Ambiguous Loss

Supporting families with

missing loved ones

Presented by:

Maureen Trask

For:

Victim Services Waterloo Region

Volunteers, Mon. Nov. 3, 2014

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Introductions

Why am I here?

My story and real life experience

(journey) of Ambiguous Loss

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3Missing since Nov. 3, 2011

Daniel Trask

Learning Objectives

Understand ambiguous loss

How to support families left behind

Reflecting on my experience

Q&A

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So what is Ambiguous Loss?

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A loss that occurs without closure or understanding

Leaves a person searching for answers

thus complicates and delays the process of grieving

Often results in unresolved grief, frozen, living in limbo.

Let’s hear from

Dr. Pauline Boss

http://www.youtube.com/watch?v=C2vYyefAgZ0

Dr. Pauline Boss and Dr. Gloria Horsley

discuss Ambiguous Loss at the annual

ADEC (Association of Death Education

and Counseling) conference, 2011.

Dr. Pauline Boss, principal theorist of the concept of Ambiguous Loss

Dr. Gloria Horsley, Open to Hope Foundation, founder and president 6

1. How does it differ from

ordinary loss?

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There is no verification of death.

No certainty that the person will come back or

return to the way they used to be.

2. Why does it matter?

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Ambiguous loss:

Freezes the grief process

Paralyzes couple and family functioning

Prevents closure

Families can name it.

Families need support.

3. How does one ease its

effects?

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Guidelines for resiliency while having to live

with ambiguous loss: (Boss, 1999)

1. Find Meaning (look at values, beliefs, traditions)

2. Accept Uncertainty (make 2 opposing ideas into 1)

3. Reconstruct Identity (forced to change roles)

4. Normalize Ambivalence (as the new norm)

5. Revisit Attachment (celebrate the missing and mourn the changes)

6. Discover Hope (look at strengths, making it with the pain)

4. What are the types of

Ambiguous Loss?

Physically Absent-

Psychologically Present

Psychologically Absent-

Physically Present

Adoption

Migration

Missing people

Miscarriage and stillborn loss

Natural disaster and

catastrophic tragedy

Addictions

Dementia and Alzheimer’s

Mental health issues

Separation/Divorce

Traumatic brain injury or coma

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Manage the contradictions

Take two opposing ideas, make into one

I am both sad - and still happy

I am both alone - and still connected

I am both powerless - and still empowered

I am both frozen - and still transforming

I am both doubtful - and still hopeful

I am both burdened - and still grateful

Daniel is both gone - and still here

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Effects of Ambiguous Loss

Emotional rollercoaster

Changes families, relationships, roles and identity

Can change spiritual beliefs

Tend to withdraw/isolate self

Goal:

Learn to live with the emotional tidal waves. Learn to live with and adapt to the changes that come with the loss AND learn to live with the ambiguity by developing meaning. (Boss, 1999)

12Boss, P. (1999). Ambiguous loss: learning to live with unresolved grief. Cambridge, MA: Harvard University Press

Ambiguous Loss Recap

Traumatic Loss (Boss, 2009)

Externally Caused (Boss, 2009)

Unclear Loss (Boss, 1999)

Senseless Loss (Boss, 2009)

Lacks Closure

Frozen Grief/being Stuck in Limbo (Boss, 1999)

An Individual Journey

Boss, P. (2009). The trauma and complicated grief of ambiguous loss. Pastoral Psych, 59(2), 137-145. doi:

10.1007/s11089-009-0264-0

Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA. Harvard University Press

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AFP Supporting those who

are left behind

14© Commonwealth of Australia 2014 AFP Australian Federal Police,

National Missing Persons Coordination Centre, Project Officer Sarah Wayland

* Framework – Working

with those left behind

5 themes for working specifically with families

of missing persons:

1. Reanimation: move past “frozen”

2. A celebration so far: respond to loss

3. The trauma timeline: explore the impact

4. A protected place: safe place of pain

5. Opportunities for growth: living with loss

© Commonwealth of Australia 2014 AFP Australian Federal Police,

National Missing Persons Coordination Centre, Project Officer Sarah Wayland 14

Framework

1. Reanimation

Move past “frozen”

Help families with their

sense of being frozen

to the time of their loved

one's disappearance

Assist families to move

from their sense of

feeling ‘stuck‘.

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Framework

2. A celebration so far

Respond to the loss

Acknowledge and honour the family's relationship

with the missing person

Facilitate families to find

an opportunity to respond

to the current loss of their

loved one.

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Framework

3. The Trauma Timeline

Explore the impact

of the disappearance

as well as the

accumulated traumas

families may have

faced prior to their

loved one going

missing.

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The Trauma Timeline

19© Commonwealth of Australia 2014 AFP Australian Federal Police,

National Missing Persons Coordination Centre, Project Officer Sarah Wayland

Framework

4. A protected place

Safe place of pain

Co-construct a space where families can

acknowledge the

pain of not knowing

while still finding

ways to live life.

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Framework

5. Opportunities for growth

Living with ambiguous loss

Explore ways in which families can live

with their loss,

rather than being

consumed by it.

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Services (Support)

Support looks different to everyone

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* Someone to really listen

* Being present

* Just being there

were by far the most popular

ways to support someone.

As a facilitator…

Educate that grief is not a linear process

Encourage to share story, call loved one by name and educate on importance of this

Help build strategies to cope with tidal waves of emotion

Help cope with the tough questions: the ‘why’, ‘what if’ and ‘should of

Help to recognize and build resilience

Help externalize the loss to release blame and guilt

Help find meaning in their experience of loss

“Help embrace the paradox & move forward with the ‘good enough’” (Boss & Carnes, 2012)

Listen more and do less

Empower to see loss in a new way

Hold multiple truths about the missing person

Normalize the experience, feelings, and thoughts

Work collaboratively with the client(s) with a lowered hierarchy-

Help build “… a new narrative that is less burdened with negative attributions, which invoke guilt, shame, remorse, or desire for retribution” (Boss & Carnes, 2012)

Use tasks as guidelines

Boss, P., & Carnes, D. (2012). The myth of closure. Family Processes, x(x), doi: 10.1111/famp.1200521

What not to say …

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Living and Learning on my

Ambiguous Loss journey

“Loss of a missing loved one is often a

lonely and an untrodden path for each of

us who has to walk it.” *

Can I learn to live with

this loss?

How do I get closure?

How do I get support? 25* Living in Limbo: Five Years On, Missing People UK, 2013

Humour - Balance

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Challenges with Police

Not being taken serious by police in the

first instance

Making sense of the entire situation

Not blaming self for the disappearance

Not being kept up to date, short or long

term as case progresses

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What Can You Do?

Be point of referral for families

Offer peace of mind for Police that the

needs of families are being addressed

Keep lines of communication open between

Police and families

Don’t try to conduct investigation on behalf

of Police

Listen - Empathize - Communicate - Be Present

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Q & A

Any questions?

Any moments or thoughts?

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Resources

Dr. Pauline Boss www.ambiguousloss.com

Australian Federal Police (AFP)

National Counselling Framework www.missingpersons.gov.au/education--training/working-

with-families/supporting-those-who-are-left-behind.aspx

Full version AFP Support Workbook www.missingpersons.gov.au/~/media/MP/Files/PDFs/Supporting%20

those%20who%20are%20left%20behind.ashx

www.afp.gov.au/~/media/afp/pdf/2/24-25-new-national-counselling-framework.ashx

Presentation and Reference Materials

Networking with Police and Agencies30

Thank You !

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Maureen Trask: trasker@rogers.com

Support for Us – Families with

Missing Loved Ones (FB page)