Grieving Loss When There’s No Clean Goodbye

When someone we love dies, we have a funeral. The loss is clear and clean—while the relationship might have been complex, the loss of the person is not. We will never see, hear, or speak with them again. But when someone we love has dementia, succumbs to addiction or mental illness, ghosts us, disappears, or cuts off contact with us, we lose the person and relationship in a way that doesn’t allow for the same kind of closure. This kind of loss is called “ambiguous loss.”

What Is Ambiguous Loss?

Pauline Boss, PhD, who coined the term “ambiguous loss,” is clear that this kind of loss is no less devastating than other losses. She states that “human relationships are often traumatized by ambiguous loss,” but that it’s often overlooked by therapists as well as our society as a whole.

In her work, Boss defines two types of ambiguous loss:

• Type One: Physical absence with psychological presence. Examples of this can range from soldiers who are missing in action to divorce, immigration, ghosting, or estrangement.
• Type Two: Psychological absence with physical presence. Examples of this can range from dementia, traumatic brain injury, mental illness, or addiction. It can also result from losses that don’t make sense to us, such as suicide, even though the person has died.

Ambiguous loss destabilizes the nervous system because there’s no clear boundary between hope and mourning, no socially recognized ritual, and no permission to grieve. The loss is never-ending. The grief freezes because the story never finishes.

Why Ambiguous Loss Is So Hard Psychologically

Source: Samantha Stein

Ambiguous loss is so challenging for us psychologically because our ability to make meaning is blocked. We remain in a frozen, chronic state of uncertainty, and chronic uncertainty activates our threat systems. Our attachment to that person remains activated, even as the relationship itself no longer exists in the way it was.

In his book Meaning Reconstruction & the Experience of Loss, Robert Neimeyer, PhD, argues that grief is not about “letting go” but about actively reconstructing meaning after loss. Ambiguous loss makes it very challenging to do this work, as the relationship has not ended permanently, and thus, we resist reconstructing meaning, often choosing to hold the current narrative. Instead, our identity is often disrupted, with questions such as, “Who am I now in relation to them?” This never-ending confusion and disorientation often leads to higher rates of anxiety, depression, and prolonged grief symptoms.

Furthermore, this type of grief has been called “disenfranchised grief,” a term coined by Kenneth Doka, PhD, when describing intense feelings of loss that are not openly acknowledged, socially validated, or publicly mourned. It’s most common when society minimizes or denies the significance of a loss or even blames the person for their loss. The grieving person doesn’t receive casseroles or have a memorial to attend, and feels subtle blame or pressure to “move on.” Thus, the experience of ambiguous loss is amplified by society’s response to it, often leading to isolation, depression, and prolonged, complicated grief. The losses are real, they’re just socially invisible.

How Do We Heal From This Loss?

When speaking about how to cope with ambiguous loss, Boss emphasizes adaptation rather than resolution. She’s identified six guidelines for building resiliency—adapting—in the face of ambiguous loss:

1. Name the loss. The loss can and should be named explicitly, by you and to those you love and trust. The loss(es) can range from the person and relationship as we knew them to our very identity and imagined future.
2. Normalize ambivalence. It’s okay to feel many mixed emotions about the loss. Most people feel anger, powerlessness, and fear, along with their sadness. Having deeply mixed feelings is normal and expected. Love and anger can be held alongside grief and fear.
3. Release the need for certainty. This can be difficult for most of us, but if we can accept that this kind of loss is accompanied by uncertainty, that can bring a different kind of mastery—not one where we are able to predict or control outcome, but instead where we can live without knowing and understand that we don’t need clarity and certainty to grieve.
4. Reconstruct identity. This happens more naturally when a loss is not ambiguous, but it’s work that can still be done when it is. We can work to understand our new role and who we are now. And then reconstruct it again, if things change.
5. Revise attachment. We have an attachment with this person, most of the time built over years and many experiences. Ambiguous loss requires us to change our understanding of this attachment and revise what it means to us and what it looks like today.
6. Find meaning without closure. While healing can be easier with closure, it's not required. Where your culture lacks a ritual, you can create your own. It’s crucial to do the work to find what meaning can be made of this painful and difficult experience.

With ambiguous losses, relationships don’t end with closure or even finality. Healing from ambiguous loss, therefore, cannot begin with closure; instead, we must learn to live inside the truth of what’s been lost, and what that means to us today. There may not be official rituals, societal acknowledgement, or even understanding from those around us about what we’ve lost, but that mustn’t stop us from doing the healing work that’s so crucial for our mental health and well-being—from living a life that’s ours to live.