mar. 16, 2016 ambiguous loss lunch & learn
TRANSCRIPT
www.cmhagrb.on.ca
Title
CMHA Waterloo Wellington Dufferin
• Presentation
• April 3, 2013
www.cmhawwd.ca
Lunch & Learnfor K-W Counselling Services
Ambiguous Loss: Supporting families with
missing loved ones Presented by: Maureen Trask Wed. March 16, 2016
Assistance by CMHA Waterloo Wellington Dufferin
1www.cmhawwd.ca1
www.cmhawwd.ca
Topics
What is Ambiguous Loss?
The Experience of Those Left Behind(Families with Missing Loved Ones)
A Framework for Support
Recap and Q & A
22
www.cmhawwd.ca
3
Daniel Trask
Missing Nov. 3, 2011 Found May 24, 2015
www.cmhawwd.ca
What is Ambiguous Loss?Dr. Pauline Boss, principal theorist of the concept of Ambiguous Loss and Dr. Gloria Horsley, founder and president of Open to Hope Foundation, discuss Ambiguous Loss at the annual Association of Death Education and Counseling (ADEC) Conference, 2011.
http://www.youtube.com/watch?v=C2vYyefAgZ0
44
www.cmhawwd.ca
Ambiguous Loss Recap Traumatic Loss (Boss, 2009)
Externally Caused (Boss, 2009)
Unclear Loss (Boss, 1999)
Senseless Loss (Boss, 2009)
Lacks Closure / Understanding Frozen Grief / being Stuck in Limbo (Boss, 1999)
A Unique Individual Journey
Boss, P. (2009). The trauma and complicated grief of ambiguous loss. Pastoral Psych, 59(2), 137-145. Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA. Harvard University Press
55
www.cmhawwd.ca
Types of Ambiguous Loss
6
1. Physically Absent- Psychologically Present
2. 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
There is no verification of death. There is no certainty that the person will come back
6
www.cmhawwd.ca
Ambiguous Loss differs from traditional loss
7
Traditional Loss Ambiguous Loss
Some knowledge and understanding from society and western culture
Lack of knowledge about what ambiguous loss is and its effects
Some services/supports available- grief counsellors/professionals
Tremendous lack of services and supports – lack of professionals that specialize or educated on this
Seen as “normal” because everyone at some point in their life has a loved one that dies
Seen as “not normal”, “complicated grief”, and not affecting the mass majority
Spiritual/belief teachings exist that speak to death and mourning
No spiritual/belief teachings discuss ambiguous loss
7
www.cmhawwd.ca
Ambiguous Loss differs from traditional loss continued
8
Traditional Loss Ambiguous Loss
Mourn the loss after the death Cannot mourn because no defined death to mourn
Customary rituals that allow for closure
Symbolic rituals that ordinarily support a loss do not exist. (Boss, 1999)
Some tolerance to the loss that results from a death.
Co-workers, peers, and society are less likely to tolerate ambiguity.
The loss as a result of a death is legitimized by society.
Ambiguous loss is not legitimized by society.
Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA: Harvard University Press. 8
www.cmhawwd.ca
Why does it matter?
Freezes the grief process Paralyzes couple and family functioning Prevents “closure”
Families can name it Families need support
99
www.cmhawwd.ca
What Families need to do…
• File Missing Person Report• Contact family, friends, last know locations• Handle jurisdiction changes• Deal with property (Home, Bills, MTO, Medical)• Manage triggers (Sightings, Remains, Psychics)• Live with the ambiguity and uncertainty• Hopefully, find meaning
1010
www.cmhawwd.ca
How does one learn to ease the effects? 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)
1111
www.cmhawwd.ca
APF Framework: 5 themes for working with families of missing persons
1. Reanimation: move past “frozen”2. A celebration so far: respond to loss3. The trauma timeline: explore the impact4. A protected place: safe place of pain5. Opportunities for growth: living with loss
© Commonwealth of Australia 2014 AFP Australian Federal Police, National Missing Persons Coordination Centre, Project Officer Sarah Wayland12
1212
www.cmhawwd.ca
1. Re-animation
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‘.
1313
www.cmhawwd.ca
2. A celebration so far
Respond to 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.
1414
www.cmhawwd.ca
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.
1515
www.cmhawwd.ca
3. The Trauma Timeline – example
1616
www.cmhawwd.ca
4. A protected place
A safe place of pain Co-construct with families a space where they can
acknowledge the pain of not knowing while still finding ways to live life.
1717
www.cmhawwd.ca
5. Opportunities for growth
Living with loss Explore ways in which families can live with
their loss, rather than being consumed by it.
1818
www.cmhawwd.ca
Services / Support:Support looks different to everyone
19
“Someone to really listen…”
“Being present…”
“Just being there …”
…were by far the most popular ways to support someone
19
www.cmhawwd.ca
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
2020
www.cmhawwd.ca
As a Facilitator - continued “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 guidelines2121
www.cmhawwd.ca
Resources Dr. Pauline Boss www.ambiguousloss.com Australian Federal Police (AFP) National Counselling website
www.missingpersons.gov.au/education--training/working-with-families/supporting-those-who-are-left-behind.aspx
Full Version AFP Framework Booklet www.missingpersons.gov.au/~/media/MP/Files/PDFs/Supporting%20those%20who%20are%20left%20behind.ashx
AFP New National Counselling Framework Announcement, 2007www.afp.gov.au/~/media/afp/pdf/2/24-25-new-national-counselling-framework.ashx
Support for Us - Families with Missing Loved Ones FB pagehttps://www.facebook.com/SupportForUs
Presentation and Reference Materials
2222
www.cmhawwd.ca
Recap and Q & A Ambiguous Loss is an uncertain loss Triggers can impact the journey Each situation is unique and individual Families need support It’s about finding meaning and hope “Closure” is a myth, families want answers
Questions? 2323
