is a Baltimore girl who has been a transplant for so long in PA, she just may be becoming a #PhillyJawn.