By Jennifer Cooperman
LICSW, ACHP-SW, CDP
Amidst the pain and darkness of loss, we often find comfort and light in the presence of others. We have funerals and rituals that bring people together to share the grief and ease the burden of carrying it alone. But what happens when the loss is not known to others? What if the loss is not clearly defined, or even recognized as a loss by others at all?
“Ambiguous grief” is a term coined by family therapist Dr. Pauline Boss in the 1970s, originally to address grief experienced by families of soldiers who were missing in action. Over the years, multiple clinicians and researchers have expanded the concept of ambiguous grief to other circumstances in which grief occurs. The physical death of a loved one brings a sense of yearning and emptiness which can feel unbearable at times. Yet the pathways forward in coping with death are forged by the universal nature of experiencing death. It helps to know we are not alone. As difficult as it may be, there is predictability in physical death. We know we will not see the person again, we are given relief from our usual responsibilities to grieve, and we know we will be offered comfort by others. Ambiguous grief is complicated by the fact that these conditions are unlikely to be met.
At its core, grief is about adapting to painful change. We grieve when we lose the future we had hoped for. This grief is present when a couple experiences infertility and loses the future they imagined as parents. This grief is present when a spouse has dementia and a life partner is physically present but no longer feels like the same person. This grief is present when divorce occurs and the life one once imagined takes a different course. In these examples, others may not even know of the grief being experienced. There are generally no ceremonies or bereavement leaves to aid in this type of grief.
The first step in coping with ambiguous loss is naming it, and recognizing that the overwhelming feelings are feelings of grief. People often think they are “going crazy.” They may be experiencing insomnia, loss if interest in activities, poor concentration, and crying spells without even recognizing they are grieving. Recognizing ambiguous grief allows us to say to others, “I am hurting, and I need your support right now.” It allows us to take a break when needed in order to mourn. It can be helpful to create rituals and ceremonies that help honor the loss and bring the support of others closer.
Just as there is not one correct way to grieve, there are also different ways in which grief can present itself. The common goal of all grief work is to learn how to integrate the loss into one’s life story. This is true when the loss is obvious and known, as well as when it is not as apparent. All mourners deserve compassion, patience, and understanding.
About the Author: Jennifer Fleischer-Cooperman, LICSW, ACHP-SW, is a clinical social worker who has been working in hospice care for more than eight years and as a medical social worker for more than 25 years. You can contact her at jcooperman@oldcolonyhospice.com.
