How to Recognize and Cope With Ambiguous Grief

Ambiguous grief can occur if you experience a loss that leaves you with absolutely no closure. This type of grief can be excruciatingly painful to experience as the lack of closure can leave your mind wandering and obsessing over what happened without a foreseeable end in sight.

What Is Ambiguous Grief?

Ambiguous grief can be experienced by anyone who has had been through an open-ended loss without knowing a conclusive outcome. This could mean that your loved one is with you physically, but no longer there psychologically, or that your loved one has gone missing and there has been no evidence or limited evidence that explains if and/or how they passed away. The ambiguous type of grief can leave those left behind at a total loss, and without enough information to feel like healing is actually possible. This can feel absolutely devastating to experience and can completely change your perspective on life.

Examples of Ambiguous Grief

Experiencing ambiguous grief is subjective. This means that what some may consider an ambiguous loss, others may not. Some examples of ambiguous grief include, but are not limited to:

• If a loved one is diagnosed with a cognitive disorder that significantly changes their behavior and personality
• If your child was kidnapped in the middle of the night
• If your child disappeared during a family outing
• If a tsunami destroyed your town and your loved one hasn't been found
• If your loved one never returns from war and their body wasn't recovered
• If you experience a miscarriage
• If your loved one has a serious drug and/or alcohol addiction and you aren't able to find them and haven't heard from them despite trying
• A natural disaster where multiple people go missing without their bodies being recovered
• If a loved one is involved in gang or other dangerous crime and isn't heard from again
• If a loved one runs away and is never heard from again despite searching
• If a loved one is diagnosed with a traumatic brain injury or dementia and no longer behaves, thinks, or emotes like their old self

Who Can Experience Ambiguous Grief?

Ambiguous grief can be experienced by anyone who understands the concept of death or prolonged absence. This means that children, teens, and adults can all experience this type of significant loss. Each individual, regardless of age, will experience and cope with this type of loss differently. This means that some children who are going through this type of loss may cope with it better than some adults and vice versa. Factors that will impact how someone copes with this type of grief include:

• Internal coping resources
• Flexible and adaptable thinking- Those who feel more comfortable with rigid rules and absolutes may have an especially difficult time with this specific type of loss
• Having a reliable and safe support system
• Having good insight and communicating with others when you need help

Signs and Symptoms of Ambiguous Grief

Ambiguous grief can present differently depending on the individual experiencing it. This type of grief can also come and go and fluctuates in intensity as time goes by and/or more information about your loved one is learned. The grieving process is fluid and this is especially true with ambiguous grief because so much about the loss may be unknown and difficult to reconcile. Some signs and symptoms of ambiguous grief include:

• Feeling like the world is unfair and unsafe
• Withdrawn, feeling like a shell of your old self
• Experiencing symptoms of anxiety, depression, obsessive disorders, drug/alcohol-related disorders, phobias, and post traumatic stress disorder among others
• Feeling consumed and tortured by this uncertainty
• Feeling like life is pointless
• Wanting to have answers to a point of obsessiveness
• Experiencing survivors guilt
• Blaming yourself for their disappearance
• Wishing you could save them or do something differently and having intrusive thoughts about doing so
• Oscillating between hopeful and hopeless

Grieving Someone Who Is Still Alive

One of the most heartbreaking aspects of ambiguous grief is the uncertainty as to whether your loved one is still alive. To some, it may feel overly morbid to begin grieving the loss of someone who may or may not have passed away. For others, grieving even if their loved one is still alive brings some semblance of closure. It is up to you to decide what feels most appropriate for you to do considering the circumstance.

For example, someone may begin the grieving process for a loved one who was diagnosed with late stage dementia, even though they are still alive, while someone else may not feel ready to begin this process until after their passing. The grieving process is incredibly personal, and your mind and body will let you know when it's the right time to begin.

Coping Interventions for Ambiguous Grief

Uncertainty is one of the most difficult concepts for the brain to make sense of. Humans naturally like closure, and not having closure, especially when extreme feelings of pain and loss are involved can feel like absolute torture. It is imperative to find healthy ways to cope, as it can feel tempting to numb the thoughts and emotions that you are experiencing. Some healthy coping techniques for ambiguous grief include:

• Finding a support group with others who have experienced something similar is incredibly important, especially if your loved ones haven't ever gone through something similar. Being with others who are experiencing this type of grief can help you feel less isolated and validated in your unique process.
• Seeking out a specialized therapist who understands ambiguous grief, as well as trauma, can provide you with support, resources, and a nonjudgmental ear as you go through this incredibly painful time.
• Getting back to basics in terms of self-care is critical. This means eating a few times a day, drinking plenty of water, connecting with others, and getting enough sleep. Sleep is especially important as your brain uses this down time to process, consolidate, and make sense of your thoughts and feelings.
• If you'd like to, you can find ways to incorporate the memory of your loved one into your life. This doesn't mean giving up hope, it's just a way to re-incorporate them into your daily routine in a different way.
• Continue looking for answers if you'd like. For some, doing something proactive can provide comfort and hope.
• Don't continue looking for answers if you don't want to. If you aren't comfortable doing so anymore, know that it's okay to stop.
• Find ways to create closure for yourself. Closure does not mean you need to have all the answers, it can simply be a way to remember your time together with your loved one and being grateful for the special moments you shared.
• Help others if possible. If you feel comfortable doing so, share your story, connect with someone else just beginning this process, or find ways to give back to an organization that meant something to your loved one.
• Work towards not blaming yourself and viewing the situation more objectively when it comes to blame. If a child or teen blames themselves, it's imperative to discuss this concept with them, as they should not feel as if this is their fault to any degree.

How to Help Children

With children, it is critical to provide them with support and be honest with them about what happened in an age appropriate way. It's also a good idea to maintain their typical routines and show and verbalize that you are there to support them. This means that you explain the situation as simply as possible and validate their emotional experience. For example:

• "I know you miss (insert name) and are wondering what happened to her."
• "Right now we don't know where she is, but we are looking for her and have notified the police who are also helping us."
• "I know this is scary, I don't like what's going on either, but we are going to keep trying to find her."

How to Help Teens

With teens it's important to be honest, and let them know that you are upset, but also that you are there to provide stability and support to them. It may feel as if your teen can handle themselves. Know that they still need you, and while it's okay to be vulnerable in front of them, it's not okay for them to become the caregiver in this situation. During this painful time, they need to know they still have you as a caregiver and protector.

Understanding Ambiguous Grief

Ambiguous grief can be an incredibly painful ongoing experience that can feel tortuous. Finding relevant support, taking care of yourself and your family, and knowing when you need additional help is a critical aspect of making it through this time. While finding total closure may not be a realistic expectation, there are still ways you can take care of yourself, honor the time you and your loved one had together, and slowly begin to heal from this complex loss.