Why Are You Sad and Irritable? It Could Be Ambiguous Loss

Yìchén* started therapy because his best friend had been badly injured in a motorcycle accident. He told me,

He survived, but he’ll never be the same. And I don’t know how to deal with it. I don’t know what to say to him when I go to visit him. I don’t know how to talk to him. And I don’t know what to do with my feelings about it. I’m not one of those guys who think it’s weak to cry, but I’m so sad, and I feel like crying all the time. The other day I broke down at work. That’s not good.

Marti* had been in therapy for a couple of years before COVID. But during the pandemic, her parents both became ill with the virus.

I was lucky. They both survived. But I’m so sad and anxious all the time now. I worry about their health and about what’s going to happen to them. I see them as so frail and vulnerable. And they’re feeling vulnerable themselves, I know. They’re talking about finding a new living situation so that they won’t be a burden on me and my siblings if something happens. I don’t want to think about these things, and I don’t want them to be thinking about them. It just makes me too upset.

James* was also upset, but as he put it,

I can’t pin it on anything in particular. My life wasn’t too bad during the pandemic, and now, with everything opening up again, it’s fine. I mean, I don’t love what’s happening globally, and I’m not thrilled with the new surge in virus cases, but in general, things are just fine. So why am I always so on edge?

I have been hearing increasing numbers of stories about tragedies and almost tragedies from clients, colleagues, friends, and relatives in the months since the roll-out of vaccines has made a significant dent in the number of deaths from the COVID-19 virus. I don’t have any statistics on this, but it seems to me that there are more of these events than there have been at any other time in my memory.

But whether you’re feeling distressed because of a genuine loss in your life, or you’re feeling anxious, sad, lonely, worried, irritable, or angry for no apparent reason, you’re not alone. You may actually be suffering from what psychotherapists call “ambiguous loss.”

“Ambiguous Loss” is a concept coined by Dr. Pauline Boss to describe the kinds of feelings that occur when a loved one is lost without some sort of resolution or closure possible. Examples include situations like 9/11, for example, where you never get to say goodbye to a loved one who dies. Still, they can also include a longing for family members who are far away accompanied by what Dr. Boss calls an “unnamed loss and melancholy that never went away.”

Ambiguous loss can also be another name for “unresolved grief,” meaning the kind of grief that gets frozen inside of us (which is why it can also be called “frozen grief”) and makes it impossible for us to move on to a happier, more content place. Of course, grief and significant loss may never be fully put behind us, but having some form of closure can lead to acceptance and a capacity to integrate the lifelong sadness into a rich and meaningful mix of emotions.

Without that kind of integration, we can remain stuck in the loss, unable to move forward in life without the person we are mourning.

Although ambiguous grief often refers specifically to the loss of a loved one, in my experience, it can also be related to life events such as we have almost all dealt with during the pandemic. Did you miss out on an important graduation experience? An opportunity to hone your acting or musical abilities in front of an audience? Did your children lose an important time of social and/or academic development? Did you miss important time bonding with grandchildren or grandparents? Or with parents or children?

While it’s essential to recognize what we learned or gained during the pandemic or to be genuinely grateful for having survived intact, with only minor losses, it’s also important to acknowledge the losses that occurred during the time. Only by recognizing and honoring those losses can you move from ambiguous loss and frozen grief to resolution and from there to new growth and integration of old experiences.

I have this discussion daily with clients in my (still remote, for now) psychotherapy practice. One of the things that bring up the feelings of loss and unease is when a client asks if I’m planning to come back into my office in person. My answer is that I’m extremely cautious and, therefore, not coming in yet because I have a spouse with an autoimmune disease. I’m waiting until we clarify the safety of being in a room together, especially now with the uptick in cases yet again.

Grief Essential Reads

Letting Go and Letting Go and Letting Go After Loss

No One’s Ever Really Gone After They Die

But that answer, and the feeling that things are not settled and the loss for some of being in the office with me in person, is unsettling for some of my clients. We talk about the difficulties, and inevitably we get to the feeling of ambiguous loss. When James and I began to explore his feelings of edginess, we discovered that one of the difficulties for him was that, as he was finally able to put into words, he wanted things to “go back to normal, including coming back into your office. I feel – I don’t know, it seems silly to say, but safe, somehow. I like being with you, and I like being in that space.”

Although I couldn’t give him what he wanted right then, the fact that he was able to say it to me and that I accepted and validated his feelings of loss actually made him feel better.

And that’s the answer that Dr. Boss offers about an ambiguous loss in general. Putting the feelings into words, recognizing that there is genuine loss even when it isn’t anything you can put your finger on, is a first step in unfreezing your grief. As I said, it won’t necessarily make the sadness go away, but it can help you integrate it into a more complex and, ultimately, realistic sense of who you are in the world – and what the world is really like. And that integration is what will help you take the next steps into the new life that is waiting for you now.

*names and identifying info changed to protect privacy

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