What Is Ambiguous Grief?

Ambiguous grief can describe the emotional response a person experiences when a loss occurs without the likelihood of resolution. Someone experiencing ambiguous grief, which can also be called ambiguous loss or disenfranchised grief, may search for answers without a significant chance of ever getting them or receiving emotional closure. Ambiguous grief was first described in the 1970s, and its meaning has expanded and grown since then.

Ambiguous grief can lead to feelings of confusion, chronic sadness, and anxiety that can be difficult to manage, but certain coping strategies may be helpful. If you’re experiencing symptoms of ambiguous loss, working with a mental health professional can be beneficial.

Dr. Pauline Boss and the theory of ambiguous loss

Ambiguous grief may occur in situations like missing persons cases or dementia diagnoses rather than a physical death. 

In the 1970s, Dr. Pauline Boss coined the term “ambiguous loss” to describe a type of loss that is unclear and has no resolution. As the theory evolved, Boss identified two types of ambiguous loss.

Type one 

Type one ambiguous grief usually concerns physical loss. It can occur when someone in your life is physically gone, but you don’t know what happened to them or if they will ever come back. 

Boss researched type one ambiguous loss extensively in the 1970s when she studied the wives of men missing in action in Vietnam for her doctoral dissertation. She called this type of ambiguous loss “physical absence with psychological presence.” This type of loss can occur in a variety of situations, including adoption, divorce, incarceration, estrangement, or unexplained disappearances of family members due to kidnapping, deportation, war, acts of terrorism, or natural disasters.

Type two

This type of ambiguous grief is usually the result of psychological loss, or, as Boss describes it, “psychological absence with physical presence.” The friend or family member may still be physically present, but they may have changed so much that they no longer seem like the person you previously knew. These changes may be caused by alcohol or substance addiction, traumatic brain injury, Alzheimer’s disease or dementia, or mental illness.

How to cope with ambiguous grief

As Boss expanded her theory over the years, she began focusing on how to help people experiencing ambiguous grief or loss, developing six pillars of coping.

Finding meaning

There can be many ways to find meaning in ambiguous grief. For example, someone whose loved one has gone missing might start campaigning to change laws or start a support group for other individuals experiencing the same type of grief. Similarly, a family who has lost someone to dementia may choose to do a fundraiser for an organization supporting dementia research.

Adjusting mastery

Adjusting mastery typically refers to recognizing how much control you have over a situation. How people manage this step can vary significantly. For people who like to be in control, living without knowing where their loved one is or realizing that concerns like dementia, mental illness, and traumatic brain injury are unlikely to resolve spontaneously can be challenging. 

It can be difficult to understand that things may never be the same. When adjusting mastery, people may work on recognizing that the world is not always fair and that the actions they take may not always have the desired outcome.

Reconstructing identity

This coping skill usually involves reevaluating how someone understands their new identity in relation to their grief. For example, people who have lost their partners to war may ask themselves, “Who am I, now that my partner has been missing for so many years? Am I still married?” 

If someone has a partner who has dementia, they might ask themselves, “Can I seek out a new relationship if my partner no longer knows who I am?” Putting one’s life on hold while waiting for a resolution can be unhelpful as, often, a resolution never comes. Working toward becoming a new version of yourself can allow you to move forward.

Normalizing ambivalence

Normalizing ambivalence can mean accepting multiple emotions that may be conflicting. For example, if your loved one is missing, you may continue to hope that they’re physically alive while also wishing for a resolution to the situation, even if that means you find out that they have passed away. While experiencing ambivalence can be a typical response to this type of grief, managing these feelings so they don’t become debilitating can help you move forward.

Revising attachment

This pillar of coping generally refers to coming to terms with the idea that a loved one is present and gone at the same time. For example, someone who is missing may come back, or they may not. If they do come back, they may be the same, or they may be very different. According to Boss, revising attachment is about learning to “carry two contradictory ideas in your head at one time.”

Discovering new hope

The final pillar is discovering new hope. In general, people experiencing ambiguous grief cannot simply put their lives on hold and wait for things to change. According to Boss, part of coping with ambiguous loss usually involves discovering something new for which to hope. This step can involve learning to move forward with joy and love without the resolution of grief and seeing possibilities and new hopes for one’s life.

Getting professional help

Ambiguous grief can be challenging to manage. Some people may be able to cope effectively and continue with their daily lives, while others may sense that they’re living in limbo, waiting for a resolution. 

People who go through ambiguous loss may experience a range of symptoms, including confusion, anxiety, depression, and hopelessness. They may have physical symptoms, too, like muscle tension, aches and pains, headaches, gastrointestinal issues, appetite changes, and sleep disruptions. 

If you are going through the grief process, working with a therapist can help. This may be especially beneficial if you’re experiencing symptoms of depression or are turning to unhealthy coping mechanisms, like using substances or alcohol. However, anyone can benefit from grief counseling. 

Grief therapy can give you a safe space to express your feelings. A therapist can also help you learn coping strategies and develop a healing approach that is tailored to your needs.

Online therapy can be a beneficial option for anyone experiencing grief. With an online platform like BetterHelp, you can work with a qualified mental health professional from the comfort of your home at a time that fits your schedule. You can communicate with your therapist via video conference, phone call, or online chat, and you can change providers until you find the right fit for you.

Research has found that online therapy can be beneficial for those who are experiencing grief. A 2021 review of nine studies found that online treatment appeared to be effective at treating symptoms of grief, depression, and post-traumatic stress.