Ambiguous Loss

An understanding of ambiguous loss is critical for psychotherapists, regardless of whether they specialize in grief counseling or work in general settings with individuals, couples, or families. Ambiguous loss is one that remains unclear and indeterminate and therefore is experienced without closure or resolution. If we listen carefully, we will appreciate that there are missing people in our clients’ lives; their loved ones may be physically absent but psychologically present, or their loved ones may physically present but psychologically absent. We also can listen for our clients’ other ambiguous losses, such as loss of certainty about health and safety, loss of hopes and dreams, loss of the ability to celebrate and mourn major life events due to the pandemic or health issues, and losses related to racial injustice. Ambiguous losses can be confusing and disorienting, challenge problem solving and adjustment, lack the symbolic rituals that ordinarily support other losses, and can be physically and emotionally exhausting. Therapists may be in a powerful position to help if we are aware of these ubiquitous losses that are often overlooked or dismissed.

This course first provides an introduction to ambiguous loss, including its manifestations, challenges, and impact on the grief process. The course also describes how psychotherapists can assist our clients with ambiguous loss by naming the loss, normalizing feelings of confusion, addressing dysfunctional coping and negative attributions, increasing tolerance for ambiguity, taking a dialectical approach to conflicted thoughts and feelings, balancing control with acceptance, and helping our clients find meaning and hope. Contemporary trends in our understanding of ambiguous loss are also reviewed.

Next, the course contains three audio interviews with transcripts that emphasize the developmental and racial/cultural influences of ambiguous loss. Ms. Tyson addresses ambiguous loss among children and adolescents, specifically its symptoms and triggers, goals for treatment, and best practices. Ms. Barth explores ambiguous loss among older adults, including triggers, therapeutic goals, making meaning of the loss, and recommended treatment strategies. Finally, Dr. Grocher reviews the individual and collective forms of ambiguous loss that are experienced among African Americans, provides treatment recommendations, and emphasizes resiliency.