By Marilee Feldman, LCPC, CADC
When someone dies, it is clear we have suffered a loss and are grieving. Our feelings of sadness are apparent and make sense to us. At times, however, we have suffered an equally difficult loss but do not realize it, and resolving the loss becomes enormously difficult. We call this ambiguous loss, and it occurs, for example, when we have lost our loved one to addiction, an affair, mental illness, or physical illness. The person is still there, and yet they aren’t there for us in the way they used to be. We may feel angry, confused, and caught in a state of alternating hopefulness and hopelessness that things may change. Grieving the loss is thus even more complicated than grieving the loss of someone who has died.
When Elizabeth first came to see me, she wasn’t aware that she had suffered a loss. Her husband Peter’s drinking had escalated slowly over the years, but it was now apparent there was quite a problem. She was enraged by his behavior and caught in a cycle of trying to control his drinking, pleading for him to stop, and hoping he would change. Sometimes she loved him and felt things would be okay; other times she hated him and felt she should divorce. She felt guilty for feeling angry, as Peter was a good provider and everyone else seemed to like him and saw his warm and affable side when he was not drinking. She felt confused and alone, her self-esteem declining sharply. When she was able to focus on her own feelings, Elizabeth was unaware of sadness or a sense of loss. Without the ability to recognize and grieve the loss, she spent years in a state of emotional paralysis, unable to decide how to proceed. She was experiencing ambiguous loss. The man she had married, the Peter that made her feel loved and special, who she could count on to behave in a reliable way, was no longer there for her. And yet there he was, walking, talking, breathing. He was partly present, partly absent, and she couldn’t grieve the loss.
Another client came in for help coping with her son’s autism. Caught in the stress of finding services for him and managing his challenging behaviors, she barely had time to recognize the loss she was experiencing, the grief, the lost hope, the uncertainty about her future and that of her son. She and her husband never discussed the loss of their hopes and dreams for this child. They were too busy. And they felt chronically guilty for sometimes feeling angry, for not being able to master their stress and make things better. It was difficult to make peace with what had happened, to accept, to move forward with hope or optimism.
Ambiguous loss makes us feel confused and incompetent. It also erodes our sense of mastery over our world. We remain stuck feeling that if only we could find the perfect solution, our problems would be solved and we could move forward. Surely there is something we could do or change to make things better, and our sense of ourselves erodes as we have difficulty figuring out what that thing might be.
And yet, with ambiguous loss, it’s important to realize that the confusion we are experiencing is normal, attributable to the ambiguity of the situation, not to anything we have done or failed to do. It’s not our fault. We don’t know if the alcoholic will stop drinking, if our loved one with an illness will get better, if our child with depression will become herself again. If we understand the problem as an inherently unclear loss, we can begin to sort out our feelings, grieve our sadness, find meaning in our experience, and resolve the self-blame keeping us stuck.